Once someone chooses to lose weight, the thought of losing the most weight in the shortest period is often the expectation. It may or may not be realistic, and the motivation may be
different for each individual, but overall the common request from my patient is this: “Doctor, what is the magic pill?”
My experience ranges from running my private practice to an academic institution and now in the private industry; the common theme is the search for the magic pill.
There is no magic pill. There, I’ve said it!
Living healthy takes effort. Changing eating habits is hard. Exercise is painful. I get it. But sadly, we have to do it. Look around! For every healthy person you see, likely, they have put in some effort to maintain their physique and probably count either calorie, carbs and/or proteins daily and are mindful about their health. They are probably wearing a fitness device to track their activities.
So, if you are about to sign onto a weight loss program; you better be ready to make changes and not for four weeks, or 10 weeks but forever. If there is anything that you don’t want to do such as:
1. Cutting out sugars in your diet
2. Refusing to move your body more
3. Trying your best to manage stress, then please don’t waste your money in any weight loss program.
Now that you are ready for the change, you step into your physician’s office and he/she may offer you a nutrition program, teach you how to decipher the nutrition facts label, buy various supplements on their shelves, give you an injection in your buttock and lastly, the offering of this so-called prescribed “appetite suppressant.”
Anti-Obesity Pharmacotherapy
There are now over six different FDA-approved medications on the market, and it ranges from sympathomimetics to novel satiety hormone. I will discuss the use of phentermine because it
has the longest track record and it is—well, affordable! I have had experiences in prescribing all the appetite suppressants since I came out of my medical training and I am passionate about their indicated uses; not because it’s a magic pill, but it is an accessible tool that allows the patient to have the opportunity to control their cravings and urges to eat inappropriately.
Phentermine is a sympathomimetic that has the active compound to work in the brain targeting receptors that causes us to ruminate about food items that get us in trouble. The fact is, our desires and urges to eat become stronger as we gain more weight because our very own fat cells release hormonal signals to the brain to increase intake and to keep storing fat. So, the more weight we gain, the hungrier we get. The use of medication is indicated when patients feel this overwhelming thought, desires and urges that they cannot shut down. The standard
doses are 15mg, 30mg, and 37.5mg but the higher the dosage, the more side effects one may feel.
When LOMAIRA came out to the market, it made total sense. It is a smaller dose at 8mg a tablet that can be taken three different times throughout the day and as late as 30 minutes before
dinner. Its fast action allows the patient to have more control on a meal to meal basis. Studies have shown that the efficacy of an 8mg tablet is comparable to a 15mg tablet without any
change in one’s blood pressure or pulse. What I really like is the control that my patients now have, which in most cases has been an ongoing issue when it comes to choosing foods that are highly calorie dense.
Phentermine is not for everyone, ask your doctor if you are a candidate. If for any reasons you cannot tolerate stimulants, there are other medications on the market such as the combination use of naltrexone and bupropion which is a great option to target specific cravings; at a higher cost. If pill taking is a problem and you don’t mind a small daily injection, something called liraglutide may be a better option for you since it mimics our body’s level of satiety hormone which keeps us feeling less urges and hunger. Whatever route you choose for weight loss make sure it is safe and recommended by your physician.
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