The current range of options for medications for weight loss is not encouraging. The only medication approved by the FDA for long-term use for weight loss is orlistat, available over the counter by the brand name Alli, or Xenical by prescription. It is only modestly effective and its most common side effect, diarrhea and greasy stool, is somewhat icky. The rest of the medications used for weight loss are only effective for a few weeks and have the potential for addiction. Even these riskier medications don’t provide significant sustained weight loss.
And that’s just the weight loss drugs that are still available. Others, like Meridia and fenfluramine, have been withdrawn from the market because of serious side effects.
Two years ago I wrote about a new weight loss medication, lorcaserin, which was at that time meandering through the FDA approval process. So far, it seems much safer than other weight loss medicines. This week, lorcaserin cleared a major hurdle for FDA approval, gaining a recommendation from a committee that advises the FDA on this class of drugs. If approved by the FDA in June, lorcaserin would be the first new weight loss drug available to patients in over a decade.
Before we get too excited, we should realize that the weight loss achieved in the trials was not spectacular. On the medication 38% of patients were able to lose 5% or more of their weight over a year, compared with 16% of patients taking a placebo. The average weight loss on the medication over a year was 3%. That’s pretty tiny, but still better than those on placebo, which should remind us how tough it is to lose weight.
Until June, the best advice I have for most people trying to lose weight is to get plenty of sleep, eat a little less, and exercise a little more. Weight loss surgery is probably the most effective choice for those who are extremely overweight, especially if their weight has resulted in health consequences such as diabetes.
My previous posts about lorcaserin: