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The weight loss drugs Qsymia and Belviq give hope to obese patients, but questions of their effectiveness compared to diet and exercise remain. Glycine propionyl L-carnitine is also a popular supplement for those working out and watching their weight.
It’s not that diet pills are a dime a dozen, although a few are close; but there are many, many of them. Few of them are actually effective, or to put it another way, the U.S. Food and Drug Administration (FDA) approves very few of them.
In fact, the FDA has approved no new weight loss drugs in thirteen years. Now in short order, it has approved two drugs, Qsymia (Vivus Pharmaceutical) and Belviq (Arena Pharmaceuticals).
There are important differences and similarities between the two drugs which can be very clear with the use of a 10 panel drugs test. The FDA considers both of them ‘controlled substances,’ meaning they are sold under restrictions and controls similar to narcotics. They are also drugs that work by affecting the chemistry of the brain.
Qsymia is a combination of two relatively common and FDA approved drugs, phentermine and topiramate. Phentermine, an appetite suppressant, was part of the notorious diet drug fen-phen (fenfluramine phentermine).
The ‘fen’ part turned out to cause fatal lung and heart valve problems, which caused the widely sold drug from the market. Phentermine, the safe part of fen-phen, works by triggering the brain to release norepinephrine, which in turn increases output of the hormone leptin, an appetite regulator.
The other drug in Qsymia, topiramate, is a drug used to control seizures and migraines. It also has several weight loss effects – an increase in the sense of fullness, a decrease in the appeal of food taste, and an increase in the burning of calories.
Belviq works by stimulating production of the brain messenger chemical serotonin. For weight loss, the dosages are relatively low and the serotonin produced does not have the powerful hallucinogenic effects as, for example, the stimulus of LSD.
Both drugs target obesity. In fact, it was the growing problem of obesity that prompted the FDA to approve these drugs in the first place. They are designed for people with a body mass index (BMI) of 30 or greater, or people with a BMI of 27 or more who also have at least one weight-related conditions such as type 2 diabetes, high blood pressure or high cholesterol.
However, there are many restrictions of who can use the drug: Neither medicine should be taken by pregnant women because of the risk of birth defects; Qsymia should not be taken by people with glaucoma, people with overactive thyroid conditions, people taking the anti-depressant MAIO and, of course, people who are allergic to phentermine or topiramate. Belviq should not be taken by people using drugs to treat heart valve diseases.
If you’re getting the picture that these are relatively powerful drugs that must be prescribed and taken with serious precautions – that is quite right. There is another important factor, price.
Both drugs are expected to be moderately expensive, with Belviq in the range of $3-$4 per day, and Qsymia somewhat higher. (The companies have not announced final pricing.)
Of course, the big question for both drugs is how effective they will be. Based on placebo-controlled clinical trials (Phases I, II and III), Belviq had an average weight loss of 3%-3.7% and over a two-year period people without diabetes lost at least 5% of body weight.
Qsymia results were somewhat higher, with an average one-year weight loss of around 9%. Because the trials had different designs, the two drugs should not (yet) be compared to each other.
Finally, both drugs are intended to be used in combination with a calorie reduced diet and a regimen of regular exercise – for the rest of a person’s life. This means that taking the medicine alone will not result in substantial weight loss.
The obvious question people are asking, “Is it worth the expense, potential side effects (especially long-term), and the usually required diet and exercise regime to get, at best, a 5% to 10% weight loss?”
The alternatives help frame the answer. Bariatric surgery, which includes a variety of procedures to shrink the size or food absorption capacity of the stomach or intestines, is quite effective with weight loss in the range up to 40%-65%. It carries the obvious risk of surgically modifying internal organs and is a relatively expensive once or twice procedure. In general, bariatric surgery is mostly recommended for people with morbid obesity (BMI of 40 or greater).
Traditional ‘diets’ of reduced food (calorie) intake and increased regular exercise continue to be the mainstay of weight loss efforts. Most diet and exercise programs are not expensive, generally have few or no side effects (unless they’re extreme in some way), and may have significant short term results (up to about 50% weight loss). The problem, as most people discover, is the difficulty of maintaining a diet or target weight.
In addition to the handful of FDA approved, prescription only, weight loss drugs, there are literally hundreds of ‘natural,’ herbal, food-additive, and appetite booster dieting supplements as you can get them as easy as going online at sites like kratommasters.com to get the best supplements. This is a huge industry, estimated around $50-60 billion a year in the U.S. alone.
Unfortunately, most of these products do not have rigorous clinical trials to prove (or disprove) their effectiveness. They rely on anecdotal evidence or intuitive plausibility to make their case, which is to say, they range from completely ineffective to slightly helpful.
Considering the alternatives, there is no ‘silver bullet’ to guarantee weight loss, especially in the long-term. Given the rising levels of obesity throughout the world, research will continue to look for effective treatments.
In that regard, Qsymia and Belviq are tip-of-the-iceberg products of a large pharmaceutical development effort. There will be other products, hopefully more effective and less costly. It is no longer the realm of science fiction to “take a pill and achieve an ideal weight.”
Reference: Drug Rehabilitation Miami.