Medication to aid weight loss?

mikomarcia · May 2022

I was wondering if anyone has had any success with medication (actually prescribed by a Dr) for weight loss. I have a feeling the specialist I see next week is going to want to put me on something, but I was prescribed metformin years and years ago and it did nothing for me. I know there are a lot more out there now but I'm super hesitant.

cwolfman13 · May 2022

Actually there are only four weight loss medications approved by the FDA. I haven't ever taken weight loss medications, but I'd stay away from Phentermine as it is a legal amphetamine. Most of these medications act as an appetite suppressant except for Orlistat which blocks the absorption of fat...and I've heard some rather unpleasant stories about it as well.

I don't think any of these medications are a magic pill...people still have to put in the work and it would appear adopting a healthy lifestyle is pretty critical in losing weight while on medication as well as keeping it off once you go off the medication. I take Naltrexone for AUD and it definitely helps to cut back on the cravings and it makes alcohol substantially less entertaining when I do drink, but I still have to put in the work if I want to be sober.

candylilacs · May 2022

I have heard good things about ozempic, but I urge you to see the YouTube videos for that one.

Cfrazier_03 · May 2022

Ozempic, if you have ins its good, if your on medicare, it will not be covered. as weight loss, it is a diabetic drug, hoever cost is over 1000 a month

mikomarcia · May 2022

Holy cow! Over a thousand a month?! I'll pass. Can't even consider that. It also makes me wonder what happens when you stop taking it. It'll be interesting to see what they say next week.

kshama2001 · May 2022

Before you agree to a fat-blocker, page 1 of this thread, especially the post by Ninkyou, is a MUST READ:

https://community.myfitnesspal.com/en/discussion/10290083/alli-xenical-does-it-work-please-only-answer-if-you-have-actually-taken-it/p1

Here are my thoughts on Phentermine:

I didn't internalize healthy eating habits when my appetite was artificially suppressed by taking a legal amphetamine-like drug and I gained all the weight back when I stopped taking it. And now I am on medication for heart palpitations.

Here's my favorite post about Phentermine: http://community.myfitnesspal.com/en/discussion/10329901/phentermine/p1

itschanelle wrote: »

I have seen a lot of posts on and off about this and other weight loss drugs. I can vouch that they absolutely work. I have lost a lot weight using Phentermine on and off throughout about a 10 year span.

BUT...

The weight doesn't stay off. And those side effects? They are real.

You could take Phentermine and lose the weight, but you might end up like me. I'm 30 years old, slightly over weight, and have moderate tricuspid valve regurgitation. As in, I might need open heart surgery because my heart was damaged by Phentermine. To be clear, I never took it for more than a few months at a time, was monitored by a doctor, and did everything "right".

My lifespan has likely been shortened to lose a few pounds. Weight I could have lost on my own with a little bit of gumption. It wasn't worth it.

shockbishop · May 2022

Lol orlastat, like that Alli stuff. If you just so happen to eat something fatty…..in my case a BK lunch break…..better bring a change of clothes.

lorib642 · May 2022

I take metformin for type 2 diabetes. It has not helped with weightloss. There are medications that suppress appetite, but like you mentioned, you have to go off them eventually. If you have insurance some plans help with coaching or gym memberships. You sound like you don’t want to take a medicine. You can refuse or ask for other options. Good luck

mikomarcia · May 2022

Thank you all. I certainly will not take Phentermine. Someone tried to give that to me a long time ago. It scares me too much. I really DON'T want to take anything, but I'm also ignorant on some of the newer options. It always seems like they're trying to get me to take something, and if there was a good, safe, option I'd be foolish to not consider. It's all overwhelming.

cmriverside · May 2022

Surgeons will suggest surgery.

Medical doctors will want to give.....medicine.

Therapy might uncover why one is over-eating in the first place.

KL1887 · May 2022

I take a drug called Topirimate (topamax), it’s not typically licensed as a product for weight loss though. It has some pretty nasty side effects and the weight loss benefit doesn’t outweigh them.

I know it’s been mixed with something else and marketed as a magic pill to fight obesity, which has been licensed for use.

cwolfman13 · May 2022

mikomarcia wrote: »

Thank you all. I certainly will not take Phentermine. Someone tried to give that to me a long time ago. It scares me too much. I really DON'T want to take anything, but I'm also ignorant on some of the newer options. It always seems like they're trying to get me to take something, and if there was a good, safe, option I'd be foolish to not consider. It's all overwhelming.

