Weight Loss From Prescription Drugs

Obesity is a medical condition. Like many serious medical issues, it can be extremely difficult to control or eliminate, even with the help of a doctor. When diet and exercise aren't enough, over-the-counter supplements prove ineffective, and surgery is too expensive (or just too scary), prescription medication may seem like the best option for weight-loss success. But many of the most effective prescription weight-loss drugs contain harsh stimulants with serious cardiovascular side effects. This makes them potentially unsafe for those patients that may need to lose weight the most.

Medications Approved by the FDA for Weight Loss

• Prescription drugs the FDA has approved for use in weight loss regimens are limited. Most of them are not specifically designed as weight-control drugs.

  Only a handful of FDA-approved prescription medications are specifically designed for use as appetite suppressants. These include phentermine, sibutramine, phendimetrazine and diethylpropion. These medications may induce side effects typical of stimulant-based medications: sleeplessness, nervousness, increased blood pressure and elevated heart rate. The last two side effects are of particular concern because they post serious risks for obese patients. The result is that many doctors may be unwilling to take risks with appetite suppressant-type medications.

  Other medications that the FDA has approved for use in weight-loss treatments include bupropion and metformin, a depression drug and a diabetes medication respectively. Seizure treatments like zonisamide and topiramate have also been approved as weight-loss medications by the FDA. Between these four medications, potential side effects include insomnia, dizziness, nausea, headache, drowsiness and dry mouth.

  Specific concerns about side effects should be discussed with a doctor before beginning any prescription-based weight-loss regimen.

Nonapproved Medications Sometimes Prescribed "Off-Label" for Weight Loss

• FDA approval only regulates how a manufacturer is allowed to promote a drug. Nonapproval does not necessarily prevent manufacturers or third-party agencies from experimenting with a drug's effectiveness in treating conditions for which it is not approved.

  A medication's FDA approval status also does not prevent a doctor from prescribing it for other "off label" uses for which he believes it may be effective or appropriate. This can be both a blessing and a curse, as "off label" prescriptions---while often effective---can be more risky.

  Some of the strongest appetite suppressants are drugs of the amphetamine class. These include ADHD medications like dextromethamphetamine (Adderall) and Ritalin. Such drugs can cause amplified instances of the same cardiovascular and neurological side effects that approved appetite suppressants do, with the added risk of dependency. For this reason, amphetamine-type drugs are on the FDA's controlled substance schedule and are rarely prescribed by doctors as part of a weight loss plan.

  More common off-label prescriptions for weight loss are antidepressant drugs like citalopram (Celexa). These are not appetite suppressants, but are prescribed in a weight-loss capacity to treat the emotional or psychological condition that is causing the patient to overeat in the first place.