On Wednesday, June 11, a new prescription weight-loss medication that combines a popular antidepressant with a medication for addiction will be reviewed by the Federal Drug Administration (FDA) for potential approval.
Losing excess weight and keeping it off is not as easy as simply popping the right pill, but medications can be a part of a healthy weight-loss diet, said an internationally recognized medical weight-loss specialist.
"Prescription drugs are no substitute for low-fat, high-fiber balanced diets coupled with regular exercise, but medication can help increase weight loss in some people," said Bipan Chand, MD, FACS, FASMBS, FASGE, director of the Loyola Center for Metabolic Surgery & Bariatric Care.
Americans spend an estimated $20 billion annually on weight-loss products, including medications.
The new prescription medication is a combination of two FDA-approved drugs, bupropion, an antidepressant, and naltrexone, which reduces the desire for drugs and alcohol. Both have been found to increase weight loss in independent research trials and combining the two in one capsule is believed to create a synergistic effect. In clinical trials, patients taking the new medication while following a diet and exercise program lost more weight than those taking a placebo and following the same diet and exercise regimen.
In a 56-week period, the nonmedicated group lost 11-16 pounds while the medicated patients lost 20- 23 pounds.
In February 2011, the FDA requested a large-scale study of the long-term cardiovascular effects of the drug before considering approval.
"Many medications for various conditions have been found to have weight loss as a side effect, and conversely, many medications can cause weight gain," Chand said. Weight-loss medications commonly involve an appetite suppressant and a metabolism booster. But not all patients can tolerate prescription weight-loss medication.
"Many obese patients are on medication for chronic conditions, such as heart disease, high blood pressure, high cholesterol, depression and diabetes," Chand said. "Adding another medication must be carefully assessed to make sure it has a positive and not a negative effect on the patient's health."
More than two-thirds of American adults are overweight or obese and 1 in 3 American children and teens are considered obese.
"Behavioral therapy, nutrition counseling, physical exercise and surgery as well as medication are all instruments in the weight-loss toolbox," said Chand, who is a board-certified metabolic surgeon at Loyola, an accredited Level 1 facility under the Bariatric Surgery Center Network (BSCN) Accreditation Program of the American College of Surgeons (ACS).
"Bariatric surgery has been the most effective tool in achieving long-term weight loss, which leads to overall improvement in health, reducing or eliminating chronic conditions and medications and increasing years of life," said Chand, who performs bariatric surgeries.
"At Loyola, we treat obesity as a complex disease and design a treatment solution tailored to each patient," Chand said. "Medication may be prescribed but so is meeting with a dietitian to design a better diet, attending support groups for education and encouragement, working with an exercise physiologist to get moving, seeing an internal medicine physician for overall health assessment and monitoring and potentially scheduling bariatric surgery for a more permanent solution," Chand said. "Many Loyola weight-loss patients succeed with medication or surgery and many succeed without medication or surgery. Our medical team of board-certified bariatric professionals work together with the patient to find the right solution."
Since opening on July 10, 2012, at Loyola's Melrose Park campus, a multidisciplinary team of bariatric-certified professionals, including surgeons, psychologists, dietitians, exercise physiologists and physicians has cared for hundreds of morbidly obese men, women and children.
Surgical procedures offered by Loyola include laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy.
The Loyola Center for Metabolic Surgery & Bariatric Care underwent a voluntary evaluation conducted by an independent team of experienced bariatric surgeons. Loyola was deemed to meet the rigorous, nationally recognized standards outlined by the BSCN ACS for:
- Safety of the bariatric surgery patient
- Documented, quality surgical outcomes
- Standards of practice
- Highly trained and experienced medical professionals
- Specially designed facilities to accommodate obese patients and their families
- Comprehensive medical, nutritional and psychological support throughout the treatment process