Using drugs to handle weight: Benefits and risks


Cover pix: Oops, I took the wrong pills!

Of prescription weight loss medicines – what to look out for.

WE’RE now rated numero uno among Asian countries for obesity. New findings from British medical journal The Lancet showed that staggering 49% of Malaysian women and 44% of men were obese.

According to the new study published in May, Malaysia was rated most overweight at 45.3% of its population, followed by South Korea (33.2%), Pakistan (30.7%) and China (28.3%).

There are numerous over-the-counter weight loss supplements, such as fat burners and fat binders. Many of these utilise ingredients containing caffeine, such as green coffee or green tea extracts, to increase your metabolism. Meal replacement drinks are also widely available from sport stores and pharmacies.

However, certain weight loss medicines are only available by prescription from a doctor’s clinic or pharmacy. You would need to consult a doctor and get a prescription in order to purchase these medicines, as they are controlled drugs that may have side effects.

Let’s discuss the common weight loss prescription drugs in this article.

Phentermine

Phentermine is a prescription medication used to suppress appetite and make you feel full faster. Your favourite nasi lemak and char koay teow would no longer pique your interest. Eating a few spoonfuls of rice would make you feel satiated, whereas previously, you could easily wolf down a plate or two.

Phentermine may be a way to kick-start your weight loss if you’re obese. It is not for those who only need to lose a couple of kilos.

Once you stop taking it, there’s a possibility you will regain the weight you have lost if you do not continue controlling your food or exercise.

For this reason, phentermine should be part of a plan that includes healthy eating and regular exercise. You’re much more likely to maintain your weight loss for the long term if you don’t rely on medications alone.

I advise my clients on phentermine (or any sort of weight loss programme, for that matter) to exercise at least five times a week, half an hour each time if possible. A combination of aerobic exercise such as jogging, and muscle toning exercises like weight training, give the best result.

Those who desire to lose weight effectively should eat small, healthy and frequent meals. Eating every three to four hours will help increase your basal metabolic rate.

Of course, instead of chugging down mee goreng and nasi briyani every three to four hours, you should instead choose healthy, nutritious food, such as wholemeal bread, whole grains, lean meat, vegetables and fruits, except for too much durian – the king of fruits is also king of calories, sugar and fat.

The method of preparing the food also plays a role in your weight loss journey. Opt for steamed, boiled and grilled foods, instead of deep fried.

Phentermine is approved only for short-term use. It should not be used for more than three months at a go. As with any medicines, it carries possible side effects. These include feelings of thirst, which is why I advise my clients to drink lots of water.

As the medicine stimulates the nervous system, there is a possibility of palpitations (fast heartbeat) and fine hand tremors. However, you will feel very energetic and your usual jogging session at the park would suddenly be a cinch.

For some clients, they may have difficulty sleeping at night due to the higher level of stimulation to the central nervous system, so I would advise my clients to take the medicine early in the morning, preferably right after waking up.

That way, the drug would be out of the system when it’s time to hit the sack. Some folks would be easily irritable and moody when on phentermine. They may feel like snapping at anyone and everyone at the slightest provocation.

Luckily, not everyone will experience the side effects of this drug. Some people will hardly have any side effects, as it is a very individual response. And for those who experience them, the unwanted effects may go away by itself after a few weeks as the body adjusts to the medicine.

Not everyone should take phentermine. It is a no-no for those with untreated heart disease, uncontrolled high blood pressure, overactive goitre and definitely should be avoided by pregnant ladies and breastfeeding mothers.

It is extremely important to have a consultation and physical examination by your doctor first before commencing treatment.

After reaching your desired weight loss goal, you should discontinue the use of phentermine after discussing with your doctor. Remember that the drug is not a long term solution and you would need to continue eating healthy and exercising regularly after discontinuing this prescription medicine.

Failure to do so would inevitably result in the weight creeping back up.

Orlistat

Orlistat is a weight loss medicine that works by blocking enzymes in the gut which digest fat. About a third of the fat that you eat does not get absorbed. Instead, it is passed out in the stool.

The normal dose is one capsule, three times a day with each meal. However, you can skip the medicine if the food you’re consuming does not contain fat.

Studies show that those on orlistat, combined with a healthy diet and regular exercise, lose more weight compared to those on diet and exercise alone. Some people lose up to 10% of their body weight within six months of starting orlistat, whereas for others, the weight loss is not as much.

Your orlistat is not a license for you to eat yummy food as much as you desire. While on this medicine, you would still need to reduce your fat and simple carbohydrate intake.

If you still consume lots of your favourite roti canai or fast foods, the beneficial effects of orlistat would be negated by the fact that you’re increasing your caloric intake.

Orlistat is not for everyone who wants to lose the pounds. Your doctor would need to ensure that you have already attempted a weight-reducing diet and frequent exercise, but were still unsuccessful in shedding the kilos.

This medicine is only for those with a body mass index (BMI) of 30 or above; or 28 or above if you have a medical condition that would benefit from losing weight, such as diabetes or hypertension.

There is no restriction on how long orlistat can be taken if the medicine is helping in your weight loss. Your doctor would monitor you regularly to decide how long you should be on this treatment.

Some people take it for even a year or two if they have a lot of weight to lose.

The most common side effects are caused by the fat, which is passed out in faeces. You may get fatty, oily stools and excess wind. There may be occasions when oil leaks onto your underwear, which is extremely inconvenient.

These unpleasant side effects are less likely to occur if you reduce the amount of fat and oil that you consume. Other side effects are rare.

> Dr Chen Tai Ho is an experienced aesthetic doctor who chills by the pool sipping espresso latte when he’s not attending to his beloved patients. For further information, e-mail starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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