Most people would agree that losing weight can be tough, so the idea of a quick fix is understandably tempting. Unfortunately, there is little evidence that any such thing exists.
“There are no magic bullets that are now available,” says Steven Heymsfield, MD, a professor and researcher at the Pennington Biomedical Research Center at Louisiana State University whose work focuses on obesity and weight loss. “All approved weight loss drugs should be used in conjunction with a healthy diet and exercise ‘lifestyle’ program.”
FDA-Approved Weight-Loss Medications
Currently, there are 5 weight-loss drugs that are approved by the FDA for long-term use of up to a year or more, and several other medications are approved for short-term use of less than three months. “Most experts recommend focusing on long-term use and to avoid crash dieting,” notes Dr. Heymsfield. Still, these drugs are far from the easy route many people seek.
“Realize that achieving long-term weight loss of 10% or more requires hard work on the lifestyle component, and the medicines are going to help with five to eight percent of weight loss,” he adds.
For individuals who are significantly overweight, losing 5 to 10% of one’s starting weight can lead to health improvements like reductions in blood pressure, glucose and triglycerides. Additionally, weight-related conditions such as joint pain and sleep apnea may also improve as a result of modest weight loss.
Weight-loss drugs can also be expensive, except for those with generic versions available, and they are associated with some pretty yucky side effects. According to Dr. Heymsfield, the 5 medications intended for long-term use, along with their common side effects, are as follows.
1. Orlistat (brand names Xenical and Alli). Side effects may include gas, oily discharge, an increased sense of urgency to go number two, so to speak, and an inability to hold it. This drug should not be used by people who are pregnant or have chronic malabsorption syndrome or cholestasis.
2. Lorcaserin (brand name Belviq). In people who do not have diabetes, side effects may include headache, dizziness, fatigue, nausea, dry mouth and constipation, while people with diabetes may experience low blood sugar, headache, back pain and fatigue. Women should not use this medication if they are pregnant.
3. Liraglutide (brand names Victoza and Saxenda). Potential side effects are nausea, vomiting, constipation, diarrhea, low blood sugar, headache, fatigue, dizziness, abdominal pain and an increase in lipase, an enzyme that helps the body break down fat for absorption by the intestines. This medication should be avoided by pregnant women and people who have a history or risk of medullary thyroid cancer or multiple endocrine neoplasia type 2.
4. Phentermine/topiramate (a combination of two medications, which is sold under the brand name Qsymia). Side effects may include insomnia, dry mouth, constipation, a burning or tingling sensation in the limbs or extremities, dizziness and impaired sense of taste. This drug should not be used during pregnancy or by people with hyperthyroidism, glaucoma or hypersensitivity to sympathomimetic amines, or by those taking monoamine oxidase inhibitors (MAOIs).
5. Naltrexone/ Bupropion (another two-drug combo, sold under brand name Contrave). Potential side effects are dry mouth, nausea, constipation, diarrhea, headache, vomiting, dizziness and insomnia. As with all of the other drug listed here, this one is a definite no-no during pregnancy, and it should not be taken by people with high blood pressure, seizure disorders, eating disorders, withdrawal from drugs or alcohol, chronic opioid use or those taking MAOIs.
Supplements Marketed for Weight Loss
So, if these weight loss medications don’t offer the quick path to a lighter you that you had hoped for, you might be wondering if supplements would be a better bet. The short answer: No. “There are many ‘dietary’ supplements that are touted as weight loss agents,” according to Dr. Heymsfield, though they are either backed by flimsy evidence or associated with dangerous side effects. The National Institutes of Health’s Office of Dietary Supplements offers a thorough review of supplements that have been said to help with weight loss, and they report that most of these have not been confirmed by researchers to be effective for that purpose.
For those that do appear to help reduce weight or body fat, particularly green coffee bean extract, green tea and white kidney bean extract, the effects appear to be small at best. In the too-good-to-be-true files, ephedra (AKA ma huang) is a Chinese herb that has actually been shown to lead to short-term weight loss, but the FDA banned it from the market in 2004 due to reports of significant adverse effects such as increased blood pressure, stroke, seizures, heart attack and death.
“Buyer beware–check with credible sources regarding any claims” that certain supplements may help you shed pounds, Dr. Heymsfield advises. “Don’t waste your money on dietary supplements for weight loss unless they can show evidence of efficacy.”
Not only is there little proof that any of these supplements work, but they may also pose major health risks.
A study published in May in the Journal of Pharmaceutical & Biomedical Analysis analyzed 160 weight loss supplements primarily found on the Internet. Though all of the supplements’ sellers claimed that they were made of 100% natural ingredients, the study determined that more than half contained active pharmaceutical ingredients, including some that have been banned from the market due to safety issues.
Bottom Line: Healthy Eating and Exercise are King
That brings us back to those lifestyle changes that inevitably must take place for significant and lasting weight loss: it typically comes down to adopting long-term healthy eating habits and regular exercise. Some people fare better with some sort of structure, as provided by support groups or formal programs.
“There are two commercial weight loss programs–Weight Watchers and Jennie Craig–that are recognized for their effectiveness by the medical community because their results are reported in medical journals,” says Dr. Heymsfield.
But again, he emphasizes the need for long-term commitment. (Alas, there’s no getting around that one.) If you think you might do best with one-on-one assistance, seek help from a licensed or certified professional such as a registered dietitian or psychotherapist specializing in overeating, for example.
Tori Rodriguez, MA, LPC is an Atlanta-based journalist, psychotherapist & health coach