By Mary Pickett, M.D.

I wish we had diet pills that could help people lose weight easily. None of the medicines on the market are worth using, if you ask me.

Drugs for weight loss that are sold over-the-counter, such as dietary supplements and appetite suppressants, don't have a strong effect on weight loss. And using these drugs can cause side effects.

Prescription weight loss drugs have drawbacks, too.

They include orlistat (sold as Xenical and Alli), sibutramine (sold as Meridia) and phentermine (sold as Adipex and Ionamin). In some

European countries, you can buy rimonabant (sold as Acomplia). It is not sold in the United States.

How do these weight loss drugs "size up"?

They're not very impressive. According to a study reported in the British Medical Journal, after using the drugs for 1 to 4 years, people lost:

    - 6 pounds on average with orlistat

    - 9 pounds on average with sibutramine

    - 10 pounds on average with rimonabant

Previous studies have found an average weight loss of 2 to 13 pounds with phentermine.

Most patients would need to spend more than $1,000 a year on the drugs in order to see these results. Cost is one reason that a lot of users don't stick with these medicines.

Another problem with weight loss medicines is their side effects:

    - Orlistat causes oily stool, grease spots on underwear, and uncomfortable urges to have a bowel movement in up to one-third of people who take it. It also may decrease the absorption of vitamins from your diet.

    - Sibutramine raises blood pressure and pulse rate. In up to 1 out of 5 patients, it can cause insomnia, nausea, dry mouth or constipation.

    - Rimonabant was associated with symptoms such as depression and anxiety in up to 1 out of four users.

    - Phentermine can cause a rapid heartbeat, high blood pressure, restlessness, anxiety, or diarrhea.

As old-fashioned as it sounds, modest daily calorie intake and regular exercise are still the cornerstones of weight control.

Weight loss drugs certainly can be a part of treatment for a person who is severely overweight. However, they're not good enough to substitute for other strategies.

I don't recommend them for most people who need to lose weight.

Mary Pickett, M.D., is an Associate professor at Oregon Health and Science University, where she is a primary care doctor for adults. She is a Lecturer for Harvard Medical School and a Senior Medical Editor for Harvard Health Publications.

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The Drawbacks and Risks of Weight Loss Drugs & Diet Pills

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