Weight Loss/Bariatric Surgery

Medications to Treat Obesity and Related Conditions

Medications for Obesity

For some people, combining weight loss medications with lifestyle and behavioral changes results in a weight loss of 10 percent to 12 percent. However, available weight loss medications are not for everyone, and whether or not to include medications in your treatment plan will be given careful consideration, depending on your individual health situation.

Drug therapy for obesity is still in its infancy. There are currently two Food and Drug Administration (FDA) approved medications for long term use in managing obesity: sibutramine (Meridia®) and orlistat (Xenical®). Orlistat is available by prescription or over the counter as Alli®. These medications are only recommended for people with a BMI (body mass index) higher than 30, or a BMI higher than 27 with other risk factors (e.g., diabetes, high cholesterol, controlled high blood pressure).

Appetite suppressants are only effective with diet and exercise and can only be prescribed for people who don’t have complicated health histories. Many people suffering from obesity are not candidates. Gradual lifestyle modification through diet and exercise is the most effective way to reduce weight long term.

Many other medications are now being tested in clinical trials. Although none have yet matched the weight loss achieved with bariatric surgery, several have fulfilled effectiveness and safety criteria and are in the FDA approval process.

Managing Medications During Weight Loss

Conditions such as high blood pressure and diabetes go hand in hand with obesity in what is known as metabolic syndrome. If you or your doctor desires, your weight loss team will treat you for these contributing conditions as part of the weight management process. If your have diabetes or high blood pressure and it isn’t well-controlled, an adjustment in medication may be helpful. Your weight loss team will also monitor you for any medication side effects.

Insulin Reduction for Type 2 Diabetes

As you lose weight, the need for hypertension drugs or insulin may decrease and dosage is modified accordingly. Many times, an individual with type 2 diabetes (a condition where the body still produces insulin, but the cells are resistant to the effects of insulin) can get off of insulin when they make the necessary lifestyle changes, such as following a wholesome meal plan and exercise routine.

As the weight is lost, insulin requirements are often less. As more and more weight is lost and insulin requirements dwindle, a decision can be made with your healthcare team as to whether insulin is necessary. People who have type 1 diabetes will always require insulin.

In other cases, a patient may be receiving treatment for an unrelated condition with medications that can cause weight gain. Every attempt is made to modify medications so that you can achieve weight loss successfully.

We’re happy to work in conjunction with your doctor on managing medications you may take for other conditions.