The Long-term Effects Of Appetite Suppressants

The Centers for Disease Control and Prevention report that as of July 2011, about one-third of adults in the United States were obese. A weight loss of 10 kg, about 22 pounds, improves high blood pressure, lowers blood lipids and decreases fasting blood sugars. With medical costs for obesity-related issues estimated at $147 billion per year, the use of appetite suppressants is a way not only to help people regain their health, but to decrease overall medical costs.

Anti-Obesity Drugs

Early anti-obesity drugs such as phentermiine were withdrawn from the market because of serious side effects. Amphetamines, once used for weight loss, are severely restricted because the potential for abuse is so high. Three anti-obesity drugs were licensed in Europe in 2008—sibutramine, orlistat, and rimonabant; brand names Meridia, Xenical and Acomplia. Of the three, only Xenical is still available in Europe and it is the only drug available in the United States, as well.

Research

A research study comparing the three drugs was published in the April 2008 “Giornale Italiano de Cardiologia.” Researchers reported that Meridia acted on the brain to increase the feeling of satiety, or fullness. The drug reduced weight and waist circumference, improved blood lipids and showed conflicting results on blood pressure. Acomplia decreased appetite by acting on receptors in the brain. It also improved blood lipids and patients taking the drug lost weight. Xenical, the third anti-obesity drug, works by decreasing fat absorption, so it is not technically an appetite suppressant.

Weight Loss with Drugs

Both Meridia and Acomplia were used in combination with other weight-loss strategies such as calorie-controlled diets, exercise and behavior modification. There was still an attrition rate of 40 percent to 50 percent for patients who used these weight loss aids. Weight loss was modest, according to a report in the December 2010 “Journal of Obesity.” Average weight loss was 2 kg to 7.9 kg, or about 5 to 14 pounds. Patients who used a placebo did almost as well as those who used the appetite suppressants.

Topamax

One other medication connected to weight loss is topirimate, or Topamax, an anti-seizure drug. The mechanism by which Topamax causes weight loss is unknown, but a study reported in the March 2007 issue of “Diabetes Care” reported that diabetic patients lost between 2.3 percent to 5.8 percent of their body weight when given Topamax over 16 weeks. The researchers concluded that Topamax has adverse psychiatric and central nervous system effects that made it unsuitable for treating obesity.

Appetite Suppressants in the United States

As of 2011, there were no appetite suppressant medications licensed for use in the United States. Xenical, which prevents fat absorption, is still used for obesity treatment. The long-term negative effects of both Acomplia and Meridia, including depression, increased risk of suicide, increased blood pressure and heart rate, were such that both medications were removed from the market.