Author: Jim Morelli, MS, RPh
Medical Editor: Louise Chang, MD
Taking a weight loss drug may not result in weight loss by itself. But using diet pills can help an overweight person stay on a diet because nearly all of these medications work on suppressing appetite. "Feeling full" is believed to be related to a number of biochemical processes in the body. Signals to indicate fullness come from fat cells and the gastrointestinal tract; these converge with signals in the central nervous system. Appetite suppressants target a couple of key neurotransmitters in this process: serotonin and norepinephrine. Increased levels of serotonin result in a feeling of fullness. Increasing norepinephrine levels stimulate the central nervous system, decreasing appetite. Only one drug among the weight loss medications works in a different way. Orlistat (Xenical, Alli) works in the gastrointestinal tract to prevent absorption of about a third of ingested fat.
Weight loss medications are best suited for those with BMIs of 27 or greater, when there is at least one other risk factor (such as diabetes or high cholesterol) present, or in patients with no other risk factors who have BMIs of 30 or greater. However these guidelines are not absolute. Physicians may avoid using certain prescription diet pills in patients with hypertension, cardiac disease, hyperthyroidism or glaucoma – as well as in those with a history of drug abuse.
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