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Rock Doc: The skinny on weight-loss drugs

Mon., Jan. 14, 2013, midnight

I’m not a medical doctor and I don’t even play one on TV. But I couldn’t help but listen to the news about two weight loss drugs the Food and Drug Administration recently approved.

We know that as a group, Americans are fat and getting fatter. Recommendations that we diet and exercise have been around for a long time, but many U.S. citizens have not met with a great deal of success based on will power alone – hence considerable interest in potential weight loss medications.

The FDA has recently approved two drugs with challenging names that may help us keep our New Year’s resolution to trim down. They are called Belviq and Qsymia.

But, you may ask, do we really need to think about medications for weight loss? Don’t we know that eating less and exercising more are the real tickets to a lasting, healthy weight?

Many people who lose weight can tell you of the problems they face even when the bathroom scale gives them good readings for a time. In short, it’s depressingly easy to regain weight that’s been lost. One reason for that is when faced with fewer calories coming in, your body tends to do two things: slow your metabolism and stimulate your appetite. These are factors that lead to regaining the weight a virtuous campaign of diet and exercise had helped a person lose. Hence the interest in anything that can help people both lose weight and keep it off.

Belviq is similar to fen-phen, an appetite suppression drug that was withdrawn from the market in the 1990s because it created heart valve problems. Dr. Donna Ryan, of the Pennington Biomedical Research Center, talked to National Public Radio about the new medication.

“Belviq was developed specifically to avoid the receptor on the heart valve which had been associated with heart damage,” Ryan said to NPR.

The second new medication, Qsymia, is made up of two older medications, a stimulant called phentermine and an anti-seizure medication called topiramate. The medication is thought to be good at helping the body avoid the metabolism-slowing and appetite-stimulating “starvation response.”

Ryan makes the point that people have to do more than just take the pills – they still have to work at watching what they eat and getting some exercise.

“Patients must intentionally go on a diet, try to reduce food intake and increase physical activity,” Ryan said to NPR.

Not surprisingly, the drugs can have side effects. Among them are a tingling in fingers and toes, an increase in heart rate, dry mouth and constipation. And Qsymia can cause birth defects. For that reason, women of childbearing age taking Qsymia will have to have a pregnancy test every month.

Is it all worth it? In studies done to date, the medications helped people lose between 4 and 8 percent of their body weight. This helped reduce their risk of diabetes. But there’s a debate about whether these results justify the potential risks of the meds.

If you’re interested, you must talk to your doctor. Both drugs are available only by prescription.

E. Kirsten Peters, a native of the rural Northwest, was trained as a geologist at Princeton and Harvard. This column is a service of the College of Agricultural, Human and Natural Resource Sciences at Washington State University.

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