You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Obesity: Should I Take Weight-Loss Medicine?
Get the facts
Your options
- Take prescription weight-loss
medicine.
- Don't take medicines.
Key points to remember
- Being very overweight makes you more likely
to have serious health problems, such as
heart disease and
type 2 diabetes.
- Weight-loss medicines may
be an option if you haven't been able to lose weight with diet and exercise and
if:
- Your
BMI (body mass index) is at least 30 (or at least 27.5
if you are Asian).
- Your BMI is at least 27 and
you also have
another health problem related to your weight, such as
diabetes, high blood pressure, or high cholesterol.
- Medicine may help you lose a small amount of
weight. But without permanent changes in eating and exercise habits, most
people gain weight again after they stop taking the medicine.
- You
must decide whether the benefit of taking a certain medicine outweighs its side
effects. Side effects of weight-loss medicines include headaches, nausea, bowel
problems, and increased blood pressure.
- Weight-loss medicines can be expensive and may not be covered by
your health insurance.
FAQs
Most weight-loss
medicines work by making you feel less hungry or making you feel full sooner,
so you don't eat as much.
Weight-loss medicines include:
- Orlistat
(Xenical). This drug prevents some of the fat calories you eat from
being absorbed in your intestines. A lower strength of it, sold as
Alli, is available without a prescription.
- Appetite suppressants (benzphetamine, diethylpropion, phendimetrazine, phentermine). These drugs keep
you from feeling as hungry. They are approved only for short-term use.
Weight-loss medicines are used along with diet changes
and more physical activity. Without those lifestyle changes, you will gain the
weight back if you stop taking the medicine.
Medicine doesn't work for everyone. If you don't lose weight within 4
weeks of starting the medicine, it probably won't help you.1
Side effects of weight-loss medicinesOrlistat (Xenical) | Appetite suppressants (benzphetamine, diethylpropion, phendimetrazine, phentermine) |
- Changes in bowel habits, including:
- Oily or fatty stool. The oil seen
in a bowel movement may be clear, orange, or brown.
- Stool or oily
matter that leaks out when you pass gas, oily matter that leaks out even when
you're not passing gas, and an urgent need to go to the bathroom. Research
shows that this happens to 22 to 27 out of every 100 people. This means that 73
to 78 out of 100 don't have this side effect.2
- Being unable to control bowel movements.
Sometimes these side effects go away after a few
weeks. But often they don't. They're the main reason people stop taking this
medicine. | -
Nervousness
- Irritability
- Sweating
- Nausea
- Headache
- Dry
mouth
- Constipation
- Sleep problems
- Possible
addiction
- Higher blood pressure
- Faster heartbeat
Most of these side effects are mild, and they
usually improve with continued treatment. |
If you are under a lot of
stress, have an emotional illness such as
anxiety or
depression, or have an alcohol or drug problem, you
need treatment for that problem before you use weight-loss medicine. If you
don't treat it, you will have a harder time losing weight.
Your doctor may recommend weight-loss medicine if:
- Your BMI is at least 30 (27.5 if you are
Asian).
- Your BMI is at least 27 and you have other problems related
to your weight, such as:
- High blood pressure.
- High cholesterol.
- Type 2 diabetes.
- And you have tried for at least 6 months to lose
weight with diet and physical activity.
- And you don't have untreated
depression or another major mental illness, and you don't abuse alcohol.
If your doctor prescribes a weight-loss medicine for you, tell him or her about all prescription and over-the-counter medicines, vitamins, herbs, and supplements that you are taking.
Your doctor will want to watch to see if your weight loss improves your type 2 diabetes, cholesterol, and/or blood pressure.
Compare your options
| | |
|---|
What is usually involved? |
| |
What are the benefits? |
| |
What are the risks and side effects? |
| |
Take weight-loss
medicines Take weight-loss
medicines - Depending on the type
of drug, you take a pill 1 to 3 times a day.
- You also make permanent changes in your diet and physical
activity level.
- Weight-loss medicines
can help you lose a small amount of weight.
- If you lose weight, you're less likely to have
related health problems, including
heart disease and
type 2 diabetes.
- Possible side effects include:
- Increased blood
pressure.
- Headache and dry mouth.
- Constipation and
sleep problems.
