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 of age - 120mg three times daily with meals. |
Treatment Effect: Liquid or oily stools, oily leakage from rectum, faecal incontinence, flatulence, malabsorption of vitamins. |
Sibutramine (Reductil) |
Re-uptake inhibitor of seroton and nor-adrenaline. (People feel full longer). |
10mg per day initially, can increase to 15mg/day. Maximum period of treatment - 1 year. |
Constipation, dry mouth, nausea, tachycardia, palpitation, arrhythmias, hypertension. |
Rimonabant (Accomplia) |
Cannabinoid receptor antagonist. (Reduces food consumption, plus enhanced metabolic benefits). |
Adult over 18 years - 20mg daily before breakfast. Not licensed for use over 2 years. |
Nausea, vomiting, a dry mouth, diarrhoea, mood changes, irritability, sleep disorders. Rarely, hallucinations. |
N.B. Orlistat and Sibutramine have National Institute of Clinical Excellence (NICE) approval.
Rimonabant is currently undergoing initial Nice appraisal.
Click on the links for details of:
Amended April 2008
