Veggie Blog

Tablets to help in weight loss

Why do people turn to weight loss tablets?

Obesity has become much more common. According to the US Centers for Disease Control and Prevention, 41.9% of American adults had obesity in 2017 to March 2020, up from 30.5% in 1999-2000. It affects children too, some of whom are already struggling when they start school. Many things play a part: fast food that is high in saturated fat, refined sugar in soft drinks and processed foods, too little fiber, genes, overeating and a slower metabolism as we get older.

Losing weight takes time, and many people do not want to wait. The idea that one pill could do the work, without changing what you eat or how you move, is very tempting, especially when a friend or relative seems to have had great results. People spend large sums on these products every year, and the companies that make them earn a lot of money.

What is the history of weight loss drugs?

Doctors have prescribed appetite-suppressing drugs for decades. Some of them worked by raising serotonin levels in the brain, which makes you feel full. In the 1990s, two such drugs, fenfluramine and dexfenfluramine, were widely used, often together with phentermine as “fen-phen”. In September 1997 the US Food and Drug Administration asked the makers to withdraw them after reports of heart valve problems. Since then, new medicines have been developed and tested far more carefully.

What is available today?

The National Institute of Diabetes and Digestive and Kidney Diseases lists six prescription drugs that the FDA has approved for long-term weight management: orlistat (Xenical, and a lower-dose version called Alli that is sold without prescription), phentermine-topiramate (Qsymia), naltrexone-bupropion (Contrave), liraglutide (Saxenda), semaglutide (Wegovy) and tirzepatide (Zepbound). Not all of them are tablets or capsules: several are given as injections. They work in different ways. Orlistat reduces the amount of fat your body absorbs from food, while most of the others act on the brain to reduce appetite.

Who can take them?

A doctor may prescribe one of these medicines if you are an adult with a body mass index (BMI) of 30 or more, or 27 or more together with a weight-related health problem such as high blood pressure or type 2 diabetes. They are not meant for everyone with a high BMI, and you should never take one just to change the way you look. Over-the-counter diet pills and supplements are a different category. We look at their safety in a separate post on whether weight loss tablets are safe, and at who should avoid them in our guide to what to know about diet pills.

What results can you expect?

Medicine works best as part of a plan that also includes a lower-calorie diet and regular activity, and that is what the clinical tests show. On average, after one year, adults who take a prescription medicine as part of a lifestyle program lose 3% to 12% more of their starting weight than people in the same kind of program without medicine. Some people lose 10% or more. Even a loss of 5% to 10% can lower blood sugar, blood pressure and triglycerides. Most of the weight is lost in the first six months, and if you have not lost at least 5% after 12 weeks on the full dose, your doctor will probably suggest stopping or changing the treatment. Expect to regain some weight if you stop the medicine.

Do you still need to exercise?

Yes. Before you start any exercise program, talk to your doctor. A good first plan combines cardio, such as brisk walking or cycling, with strength exercises. This burns calories and builds muscle, which helps your metabolism. Whatever you choose, the most important thing is to stick to the plan. For more ideas, read our post on weight loss tips.