- Unpleasant changes in bowel habits.
- Unless you make permanent changes in your eating and exercise
habits, you are likely to gain back the weight after you stop taking the
medicine.
- Weight-loss medicines can be expensive and may not be covered by
your health insurance.
Use only diet and
exercise to lose weight Use only diet and
exercise to lose weight - You
make permanent changes in your diet and physical activity level.
- Eating
fewer calories while increasing activity is the way to lose weight that works
best for most people.
- You avoid the risks and side effects of
taking weight-loss medicines.
- You avoid the expense of taking medicine.
- If you aren't able to lose weight using diet and exercise, you're more likely to have
related health problems, including
heart disease and
type 2 diabetes.
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
I was
concerned about taking a weight-loss medicine. I was worried about those
stimulant diet pills that people took years ago that had such a questionable
reputation. But after struggling to lose not even 5 pounds over the past
8 months, I am now ready to see whether medicines can add anything to the
good habits I've tried to establish. I know the medicine isn't going to be a
magic bullet, but I hope it can give me that little extra help I seem to need.
I realize that I didn't gain my extra
weight in just a few months, and I don't expect to be able to lose it all
quickly. I want to get back to eating a more balanced diet again, and set a
good example for my kids so that they don't develop poor eating habits as they
grow up. I plan to start taking them for walks and introducing them to lots of
outdoor activities that we can do together. I don't want to be on pills for the
rest of my life. I need a long-term solution.
My sister
has been taking a weight-loss medicine for about 4 months now, and she has
been on a low-fat diet. We have been walking together 3 times a week. She has
lost about 10 pounds already. I don't think I've lost any weight yet,
even though I have been watching what I eat, too. I think if the medicine
gives me a little help toward losing those first few pounds, I have the good
habits and will power to keep the weight off on my own.
The side
effects of Xenical sound pretty unpleasant to me. I have made a few changes in
my diet, and I am walking twice a week. I'm going to give myself at least a
year of a balanced diet and exercise before I consider whether I want to try
taking a medicine.
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take weight-loss medicine
Reasons not to take weight-loss medicine
I am desperate to lose weight, and I think medicine will help me.
I don't like the idea of taking medicine.
More important
Equally important
More important
I have tried diet and exercise, and I just can't seem to lose weight.
I want to keep trying diet and exercise before I start taking medicine.
More important
Equally important
More important
I'm not worried about the cost of medicine.
I don't think I can afford the cost of medicine.
More important
Equally important
More important
I think losing a little bit of weight is worth the side effects of medicine.
I don't think the side effects are worth the small amount of weight I might lose by taking medicine.
More important
Equally important
More important
Along with taking medicine, I'm willing to work hard to make permanent changes in my eating and exercise habits.
Medicines aren't worth it to me if I'll just gain the weight back without permanent lifestyle changes.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking weight-loss medicine
NOT taking weight-loss medicine
Leaning toward
Undecided
Leaning toward
What else do you need to make your decision?
1.
Weight-loss medicine is all I need to lose lots of weight permanently.
2.
I may suffer unpleasant side effects if I take weight-loss medicine.
3.
I am just a little overweight, so weight-loss medicine is probably a good choice for me.
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
3.
Use the following space to list questions, concerns, and next steps.
Your Summary
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Key concepts that you understood
Key concepts that may need review
Credits
| Credits | Healthwise Staff |
|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | Theresa O'Young, PharmD - Clinical Pharmacy |
|---|
References
Citations
- Klien S, Romijin JA (2008). Obesity. In HM Kroneberg
et al., eds., Williams Textbook of Endocrinology, 11th
ed, pp. 1563–1587. Philadelphia: Saunders.
- Arterburn DE, et al. (2008). Obesity in adults, search
date February 2007. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Obesity: Should I Take Weight-Loss Medicine?
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the facts
Your options
- Take prescription weight-loss
medicine.
- Don't take medicines.
Key points to remember
- Being very overweight makes you more likely
to have serious health problems, such as
heart disease and
type 2 diabetes.
- Weight-loss medicines may
be an option if you haven't been able to lose weight with diet and exercise and
if:
- Your
BMI (body mass index) is at least 30 (or at least 27.5
if you are Asian).
