Treatment
Some people find it impossible to alter their lifestyle and diet sufficiently to lose weight or maintain weight loss after a trial period (usually 3 months) of supervised diet, exercise and behaviour modification.
Therefore there may be a place for some drugs (if medically appropriate), which control appetite, alter metabolic rate or inhibit absorption of calories. It is felt that weight-loss medication is only appropriate for persons with a BMI of 30 or more or a BMI of 27.0 to 29.9 with co-morbid conditions.
The drugs licensed for the treatment of obesity are:
Weight Loss Medications
| Medication | Mechanism of Effect | Dosage | Side Effects |
|---|---|---|---|
|
Orlistat (Xenical) |
Lipase inhibitor – it reduces the absorption of dietary fat. | Over 18 years, 120 mg taken immediately before, during, or up to 1 hour after each main meal (max. 120 mg 3 times daily); continue treatment beyond 12 weeks only if weight loss since start of treatment. Treatment should only be given beyond 12 months after discussion with the patient regarding side effects. |
Treatment Effect: Liquid or oily stools, oily leakage from rectum, faecal incontinence, flatulence, malabsorption of vitamins. |
N.B. Orlistat has National Institute of Clinical Excellence (NICE) approval.
Sibutramine (Reductil) and Rimonabant has been withdrawn as the risks outweigh the benefits.
Some patients may be given Methylcellulose, but there is little evidence to support its use in obesity.
Amended October 2012
