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Drugs for weightloss - How effective?
Weight-loss drugs may
sound like a dieter's dream. But they aren't a good choice for everyone who's
overweight. In fact, many
doctors reserve them for people with weight-related health problems.
It's best to lose weight through
a healthy diet and regular
exercise. But if
you're among those who struggle to
lose weight and the excess weight has
produced medical problems, weight-loss
drugs may be able to help you.
Here's an update on their credentials:
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Drugs which flush water out of the body. Diuretics (or "water
pills", as they're called) increase the rate at which water is excreted from
the body. They have the same 'weight –loss' effect as saunas and steam baths:
you lose water, not fat, and as soon as you replenish your body with
fluids, you'll get all that weight back. Because diuretics deprive the body of
essential
minerals like
potassium and
sodium, they are avoidable unless you
have a specific disorder such as fluid retention (and then, only under medical
supervision). Diuretics have no legitimate place in a normal weight-loss programme.
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Drugs which raise levels of thyroid. The only valid use for these
drugs is in those persons who have low thyroid levels. They produce less
thyroxin, a hormone which helps
fat-burning, and as a result are likely to be
obese. Such persons improve with thyroid therapy. But thyroid drugs are not
advisable as a routine prescription for raising
metabolic rate in the
overweight. That is because they can achieve this effect in healthy people
only when taken in dangerous amounts.
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Drugs that depress the appetite. They are also known as anorectics
from the medical term,
anorexia, which means loss of appetite. They include
amphetamines and amphetamine-like drugs. Amphetamines are drugs which
stimulate the nervous system; they also increase the metabolic rate and
suppress the appetite. Soon, however, the body develops a tolerance for the
drug, and it will not have its appetite-suppressant effect at the initial
dose. You'll need increasingly stronger doses to achieve the same effect,
leading to drug dependency. Besides causing dependency, such drugs can also
have direct health hazards such as raising the
heart rate (tachycardia) and
blood pressure.
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Drugs which temporarily raise the metabolic rate. They are known as
thermogenics (e.g.. Ephedrine, and ephedra-based products like ma-huang).
After deaths were reported with "Herbal Ecstasy", the American FDA took some
brands off the market, but weight-loss formulas can still be bought off
shelves in the U.S. and other countries. Thermogenics supposedly work by
increasing the body's core temperature so that you're working in a “hotter”
environment and burning more fat. But some experts say they aid weight loss by
working as appetite suppressants really, almost like amphetamines. As their
effect wears off, you'll
crave food, besides feeling fatigued. Thermogenics
are yet to be tested in clinical trials to determine whether they carry the
risks of elevated heart rate and blood pressure, as strongly suspected by the
medical community. Until these tests are done, they are definitely
contraindicated for those with any kind of heart or circulatory problem.
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Drugs which produce a feeling of fullness. These drugs are known as
bulking agents. Taken with water before a meal, the bulking agent swells in
the stomach, producing a sensation of satiety, which takes the edge off your
appetite. Though they do not act on the central nervous system and do not have
the dangerous side-effects of amphetamines, they do produce tolerance – which
means that, over a period, the initial dose is no longer sufficient to bring
about the intended effect, and a higher dose must be taken. Besides, the
dependency that they cause is unlikely to motivate their user to introduce the
diet and other lifestyle changes that constitute the basis for permanent
weight loss. Used too often, or in high doses, they are also likely to have a
laxative effect and may even bring on diarrhoea You can get a similar appetite
– suppressing effect eating a high-fibre diet. Bran, for instance, used in
soups, or breakfast cereal can blunt the edge of hunger. Wholegrains,
wholegrain breads, fruits and
vegetables, peas and beans are other cheaper ways
of bulking up your meal and allowing you to eat fewer calories. They are a
safer, healthier alternative to bulking agents.
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Drugs that prevent calories from being absorbed by the intestines.
These include the "starch blockers" and "fat blockers" which supposedly allow
you to eat your cake and lose weight too. But research on starch blockers
found that starch was not excreted by pill users- instead they caused
mal-absorption with noxious side effects, including nausea, vomiting , cramps, diarrhoea and bacterial fermentation in the gut. For this reason, they proved
more appealing in theory than in reality and the FDA in the U.S. banned them.
The latest drug "off the block" in this category is xenical, which is said to
prevent absorption of up to one-third of fat by the body.
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Drugs that help your body to burn fuel more efficiently. This
category comprises supplements that supposedly enable your body to use glucose
more efficiently instead of quickly storing
carbohydrates as
fat. The
"hottest" weight-loss supplement right now is chromium – as
chromium picolinate, which is supposedly more easily absorbed than chromium
alone, and as chromium polynicotinate.
The net effect of its weight-loss claim is that it lowers
body fat by
preserving muscle.
There's no scientific evidence whatsoever that chromium supplements help you
to lose weight. A study on football players at the University of Massachusetts
found that chromium pills did not help them to Build muscle or lose fat.
Combining weight-loss drugs with a
low-calorie diet and regular exercise can
help you lose more weight than can either drugs or
lifestyle
changes alone.
Combining all three — medication, fewer
calories and more activity — can help
you lose anywhere from 5 percent to 10 percent of your total body weight within
a year.
Factors to consider
You and your doctor need to carefully evaluate the potential benefits of
taking a drug and weigh them against the possible long-term risks. Your doctor
will also consider your health history, the possible side effects and the
potential interaction of weight-loss drugs with other medications you're taking.
Keep in mind that some health insurance plans don't cover weight-loss
prescription drugs. And some companies may require prior authorization before
covering the expense. If you're unsure of your prescription coverage, contact
your health insurance provider.
These medications can help you with
weight maintenance, especially if you
continue exercising regularly. But
keeping off the pounds once you've lost them
is an ongoing concern. And despite your efforts, you might still regain the
weight.
As you consider weight-loss drugs, make sure that you make every effort to
exercise, change your eating habits and adjust any other lifestyle factors that
have contributed to your excess
weight.
Weight-loss drugs aren't the easy answer
to weight loss, but they can be a useful tool to help you make the necessary
diet and lifestyle changes.
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