- Your BMI is at least 27 and
you also have
another health problem related to your weight, such as
diabetes, high blood pressure, or high cholesterol.
- Medicine may help you lose a small amount of
weight. But without permanent changes in eating and exercise habits, most
people gain weight again after they stop taking the medicine.
- You
must decide whether the benefit of taking a certain medicine outweighs its side
effects. Side effects of weight-loss medicines include headaches, nausea, bowel
problems, and increased blood pressure.
- Weight-loss medicines can be expensive and may not be covered by
your health insurance.
FAQs
What are weight-loss medicines?
Most weight-loss
medicines work by making you feel less hungry or making you feel full sooner,
so you don't eat as much.
Weight-loss medicines include:
- Orlistat
(Xenical). This drug prevents some of the fat calories you eat from
being absorbed in your intestines. A lower strength of it, sold as
Alli, is available without a prescription.
- Appetite suppressants (benzphetamine, diethylpropion, phendimetrazine, phentermine). These drugs keep
you from feeling as hungry. They are approved only for short-term use.
Weight-loss medicines are used along with diet changes
and more physical activity. Without those lifestyle changes, you will gain the
weight back if you stop taking the medicine.
Medicine doesn't work for everyone. If you don't lose weight within 4
weeks of starting the medicine, it probably won't help you.1
What are the risks and side effects of weight-loss medicines?
Side effects of weight-loss medicinesOrlistat (Xenical) | Appetite suppressants (benzphetamine, diethylpropion, phendimetrazine, phentermine) |
- Changes in bowel habits, including:
- Oily or fatty stool. The oil seen
in a bowel movement may be clear, orange, or brown.
- Stool or oily
matter that leaks out when you pass gas, oily matter that leaks out even when
you're not passing gas, and an urgent need to go to the bathroom. Research
shows that this happens to 22 to 27 out of every 100 people. This means that 73
to 78 out of 100 don't have this side effect.2
- Being unable to control bowel movements.
Sometimes these side effects go away after a few
weeks. But often they don't. They're the main reason people stop taking this
medicine. | -
Nervousness
- Irritability
- Sweating
- Nausea
- Headache
- Dry
mouth
- Constipation
- Sleep problems
- Possible
addiction
- Higher blood pressure
- Faster heartbeat
Most of these side effects are mild, and they
usually improve with continued treatment. |
If you are under a lot of
stress, have an emotional illness such as
anxiety or
depression, or have an alcohol or drug problem, you
need treatment for that problem before you use weight-loss medicine. If you
don't treat it, you will have a harder time losing weight.
Why might your doctor recommend weight-loss medicine?
Your doctor may recommend weight-loss medicine if:
- Your BMI is at least 30 (27.5 if you are
Asian).
- Your BMI is at least 27 and you have other problems related
to your weight, such as:
- High blood pressure.
- High cholesterol.
- Type 2 diabetes.
- And you have tried for at least 6 months to lose
weight with diet and physical activity.
- And you don't have untreated
depression or another major mental illness, and you don't abuse alcohol.
If your doctor prescribes a weight-loss medicine for you, tell him or her about all prescription and over-the-counter medicines, vitamins, herbs, and supplements that you are taking.
Your doctor will want to watch to see if your weight loss improves your type 2 diabetes, cholesterol, and/or blood pressure.
2. Compare your options
| | Take weight-loss
medicines | Use only diet and
exercise to lose weight |
|---|
| What is usually involved? | - Depending on the type
of drug, you take a pill 1 to 3 times a day.
- You also make permanent changes in your diet and physical
activity level.
| - You
make permanent changes in your diet and physical activity level.
|
|---|
| What are the benefits? | - Weight-loss medicines
can help you lose a small amount of weight.
- If you lose weight, you're less likely to have
related health problems, including
heart disease and
type 2 diabetes.
| - Eating
fewer calories while increasing activity is the way to lose weight that works
best for most people.
- You avoid the risks and side effects of
taking weight-loss medicines.
- You avoid the expense of taking medicine.
|
|---|
| What are the risks and side effects? | - Possible side effects include:
- Increased blood
pressure.
- Headache and dry mouth.
- Constipation and
sleep problems.
- Unpleasant changes in bowel habits.
- Unless you make permanent changes in your eating and exercise
habits, you are likely to gain back the weight after you stop taking the
medicine.
