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Anti-obesity drugs or weight loss drugs are pharmacological agents that reduce or control excess body fat. These drugs alter weight control, one of the basic processes in the human body: reduce appetite, thereby increasing energy intake, increasing energy excretion, redirecting nutrients from adipose to lean tissue, or interfering with caloric absorption.
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Weight loss drugs have been developed since the early 20th century, and many have been banned or withdrawn from the market due to adverse effects, including deaths; Other drugs proved ineffective. Although many of the earlier drugs were stimulants such as amphetamines, in the early 2020s, GLP-1 receptor agonists became popular for weight loss.
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A combination of low-calorie diet and increased physical activity is approved by the US Food and Drug Administration (FDA) for weight management. As of 2022, no drug has been proven to be as effective for long-term weight loss as bariatric surgery.
Weight loss efforts were first described by the Greek physician Soranus of Ephesus in the 2nd century AD. He prescribed laxatives and purgative elixirs, heat, massage, and exercise. For more than a thousand years it has remained a mainstay of treatment. New treatments did not begin to appear until the 1920s and 1930s. Based on its effectiveness for hypothyroidism, thyroid hormone has become a popular treatment for obesity in euthyroid people. It had a modest effect but caused symptoms of hyperthyroidism such as palpitations and difficulty sleeping as a side effect.
2, 4-dinitrophol (DNP) was introduced in 1933; It worked by disrupting the biological process of oxidative phosphorylation in the mitochondria, causing it to produce heat instead of ATP. Overdose has caused fatal hyperthermia and DNP has caused cataracts in some users. After the Food, Drug, and Cosmetic Act was passed in 1938, the FDA banned DNP for human consumption.
Amphetamines (marketed as Bzedrine) became popular for weight loss in the late 1930s. They worked primarily by suppressing appetite and had other beneficial effects, such as increased alertness. The use of amphetamines increased in the following decades, including Obetrol, culminating in the “rainbow diet pill” regime.
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It was a combination of multiple pills, all supposed to help with weight loss, taken throughout the day. Common regimens include stimulants such as amphetamines and thyroid hormone, diuretics, digitalis, laxatives, and barbiturates to suppress the side effects of stimulants.
Several deaths attributed to diet pills in 1967/1968 led to a state investigation and the gradual implementation of greater restrictions on the market.
While rainbow diet pills were banned in the US in the late 1960s, they reappeared in South America and Europe in the 1980s.
In 1959, phtermine was approved by the FDA, followed by fluramine in 1973. Two studies in the early 1990s found that the combination of these drugs was more effective than either alone; f-ph became popular in the United States, with more than 18 million prescriptions in 1996.
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Evidence emerged that valvular heart disease occurred in up to 30 percent of those who took the combination, leading to the withdrawal of f-ph and dexfluramine from the market in September 1997.
In the early 2020s, GLP-1 receptor agonists such as semaglutide became popular for weight loss because they were more effective than earlier drugs, leading to a shortage of patients prescribed these drugs for type 2 diabetes, their original indication.
The United States Food and Drug Administration and the European Medicines Agency have approved weight loss medications for adults with either a body mass index (BMI) of at least 30 or a body mass index of at least 27 with associated comorbidity. This patient population is considered to have sufficiently high baseline health risks to justify the use of anti-obesity drugs.
The American Academy of Pediatrics previously did not support the use of weight-loss drugs in adolescents, but issued new guidelines in 2023. It now recommends considering the use of weight loss medication in some overweight children aged 12 years or older.
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Semaglutide is approved by the European Medicines Agency for children 12 years of age or older with a BMI in the 95th percentile for their age and a weight of at least 60 kg (130 lb).
The US Food and Drug Administration (FDA) approves anti-obesity medications as an adjunctive treatment to diet and exercise, when lifestyle changes do not result in adequate weight loss. In the United States, semaglutide (Vegovi) is FDA approved for chronic weight management.
FDA guidelines state that a therapy results in weight loss that is statistically significant over placebo if at least five percent of body weight loss comes from fat mass within six months.
Some other prescription weight loss drugs are stimulants and are recommended for short-term use only, so they are of limited use to patients who need to lose weight over months or years.
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As of 2022, there is no path to approval for fat mass-reducing drugs without 5 percent overall weight loss, even if they significantly improve metabolic health; None of the drugs help petites lose weight, although it is more difficult than losing weight.
As of 2022, no drugs have been found to equal the effectiveness of bariatric surgery for long-term weight loss and improved health outcomes.
It is FDA-approved for weight management (chronic), but the American Gastroenterology Association recommends limiting its use to clinical trials due to a lack of evidence.
Adopted in 1960, withdrawn in 1973; Adderall was later approved for ADHD and narcolepsy and is still used for those purposes
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Some anti-obesity drugs can have serious, even fatal, side effects, f-ph being a famous example. F-ph has been reported by the FDA to cause abnormal echocardiograms, heart valve problems, and rare valvular diseases.
Of the 25 anti-obesity drugs withdrawn from the market between 1964 and 2009, 23 altered the activity of chemical neurotransmitters in the brain. The most common side effects of these drugs leading to withdrawal are mental disturbances, cardiovascular side effects, drug abuse or drug dipdisease. Deaths linked to Sev products.
Ephedra was removed from the US market in 2004 after concerns that it could raise blood pressure and lead to heart attacks and death, and talk about using semaglutides, known under the brand names Ozempic, Wegovy and Monjauro, for weight loss. It also creates some controversy.
Semaglutide is a drug commonly prescribed for people with type 2 diabetes. One of the positive side effects is weight loss. So doctors started prescribing it off-label to help people lose weight.
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Louis Alford is now Director of Product Management for Any Lab Test. He explains how it works.
“It slows down the motility or motility of the gut, so basically people feel fuller for longer and don’t absorb as much food, so it ultimately helps with weight loss,” Alford said.
The FDA recently approved these drugs for weight loss in obese people who are at risk for other diseases. This led to a huge increase in demand, putting some drugs on backorder and pinching supplies for diabetics.
Dana Omari, a dietitian and content creator, shared her experience with the compounded version of semaglutide on social media.
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She has lost 40 pounds since starting last August. She is frustrated with the criticism that people use it to lose weight.
“It’s accepted for weight loss and to say one health condition is more worthy than another, especially if it’s not a life-saving drug. It’s a secondary drug for diabetes. That’s really not fair,” Omari said.
Omari says she is slowly coming off medication and losing weight. She adds that it’s important for people taking this drug who are trying to lose weight to eat healthily and stay physically active.
Possible side effects of semaglutides range from mild — like nausea, vomiting, and diarrhea — to severe like pancreatitis. You should also be under the supervision of a healthcare provider while taking the medication.
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Also, semaglutide is not a magic pill – it doesn’t work for everyone. Alford says several lab tests can be done to check your hormone levels, thyroid and DNA to find a diet that works specifically for you.
We checked Ozempic shortage. The FDA’s website shows that some doses are in limited supply, but they are expected to be fully available again in a few weeks.
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