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See all the Healthcast at https://www.biobalancehealth.com/healthcast-blog/ During 2021 several new weight loss drugs have been approved by the FDA for weight loss. The Lancet is a very well-respected medical journal and in December of 2021 they-compared the available medications intended to help people lose fat and become healthy. Today I will discuss the weight loss medications that we use to assist our patients in weight loss and in our next Blog I will review the new, very effective weight loss drugs that have been released, and explain how doctors choose the right weight loss medication for you. At BioBalance Health® we provide medical weight loss treatment utilizing all the common methods of managing food intake, and exercise, and we add medications that are chosen for each patient based on their age, medical conditions and type of trigger that causes overeating. This is referred to as an individualized medical weight loss program and we have been very effective. Choosing a treatment program for each patient requires that we order blood lab tests, measure body composition at each visit, and find out a patient’s history of weight gain to determine the most effective weight loss drug to prescribe for each patient. We also use blood type diets, which are a type of genetic evaluation that determines the best and worst food for each person. It has been scientifically discovered that different body types (endomorph, ectomorph or mesomorph) require different forms of exercise and this observation plus blood type, and personality type helps us suggest the most effective type of exercise. In the future we will be employing genetic testing to determine which medications would be the best for each individual. Today we will discuss the medications available by prescription that can make weight loss, or rather fat loss, possible. Because we are all different it is true that one particular medication, like one particular diet is not effective for all people. The first thing we consider is the medical condition of the patient including other medications that they are on which might interact with weight loss medications, and we don’t want to give a patient that would make her blood pressure or other condition worse. After considering the safety of a particular treatment for an individual patient, I consider an individual’s problem with food: Does she have anxiety that she soothes by constantly snacking? Does she eat sweets because of a metabolic dysfunction like hypoglycemia, that causes her to be tired when her blood sugar drops and she eats sugar to regain energy, Does she have bad eating habits from never learning how to eat cleanly, or how to cook? Does she always feel hungry even right after she eats which is genetically determined? Does she have a genetically determined inability to feel full? Because there are so many reasons for people to be overweight, many solutions must be found to treat the problem that causes weight gain. The first and most popular weight loss class of medication is appetite suppressants, or amphetamines, are ideal for patients who always feel hungry, who are young, and who don’t have hypertension, or heart disease. Amphetamines are the same medication that are used for ADD/ADHD, and both constant hunger and ADD originate from a deficiency of norepinephrine in the brain. Patients with untreated ADD and weight gain are a perfect match for amphetamine appetite suppression. Amphetamines were the first weight loss medication available for appetite suppression. They were commonly prescribed to women beginning in the 1960s. These medications were widely used and were very effective, however they were often habit forming and only continued weight loss as long as they were taken. When they were discontinued patients generally gained their weight back. This particular class of medication didn’t fail to result in lasting weight loss because of the drug itself, but when given without diet and exercise training, patients could not sustain the weight loss after the drug was stopped. Today we still use amphetamines for appetite suppression and weight loss, but we combine it with low carbohydrate diets and daily exercise to achieve long lasting weight loss in a select group of patients. The names of these drugs are Phentermine, Dexedrine, and phendimetrazine. In the 1980s a drug called Orlistat® was introduced. This weight-loss medication worked by causing fat that was in a meal to pass through without being digested and absorbed. The fat passes through to the intestines and resulted in fatty stools. This medication worked by decreasing calories absorbed from fat in the diet. This was somewhat effective for patients who would not, or could not diet, but who still wanted to lose weight. This in itself did work for a time in some patients, but was not an effective lifetime plan, because there was no accompanying training on how to eat appropriate amounts of food, and how to incorporate exercise in their diet. This medication is now over the counter even though it prevents the absorption of fat soluble vitamin like Vitamin D, A, and E. Worse yet Orlistat causes the side effect of fatty diarrhea, fecal incontinence, and terrible gas. This medication was not a long-lasting answer to obesity because it was not well tolerated and because it didn’t cause patients to change their overeating habits so what weight was lost, came back when they were off the medication. The third weight loss medication is a combination of two drugs, Topamax (an anti-seizure medication) plus amphetamines, specifically phentermine. This duo is effective as a long-lasting weight loss answer for patients who are always hungry and can’t control their appetite, as well as patients with food addiction, and sleep related eating disorders. This treatment requires that a patient takes 25-100 mg of Topamax at bedtime and a dose of phentermine in the morning. Weight loss with this drug combination is effective when it is combined with low carbohydrate diets and daily aerobic exercise. This weight loss medication can be used long-term, however there are side effects for some patients which makes it intolerable. Some patients experience dizziness, diarrhea, insomnia, depression, and numbness, that can cause patients to stop taking it, as well as to change to another medication for weight loss. Many of the patients who have had success with these drugs, can’t say enough good things about this combo! Next week we will discuss the new weight loss medications, who they are effective for and their side effects. I hope you join us to discover the new long-term answers to weight gain and obesity.