- Weight-loss medicines can be expensive and may not be covered by
your health insurance.
| - If you aren't able to lose weight using diet and exercise, you're more likely to have
related health problems, including
heart disease and
type 2 diabetes.
|
|---|
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These
personal stories
may help you decide.
Personal stories about using medicine for obesity
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I was concerned about taking a weight-loss medicine. I was worried about those stimulant diet pills that people took years ago that had such a questionable reputation. But after struggling to lose not even 5 pounds over the past 8 months, I am now ready to see whether medicines can add anything to the good habits I've tried to establish. I know the medicine isn't going to be a magic bullet, but I hope it can give me that little extra help I seem to need."
"I realize that I didn't gain my extra weight in just a few months, and I don't expect to be able to lose it all quickly. I want to get back to eating a more balanced diet again, and set a good example for my kids so that they don't develop poor eating habits as they grow up. I plan to start taking them for walks and introducing them to lots of outdoor activities that we can do together. I don't want to be on pills for the rest of my life. I need a long-term solution."
"My sister has been taking a weight-loss medicine for about 4 months now, and she has been on a low-fat diet. We have been walking together 3 times a week. She has lost about 10 pounds already. I don't think I've lost any weight yet, even though I have been watching what I eat, too. I think if the medicine gives me a little help toward losing those first few pounds, I have the good habits and will power to keep the weight off on my own."
"The side effects of Xenical sound pretty unpleasant to me. I have made a few changes in my diet, and I am walking twice a week. I'm going to give myself at least a year of a balanced diet and exercise before I consider whether I want to try taking a medicine."
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take weight-loss medicine
Reasons not to take weight-loss medicine
I am desperate to lose weight, and I think medicine will help me.
I don't like the idea of taking medicine.
More important
Equally important
More important
I have tried diet and exercise, and I just can't seem to lose weight.
I want to keep trying diet and exercise before I start taking medicine.
More important
Equally important
More important
I'm not worried about the cost of medicine.
I don't think I can afford the cost of medicine.
More important
Equally important
More important
I think losing a little bit of weight is worth the side effects of medicine.
I don't think the side effects are worth the small amount of weight I might lose by taking medicine.
More important
Equally important
More important
Along with taking medicine, I'm willing to work hard to make permanent changes in my eating and exercise habits.
Medicines aren't worth it to me if I'll just gain the weight back without permanent lifestyle changes.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking weight-loss medicine
NOT taking weight-loss medicine
Leaning toward
Undecided
Leaning toward
5. What else do you need to make your decision?
Check the facts
1.
Weight-loss medicine is all I need to lose lots of weight permanently.
You're right. Medicine will probably help you lose just a small amount of weight. And unless you make permanent changes in your eating and exercise habits, you will likely gain back the weight after you stop taking the medicine.
2.
I may suffer unpleasant side effects if I take weight-loss medicine.
That's right. Side effects of weight-loss medicines include headaches, nausea, bowel problems, and increased blood pressure. Some people stop taking the medicine because the side effects are too unpleasant.
3.
I am just a little overweight, so weight-loss medicine is probably a good choice for me.
Yes, you're right. Weight-loss medicine is usually only for people whose BMI is at least 30 (27.5 if you are Asian or 27 if you have a health problem related to your weight).
Decide what's next
1.
Do you understand the options available to you?
2.
Are you clear about which benefits and side effects matter most to you?
3.
Do you have enough support and advice from others to make a choice?
Certainty
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
3.
Use the following space to list questions, concerns, and next steps.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | Theresa O'Young, PharmD - Clinical Pharmacy |
|---|
References
Citations
- Klien S, Romijin JA (2008). Obesity. In HM Kroneberg
et al., eds., Williams Textbook of Endocrinology, 11th
ed, pp. 1563–1587. Philadelphia: Saunders.
- Arterburn DE, et al. (2008). Obesity in adults, search
date February 2007. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.Last Revised:
April 1, 2011
Klien S, Romijin JA (2008). Obesity. In HM Kroneberg
et al., eds., Williams Textbook of Endocrinology, 11th
ed, pp. 1563–1587. Philadelphia: Saunders.
Arterburn DE, et al. (2008). Obesity in adults, search
date February 2007. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.