The only one I would even consider would be naltrexone-bupropion. It's pretty safe. Naltrexone is primarily used for AUD and opioid use, but there have been good findings for weight loss as well. It works primarily to disrupt the pleasure receptors in the brain...so for me, I can drink on naltrexone and I can get drunk...but it just makes it not particularly pleasurable or fun and I don't get much out of it so it has slowly but surely changed my drinking behavior. Bupropion is an anti-depressant and somehow this combination has shown to work well with people who have binge eating disorders and things like that.

hesn92 · May 2022

Yikes, hearing all this stuff about phentermine. I knew it was probably not great but didn't know it was that bad. My coworker uses it

And she's had some heart issues within the last year or so so that worries me. I wish she wouldn't but she's desperate! I've tried to get her onto MFP but it didn't seem to work for her

springlering62 · May 2022

hesn92 wrote: »

….I've tried to get her onto MFP but it didn't seem to work for her

At the risk of sounding like a smart *kitten*, I suspect she didn’t work for MFP.

That’s too often how it goes, and then people blame the app. 🙄

Xellercin · May 2022

So it all depends on what part of weight loss you are looking to medicate.

There are no drugs that make you lose weight, only drugs that try to improve certain aspects of the weight loss process.

Some diabetes drugs help people with diabetes/prediabetes lose weight more effectively by modulating their metabolic processes. But if you don't need those *specific* metabolic processes modulated, or if you just eat more, they won't do anything.

Stimulants and thyroid meds will up your energy expenditure, which sky-rockets the CO part of the CICO equation, but they come with a cost. The body won't just allow you to artificially amp up it's energy expenditure for long, it will start adjusting other internal chemicals to slow you down, and this can be brutal (addiction and tolerance to stimulants, crashes in thyroid function, etc). There's no free ride when it comes to energy from a pill/injection.

Steroids can help you build more muscle mass instead of storing calories as fat, which won't produce weight loss, but will alter the effects of the incoming calories. But again, your body will react over time.

Then there's appetite suppression. That works on the CI side of the equation. These are totally unpredictable, and if the person eats for emotional reasons, then it doesn't really matter if they're less hungry, because they were never eating for real hunger to begin with.

However, there are drugs that lower appetite, but it by lowering actual appetite signals, they work by making food itself less appealing. This is what the naltrexone mentioned above does. It's used for people with addictions because it makes the things that get you high get you less high, or not high at all.

So if you love alcohol, it makes alcohol boring and dreadful, if you love food, it makes food less satisfying. I was on ultra low dose naltrexone for nerve pain, it didn't help, but it did make me totally disinterested in greasy pizza, which is my very favourite comfort food normally.

So it didn't modulate my hunger, it lowered my emotional attachment to food and eating. It just wasn't interesting to me. However, I didn't lose weight because my problem wasn't the CI part of the equation, I had damaged metabolism, so I needed help with the CO part of the equation. I didn't eat less on naltrexone, I just enjoyed my food less.

All drugs come with side effects, so it's critical to try and understand why you gained weight in the first place and exactly what barriers are holding you back from losing before you resort to meds, many of which can eff you up long term.

No matter what med/surgery/procedure you try, you can still overcome its effects by chronic overeating, even just by small amounts every day. I originally got obese with just an extra 100-300 calories daily over 4 years.

Even people who have gastric bypass need to relearn how to eat for weight loss. Medicine can't do the heavy lifting for you, but it can help support specific deficiencies in your system if you find that a reasonable, consistent diet and exercise aren't working for you as well that they physically should.

mikomarcia · May 2022

So yesterday I spent the day with the specialist and her team. Ultimately tests determine I am insulin resistant. They were very pleased with my diet and activity levels. So they put me on Ozempic. It's not cheap but my insurance will cover it with prior auth. Luckily, I am NOT a chronic overeater. I never have been. I am also very active. (20-30 mile bike rides on weekends, tennis player) but this does explain a lot. She said she could tell without tests what my problem was since all my weight was in my belly but I have skinny arms and legs. So, after going over everything, I'll give it a try. The nice thing is that it isn't a forever drug. Just until my bloodwork is normal or I reach my goal weight. Side effects seem fairly low too. So we'll see. They start you low and work up the dosage. She said the first month I shouldn't expect much as it's really more to get my body used to the medication. Either way, I'll be monitoring it closely. Hopefully the other test results (which I'll get in a few days) don't show any other underlying issues. Hopefully I can manage this. I have to admit, the naltrexone is interesting to me, too. When I do have a bad day, it's because I just CRAVE something so bad I can't resist. It's never sweets, but things like taco bell, pho, sushi... and while not bad on it's own, I do it so seldom I eat till I'm stuffed. It would be nice to not have those cravings. I'd say once a month one hits me.
Anyway, we'll see what happens. Ozempic has some amazing success stories so I'm hoping I'll be one of them and can get off fairly quickly.

