Ready or not, everyone is about to be bombarded by commercials due to the recent FDA approval of two new medications for the treatment of obesity. Each medication is unique and helps patients shed some pounds. Consider this your guide to knowing more about the medications, what they do and what to expect as results.
Lorcaserin (Belviq) was approved on June 27th by the FDA and is an agonist of the 5-hydroxytryptamine (5-HT, or serotonin) receptor 5-HT2C. This means that it switches on this serotonin receptor to help decrease appetite. Locaserin provided about 4kg or 9 lbs of weight loss over 1 year in one study and about 4-5% drop in body weight in a study of diabetic patients. The drug was also shown to decrease blood sugars, cholesterol and blood pressure due to the weight loss effects. It is generally well tolerated with minimal side effects. It is important to note that works on a different receptor (5-HT2B) than Fenfluramine, the drug in Phen-Fen which caused valvulopathy and cardiac death. Lorcaserin’s effect on the heart was extensively studied and showed very little interaction on the heart.
Phentermine/Topiramate (Qsymia formerly Qnexa) was approved on July 17th by the FDA and is a combination of two already available drugs used to decrease appetite. Phentermine is an old, safe, and effective appetite suppressant which works by turning on the sympathetic nervous system and subsequently decreasing hunger. Topiramate (Topamax) is a neurological medication with multiple usages that has been shown to cause a change in our response to hunger which helps reduce the feeling of hunger. Qsymia resulted in 6.7-8.9% drop in body weight. The most notable side effects are a higher heart rate, dizziness, insomnia, numbness in the hands and feet and possible constipation. The FDA thoroughly reviewed the effect of Qsymia and its result on the heart and found no concerning evidence of any negative cardiac side effects.
Another medication by the name of Contrave may be approved later by the FDA which is a combination of two existing drugs Wellbutrin (Buproprion) and Naltrexone. Contrave will target the brain and hypothalamus in order to decrease food intake, hunger, and control cravings.
Although these new medications offer new tools and no doubt will further increase the awareness of the negative impact obesity is having on our nation’s health, it is important to remember that these medications are only a tool and not a simple long term fix. In order to have long term success with weight loss individuals need to commit to long term lifestyle changes. Education for lifestyle change is well supported with in weight loss programs that lend support structure. Frequent follow up visits translates to long term success. In summary, these medications will be of great assistance to many patients seeking a leg up on their weight loss pursuit but no drug will ever compete with a commitment to lifelong dietary and exercise change.