obesity medication options

Why Aren’t Doctors Writing More Obesity Management Medications?

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People who want to lose weight often use multiple tactics to help with this process. This is especially common among adults who have struggled to achieve results through exercise and eating habits. Endocrine Society Clinical Practice Guidelines from 2015 give recommendations for treating overweight and obese patients who have not achieved weight loss from diet or lifestyle changes. Medications that are approved for weight loss are useful and effective when diet and exercise are not enough. Unfortunately, many people do not know about these medications or which ones are most effective. The information below is intended to help men and women who are trying to determine what medication treatment options are available to fight obesity.

Weight gain is an undertreated problem and many doctors and healthcare providers are not writing weight loss medications despite clinical practice guidelines recommending they do so. Weight loss can be difficult for patients and medications often help turn the tide and when used long term help keep the weight from returning. Medical weight loss should be a higher priority amongst medical providers, and patients should be given the option of medications to assist in weight loss when appropriate. Phentermine is an effective and safe medication used for over fifty years. It is approved for short term use by the FDA and recommended for off-label long-term use by Endocrine Society Guidelines with medical monitoring. 

Overweight and Obesity is a Problem

The healthcare costs of people being overweight and obese exceed the costs of tobacco use and illnesses that result from tobacco use. The terms overweight and obesity refer to increased amounts of body fat, commonly assessed by the body-mass index (BMI, calculated as weight in kilograms divided by height in meters squared). The standard categories are underweight (BMI less than 18.5), normal (18.5–24.9), overweight (25–29.9), and obese (30 or more). According to these criteria, about one in three Americans are overweight but not obese, and an additional one in five are obese.

Weight loss is a very common goal that patients have when seeking healthcare. How to help patients achieve their goals for weight loss is an important discussion that should occur between the patient and healthcare provider. A recent Medscape article (which is a news and reference site for physicians and nurses) asks the question: “Will Physicians Ever Adopt Obesity Drugs?” The article notes that only 58% of providers write medication for weight loss even when a patient meets all criteria for a prescription.  

Medications for Weight Loss

The medication that is most commonly used for weight loss is called Phentermine (Adipex). This is an amphetamine-like prescription medication used to suppress appetite. Phentermine helps with weight loss by decreasing your hunger or making you feel full longer.  Like other prescription weight-loss drugs, phentermine is intended to be used as part of an overall weight-loss plan that includes diet counseling and office visits to check weight and waist measurements. It is indicated for people who are obese, and who have failed to lose enough weight with diet and exercise alone. It is not for people who want to lose just a few pounds.

Phentermine is a Schedule IV drug, a classification given to drugs that have a potential for abuse, although the actual potential appears to be low. Persons with a history of disease, or glaucoma should avoid phentermine. Phentermine can worsen anxiety in some people, most people tolerate this medication well and find that they can lose weight easier.  

Phentermine is FDA approved for short term use and can be given long-term to maintain weight loss off-label. The research also shows that there is minimal evidence of any serious long-term side effects when phentermine is used alone for weight loss. 

Next steps for weight loss

If you have found weight loss a frustrating and difficult pursuit throughout your lifetime or recently, there are helpful medications available. It is crucially important that these medications are carefully monitored by a healthcare practitioner so that harmful effects are avoided. Reach out to us at 25 Again if you are interested in learning more about how we use these medications and other tactics to help adults lose weight and regain their health.

 

Sources

National Center for Health Statistics, Health, United States, 2000 (Hyattsville, Md.: NCHS, 2000 ), Table 69 2.

HEALTH AFFAIRSVOL. 21, NO. 2: THE DETERMINANTS OF HEALTH https://www.healthaffairs.org/doi/full/10.1377/hlthaff.21.2.245

https://www.medscape.com/slideshow/2018-obesity-report-6009712#4

https://www.mayoclinic.org/healthy-lifestyle/weight-loss/expert-answers/phentermine/faq-20057940#targetText=Phentermine%20(Adipex%2DP%2C%20Lomaira,for%20weight%20loss%20(Qsymia).

J Clin Endocrinol Metab. 2015 Feb;100(2):342-62. doi: 10.1210/jc.2014-3415. Epub 2015 Jan 15.

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