It’s fair to say that if there was any medication that could reliably and consistently cause weight loss we wouldn’t have any people overweight.
Unfortunately there is no one pill that will solve people’s weight problems. Often we find that through trial and error and some of that trial and error has been a little bit controversial over the years too. At the end of the day weight is more a function of physics than biology, it is a function of energy in, that’s the food we consume, and energy out, which is the amount of exercise or physical activity we do, plus of course the amount of energy we use up keeping ourselves going. That’s what is called the basal metabolic rate. There is a certain amount of energy required to keep the heart pumping, to keep the kidneys filtering and all the other processes within the body.
There a lot of people searching for something that will help them lose weight and a substantial amount of people who are grappling with weight issues. As a group of medications, weight loss tablets have not been very successful. Indeed they have plagued by some difficulties leading to quite a few that have been withdrawn from the market over the years. There were a couple withdrawn in the late 1990s and another one in the early 2000s and that was because of side effects including problems with the heart and some deaths.
The two main groups that remain on the market are ones that block fat absorption and these used to be on prescription but you can now get them over the counter. They work to a point and if they worked consistently for everybody we would have no weight problems. They work by blosking fat absorption – the catch though, is if we have even small amounts of fat in the diet you can end up with diarrhoea and people don’t tend to appreciate it that much. Longer-term studies have shown that weight loss is marginal at best but again if used in conjunction with a low fat diet it may give you a little bit of a helping hand but it will not do it all for you.
The other group is appetite suppressants and there are only one or two left on the market. They unfortunately can have side effects in some people and they can include keeping you up at night time, so it’s a good idea to take them in the morning, some people get a rapid heart rate, some people get headaches, some people can get vomiting with them. Once again they do not do it for you. The role for any appetite suppressant if used is to give you a little bit of a head start. You’ve heard anecdotal tales of people going to the chemist to get their prescription filled out for their appetite suppressant and buying a pack of jelly beans while they’re standing at the chemist counter waiting. Now that’s not going to work. So at the end of the day there is no one pill or tablet that is going to cause you to lose weight. If you are hoping that is the case then unfortunately you will be disappointed but there’s no point living in a fantasy land.
The way to lose weight is by a change in your calorie equation and that’s your energy in versus your energy out. There can be a role for short-term use of some medications and you need to chat with your doctor about this to get you kick started. That’s essentially it, they cannot do it for you. They may have a role in some people but you do have to be aware of side effects and you do need to chat about it with your doctor.