DEAR DR. ROACH: I’m wanting for recommendation on slimming capsules. I’ve tried all the things. I eat effectively, go to the health club and stroll, however my meniscus drawback limits my strolling velocity. Since menopause, I’ve gained 30 kilos. I’m certain there’s something on the market that can kick-start my metabolism. I’m so depressed, and my physician has no sympathy. — A.R.
ANSWER: Difficulty shedding extra weight is likely one of the best public well being issues in industrial nations, and I am not going to unravel it right here, however I will attempt to talk about rules of drug remedy for weight.
One essential challenge is to take a look at any drugs you’re taking: Many may cause weight acquire, and a few, like beta blockers, typically used for hypertension, are unrecognized by many medical doctors. Stopping medicines that predispose to weight acquire is essential.
Depression itself is a predisposing issue to weight acquire. Some individuals lose weight with despair, however my expertise is that weight acquire is far more widespread. Many anti-depression medicines trigger weight acquire. One, bupropion, generally causes weight loss.
Among medicines particularly for weight loss, most work both by lowering fats absorption or by decreasing urge for food. They do not actually improve metabolism, apart from phentermine, which does improve resting vitality expenditure considerably and could also be helpful in stopping weight regain in individuals who have misplaced weight, for whom metabolism does typically decelerate.
Orlistat (referred to as Xenical by prescription, Alli over-the-counter) prevents the physique from absorbing a number of the fats within the weight loss program. The fats is then excreted by stool. This could trigger many individuals to have gastrointestinal unintended effects, that are diminished when on a low-fat weight loss program. Orlistat triggered individuals to lose about 7 kilos greater than placebo.
There are a number of medicine that work on urge for food. Liraglutide is a diabetes medication that has been discovered to be useful in obese individuals even with out diabetes. Metformin is one other diabetes medication that’s generally used for weight loss, though it doesn’t have a Food and Drug Administration indication for this. Both of those diabetes medicine typically have gastrointestinal unintended effects. Lorcaserin (Belviq) is about as efficient as orlistat, however with fewer unintended effects (headache was the most typical). Some weight loss specialists use mixture medicine, together with phentermine/topiramate (Qsymia) and bupropion/naltrexone (Contrave). These have extra vital dangers. I do not prescribe these medicine, however I do refer my sufferers who’re fascinated by medicine remedy to a weight loss professional. Look for a physician who’s board licensed in weight problems administration.
It’s necessary to keep in mind that drugs usually are not a remedy for being obese. Once the medicines cease, weight is anticipated to rise, except an individual makes vital modifications in weight loss program and train.
DEAR DR. ROACH: Recently, some mates and I thought of taking OTC movement illness tabs day by day, even when not boating. Then, we would all the time be prepared for any movement illness conditions. It looks like an awesome concept, however would we develop a tolerance for movement illness tabs and must take extra as time goes by? — J.W.
ANSWER: I do not advocate it. OTC movement illness tablets are usually antihistamines, they usually have the potential for unintended effects, particularly sleepiness, falls and motorcar accidents. More importantly, there’s some proof of tachyphylaxis — that they are going to be much less efficient over time. Taking the next dose is perhaps simpler, however then the chance of aspect impact turns into even greater.
I’d advocate protecting the movement illness tablets with you (and even in your boat), so you might be prepared anytime.
Dr. Roach regrets that he’s unable to reply particular person letters, however will incorporate them within the column every time doable. Readers could e mail inquiries to ToYourGoodHealth@med.cornell.edu or ship mail to 628 Virginia Dr., Orlando, FL 32803.