xenical and meridia - fda approved short-term prescription weight loss drugs

A drug can only be called a prescription drug if it has been approved by the Food and Drug Administration (FDA). Also called ethical drugs, their purchase is only possible through the approval of a registered physician.

The different array of available FDA-approved prescription weight loss medications can generally be classified into two different groups. This is based on their recommended duration of use – short- or long-term. This article will be looking at the different types of long-term prescription weight loss drugs that have been approved by the FDA.

Before proceeding, it is important to remember that these long-term prescription weight loss drugs have certain restriction. Only two groups of individuals are meant to use these drugs.

The first group is individuals who are overweight. These are individuals who have with a BMI that is between 27 and 30.

Secondly are persons who have obesity-related health conditions or obese. These persons have a BMI that is over 30 and also have obesity-related health conditions.

Some of the obesity-related conditions include heart disease, high blood pressure, high blood cholesterol, or diabetes. They are conditions that are generally detrimental to the lives of the individuals.

The short-term FDA-approved prescription weight loss drugs are generally appetite suppressants. However, the long-term FDA-approved prescription weight loss drugs belong to two different types of drugs. This is based on their generic names, as well as their functions.

Sibutramine (Meridia or Reductil)

Sibutramine is sold as Meridia in the United States and as Reductil in other countries. The FDA approved it in 1997 as a long-term weight loss medication. It is for use in treatment of obesity for up to a period of two years.

Like most of the other FDA-approved short-term weight loss drugs, Sibutramine is an appetite suppressant. The only difference is the approval for long-term use. This might be responsible for its popularity.

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Sibutramine works by inhibiting the reuptake of the catecholamines – norepinephrine, and dopamine, as well as serotonin.

Norepinephrine and dopamine (a precursor of epinephrine, aka adrenaline) increases blood pressure. They also increase the rate and depth of breathing, and cause decrease in the activities of the intestines.

Serotonin on the other hand, carries signals of satisfaction from nerve cells to the brain.

How Sibutramine Works

Reuptake is a process of chemical re-absorption by the body. During the process of reuptake, neurotransmitters are first secreted into the synapses – the gap between nerve endings. Once they have passed on their chemical signal, the presynaptic neuron clears the synapses of the neurotransmitter molecules by absorbing the same. The presynaptic neuron is the nerve cell from where the signal was released.

Sibutramine blocks the reuptake process. This allows the neurotransmitters to remain in the synapse for a longer period of time. Consequently, this prolongs its ability to act as a signal.

As a result, there is an increased level of the circulating amounts of these neurotransmitters in the body. This makes you feel more energetic and satiated for longer periods of time even with reduced food intake.

Additionally, Sibutramine also inhibits neuropeptide Y – a neurotransmitter. This neurotransmitter signals the body to eat, decreases physical activity levels, and increases fat storage.

In a study published in 2007, researchers found that 85% of obese patients taking Sibutramine lost at least 5 percent of their body weight. Another 30 percent lost an average of 10 percent of their body weight. These were in the first three (3) months, Phase I, of the study that lasted for one year [1].

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However, safety and efficacy of Sibutramine beyond two years have not been established.

The usage of Sibutramine has some side effects. These include but not limited to: increased blood pressure, dry mouth, headache, constipation, and insomnia.

Sibutramine should not be used by individuals who have been diagnosed with stroke, uncontrolled high blood pressure, congestive heart failure, or heart disease.

Orlistat (Xenical)

On the 26th of April 1999, the FDA approved Orlistat for long-term use. Orlistat is the first non-appetite suppressing prescription weight loss medication. Orlistat is a whitish crystalline power and also called tetrahydrolipstatin (THL). It is classified under the drug class of lipase inhibitors.

Orlistat, marketed under the brand name Xenical by Roche prevents the digestion and absorption of dietary fats into the bloodstream. It does this by inhibiting the pancreatic enzyme lipase.

Orlistat reduces the production level of pancreatic lipase. The function of pancreatic lipase is to break down fats within the intestines.

Therefore, Orlistat stops ingested dietary fat from being hydrolyzed into free fatty acids. These free fatty acids are very easily absorbed into the bloodstream. The undigested fat is then excreted in the feces.

Lipase inhibitors can reduce the amount of absorbed dietary fat by as much as 30%. The body only absorbs a little amount of Orlistat. Most of it flows into the gastrointestinal tract and subsequently excreted in the stool.

Data from five clinical trials shows that Orlistat can help adults lose between 12.4 to 13.4 pounds in six months. 57% of the patients treated lost 5% of their body weight after one year. All patients were on a nutritionally balanced, reduced-calorie diet [2]. Several other studies have reported similar successful results using Orlistat [3].

Side Effects of Orlistat

However, the usage of Orlistat has some side effects also. These side effects normally occur within the first year of using Orlistat. However, the severity and number of problems gradually reduces over time as the body becomes accustomed to the drug.

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Most of these side effects however tend to be acute, especially following the consumption of fatty foods. They include diarrhea, bloating, flatulence, and loose, fatty, or oily stools.

Additional side effects might include abdominal, rectal, or chest pain; nasal congestion and difficult breathing. There might also be fever and headaches, running nose, sneezing and sore throat.

Preliminary medical claims indicate that Orlistat may also increase the risk of breast and colon cancers. However further scientific research is necessary to validate these claims.

Furthermore, Orlistat inhibits the absorption of certain nutrients. These include the fat-soluble vitamins, especially A, D, E, and K as well as beta carotene. A daily multivitamin supplement containing these nutrients is recommended.

Lastly, the safety of using Orlistat for long term treatment of obesity is unknown.