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Is the new obesity pill a miracle drug? As with all these drugs, it’s approved by the FDA for people who are obese—they have a body mass index (BMI) greater than 30 (for example, someone who is 5’6″ would have to weigh more than 185 pounds); or for people who have a BMI greater than 27 (such as a 5’6″ person who weighs 167 or more) with an obesity-related condition such as diabetes, sleep apnea, high blood pressure or high cholesterol. You can calculate your BMI here.
Lorcaserin (Belviq) is a brand-new molecule that stimulates the area of the brain that regulates appetite and satiety, explains Scott Kahan, MD, MPH, the director of the National Center for Weight and Wellness in Washington, DC. Belviq takes aim at the brain receptors for serotonin, a brain chemical that plays a role satiety. (Serotonin also plays a role in mood regulation.)
What can you expect? Studies comprising nearly 8,000 obese and overweight people who took Belviq show an average weight loss of 3 to 3.7 percent, and those who combined the drug with diet and exercise lost even more. His rule of thumb is that if you do not lose 5 percent of your weight after 12 weeks of treatment, you likely will not respond. “We are seeing good weight loss in about 50 percent of patients and it is very safe,” he says. Both cholesterol and blood sugar levels also seem to decrease among Belviq users. Side effects may include headache, dizziness, fatigue, nausea, dry mouth, constipation, and low blood sugar for people who take drugs to treat diabetes, but there is a very low likelihood of these, he says. It is among the best weight loss pills when it comes to safety. “One of the feathers in Belviq’s hat is that it is very well tolerated,” he says. That said, people with a history of heart disease, psychiatric disorders and those who are pregnant should not take this medication. The FDA’s advisory panel initially rejected this weight loss pill due to risk of tumors seen in animal studies, and the European Medicines Agency was so concerned about the drug’s safety that it rejected Belviq. However, an analysis in JAMA indicates that Belviq is linked to fewer adverse events than other Rx weight loss pills.
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Approved in 2014, Saxenda stands out from the Rx weight loss pill pack because it is the only one given as shot. It is a higher dose of an older diabetes drug called Victoza. Saxenda mimics the effects of GLP-1, 1 (glucagon-like peptide), a hormone made in the intestines, that curbs appetite.
What can you expect? Study participants who ate a reduced-calorie diet, increased their exercise regimen and took Saxenda lost an average of 18 and a half pounds over 56 weeks. By contrast, those who made these lifestyle changes, but received a placebo instead of Saxenda lost just six pounds. These findings were published in the New England Journal of Medicine. “I have seen great results with Saxenda especially in patients at risk for diabetes and those who have a family history of diabetes,” says Reshmi Srinath, MD, assistant professor of Diabetes, Endocrinology, and Bone Disease at the Icahn School of Medicine at Mount Sinai in New York City. To know whether you’re at risk, check to see if you have these seven habits that raise your chances of developing diabetes. Saxenda side effects may include nausea, which can be severe, vomiting, diarrhea, constipation and/or low blood sugar, Dr. Kahan says.