Xellercin · May 2022

mikomarcia wrote: »

So yesterday I spent the day with the specialist and her team. Ultimately tests determine I am insulin resistant. They were very pleased with my diet and activity levels. So they put me on Ozempic. It's not cheap but my insurance will cover it with prior auth. Luckily, I am NOT a chronic overeater. I never have been. I am also very active. (20-30 mile bike rides on weekends, tennis player) but this does explain a lot. She said she could tell without tests what my problem was since all my weight was in my belly but I have skinny arms and legs. So, after going over everything, I'll give it a try. The nice thing is that it isn't a forever drug. Just until my bloodwork is normal or I reach my goal weight. Side effects seem fairly low too. So we'll see. They start you low and work up the dosage. She said the first month I shouldn't expect much as it's really more to get my body used to the medication. Either way, I'll be monitoring it closely. Hopefully the other test results (which I'll get in a few days) don't show any other underlying issues. Hopefully I can manage this. I have to admit, the naltrexone is interesting to me, too. When I do have a bad day, it's because I just CRAVE something so bad I can't resist. It's never sweets, but things like taco bell, pho, sushi... and while not bad on it's own, I do it so seldom I eat till I'm stuffed. It would be nice to not have those cravings. I'd say once a month one hits me.
Anyway, we'll see what happens. Ozempic has some amazing success stories so I'm hoping I'll be one of them and can get off fairly quickly.

I personally would choose really good therapy over naltrexone.

Cravings can be driven by physiological signals, like when people with low iron obsessively crave eating dirt or something like that. But the majority of people experience cravings because of emotional reward pathways that have become reinforced through repetitive behaviour, and this can be effectively modified through the appropriate therapy.

This is WAY more effective longterm because it helps the person better understand their relationship with food and modify it to be healthier permanently. Whereas something like naltrexone has significant side effects and the affect will disappear when the person stops taking it.

No one would suggest that a drug/alcohol addict *just* take naltrexone and not work on the psychological side of their behaviour, that would be nuts, but the naltrexone helps make abstaining a lot easier *while* they work on those issues. It doesn't solve the problem, it acts as a support while they do the real work of healing.

Again, as I said in my previous post, the key is to understand the underlying sources if challenge and to address them with the most appropriate supports. There's no way I would ever recommend someone take naltrexone to manage food cravings without them having already been in effective counselling, and their counsellor is suggesting that they could use a pharmaceutical support at this phase of their therapy.

Naltrexone, whether regular dose, low dose, or ultra low dose can be totally unpredictable. It might lower your enjoyment of fast food, but it might also blunt the sensations of sex, exercise, spending time with your loved ones, and the satisfaction of doing a good job at work.

You can't just cherry pick which satisfying experiences it blunts.

I've often said that the best diet is a good therapist, and I stand by that.

Annabobanna1985 · May 2022

cwolfman13 wrote: »

mikomarcia wrote: »

Thank you all. I certainly will not take Phentermine. Someone tried to give that to me a long time ago. It scares me too much. I really DON'T want to take anything, but I'm also ignorant on some of the newer options. It always seems like they're trying to get me to take something, and if there was a good, safe, option I'd be foolish to not consider. It's all overwhelming.

The only one I would even consider would be naltrexone-bupropion. It's pretty safe. Naltrexone is primarily used for AUD and opioid use, but there have been good findings for weight loss as well. It works primarily to disrupt the pleasure receptors in the brain...so for me, I can drink on naltrexone and I can get drunk...but it just makes it not particularly pleasurable or fun and I don't get much out of it so it has slowly but surely changed my drinking behavior. Bupropion is an anti-depressant and somehow this combination has shown to work well with people who have binge eating disorders and things like that.

I'm currently taking this and am experiencing the above description. The naltrexone seems to curb my more addictive behavior with food and alcohol and I guess the bupropion makes me feel ok about it? I'm adding an intermittent fasting schedule along with at least two miles of walking mod pace to see if I can finally get to my Weight Loss goal

gregsbabe12 · May 2022

I took Phentermine for a few months years ago, then ended up with AFIB and heart palpitations, so I don't recommend that one lol Lost tons of weight though, but put it back on.

mikomarcia · June 2022

Just in case anyone wants an update. I've been on Ozempic for a month. And I've lost about 6lbs and 2 inches off my waist. I am on the lowest dose and tomorrow I start 7mg. I feel suprisingly good and more mentally sharp than I have in probably two years. What I really like is the weight is coming off my belly and neck. Usually I lose weight everywhere BUT the issue areas. Doctor is thrilled as we didn't expect any real changes this month.

kshama2001 · June 2022

Thanks for the update!

Medication to aid weight loss?

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