Medications are hit-and-miss for weight loss…mostly a miss.

I recently had a request to write an article on weight loss medications.   As a physician, I try everything in my arsenal to avoid going this route with patients.  I would prefer that they not have to take medications, but some cannot lose weight without them.  My personal opinion is ……

Ok, I prescribe weight loss medications.  They are not a magic bullet that will let you lose weight fast without diet and exercise.  Even with this medication, you must watch what you eat and exercise.  Without a multi-prong approach, you will not lose weight, or even if you do happen to lose a few pounds, you will gain it back once you stop the medication because you failed to change the behavior that causes the weight gain.  If your weight gain is because you are sedentary and overeat, the risk of the medication is not worth the benefit unless you change the behavior.  

 I personally think that they should rarely be used for weight loss.  Most of the patients that have asked me to prescribe them have not done their due diligence to try to lose weight without them.  They want a quick fix, and I refuse to prescribe that group. 

When do I write for them?  I am not a weight loss specialist, but I have ample experience helping patients lose weight.  I usually require them to do several steps before I am willing to consider a medication:

1. Some providers start weight loss medication at a BMI of 27.  I do not consider them until 30.  
2. The patient must have labs that are normal lab tests.  Endocrinology causes are the minority, but they are quick to win when you find them.
3. I will review their medical history to ensure that they do not have a history of an eating disorder.  
4. Patients must see a Dietician to review their diets.
5. Patients must see a Trainer and try at least six weeks of diet and exercise without successful weight loss.  
6. All patients are referred to a behavioral health provider to ensure there is not a Behavioral Health condition hampering their ability to lose weight.

Remember, more is not better.  A handful is dangerous, so take them as prescribed.  All of the medications are addictive or have potentially fatal side effects.  I would never take them lightly.  Do not mix any other weight loss supplements with them.  

Do they work?  The bottom line is that they do work to help with weight loss, but they do not work to cause long-term weight loss maintenance.  Most studies show that in the long term, patients regain the weight.  You must learn to eat healthily, so if you plan to keep it off, you might be better off learning to eat and exercise correctly.  

The bottom line: There is no magic pill for weight loss. Medications and supplements can help, but they have side effects, and you will regain the weight if you do not make life-lasting changes.