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Ask Dr. K: Diet drugs not for mildly overweight

DEAR DOCTOR K: Should I take a weight-loss drug to help me lose weight?

DEAR READER: If you are only mildly overweight or just want to lose a few pounds to improve your appearance, then weight-loss drugs are not for you. On the other hand, if your health is at risk and you haven’t been able to lose weight through diet and exercise, drug therapy may increase your chance of success.

There are a handful of FDA-approved weight-loss drugs on the market today. One is available over-the-counter; the others are prescription only. When I was a medical student, virtually none of them were available. The growing epidemic of obesity has led to the development of many drugs that can be helpful.

When deciding whether to recommend weight-loss drugs to my patients, I consider their body mass index. BMI estimates a healthy weight based on height. (Refer to the BMI chart I’ve put on my website,, to determine your BMI.)

You should consider taking a weight-loss drug only if you:

• Have a BMI of 30 or higher, or

• Have a BMI of 27 or higher and also have one or more weight-related health problems, such as Type 2 diabetes or high blood pressure.

Before you start a weight-loss drug, consider why you overeat. For example, do you overeat because of stress, bad habits or emotional issues? If so, you may benefit less from medication and more from psychotherapy or behavioral therapy. On the other hand, if you overeat because of hunger, then weight-loss drugs are more likely to help.

Over the years, several weight-loss drugs have been taken off the market because of safety concerns. It can take time, and lots of people taking a new drug, before any safety issues become apparent. Most of the drugs now available have not been on the market very long, so talk to your doctor about your individual risks and benefits.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.

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