New products to try to lose weight

Mahitab Hany, BS Pharm, PGDipClinPharm, PGDipClinNutrition

People will be trying various products to try to lose weight. People typically lose just 5 to 10 pounds in a year with orlistat (Xenical, etc) 120 mg PO TID with each main meal containing fat (and a diet with ~30% of calories from fat), phentermine or diethylpropion (phentermine and diethylpropion are NOT available in EGYPT). So many people are looking for new options...

          Human chorionic gonadotropin (HCG, Pregnyl, etc). Proponents say this pregnancy hormone and fertility drug redistributes fat, decreases hunger and improves mood in women. But there's NO proof to these claims. Explain that any weight loss is likely from the low-calorie diet that's used with HCG. Exenatide (Byetta) 5 to 10 mcg SC every 12hr and Liraglutide (Victoza, Saxenda) 3 mg subcutaneously once daily (start with 0.6 mg once daily, increase dose weekly by 0.6 mg to goal of 3 mg once daily). Diabetes patients on these medications can lose 4 to 5 pounds and sometimes much more. Now these drugs are being approved to help patients WITHOUT diabetes lose weight. For adults, discontinue after 16 weeks if <4% (after 12 weeks if < 5% [Canada]) weight loss achieved. See also "Wegovy for weight loss" and "Explaining the role of Mounjaro for Type 2 Diabetes".

Thyroid hormone (Euthyrox, Eltroxin). Many people are tempted to take thyroid hormone to boost their metabolism, but this isn't safe. Explain that too much can lead to heart palpitations, bone loss, etc. Also advise patients to stay away from "thyroid booster" supplements that contain iodine, kelp, or animal glands. New combos (NOT available in EGYPT) contain phentermine or bupropion which are already used for weight loss, plus a second drug to try to enhance the effect. Metformin (Glucophage) can be used for adults with overweight and obesity and prediabetes, polycystic ovary syndrome, or antipsychotic-associated weight gain. Bupropion (Abstain, Fumiban) 150 mg twice daily may promote weight loss in women with overweight and obesity with binge eating disorder. Topiramate (Topamax) monotherapy at varying doses (25 mg orally daily, titration, once weekly over 8 weeks to 400 mg/day) may reduce weight in patients with obesity, but its use may be limited by high rate of adverse effects (abnormal vision, drowsiness, constipation, etc), it acts as appetite suppressant and improves glycemic control in obese patients. Zonisamide (Convagran) 400 mg daily plus diet and lifestyle counseling may improve weight loss in adults with obesity.

Sensa (maltodextrin plus flavorings - NOT available in EGYPT). Sensa claims to trick the body into thinking it's full, by intensifying flavor when it's sprinkled onto food. But there's no reliable evidence it works. Explain that no current supplement is a magic bullet for weight loss. FOR MORE INFORMATION, get our guidance "7 Diet, a professional guide for weight loss" to help overweight and obese patients.

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