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By Ellie Rodgers, Contributing Writer, myOptumHealth

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Is there a magic pill for easy weight loss? You might think so if you believe advertising gimmicks. But weight loss isn't that easy. The only "magic" formula is the one you've heard a million times. Eat fewer calories. Move your body more.

But if your weight puts you at high risk for medical problems, a doctor may suggest medication when diet and exercise alone do not work.

Prescription weight-loss medicines

Prescription weight loss medicines have been through rigorous study and approval processes, but you still need to take precautions when using them. The drugs, sibutramine and orlistat, are approved for long-term use, but keep these things in mind:

• They are approved only for people whose weight is a health risk, not for cosmetic weight loss.
• They are prescribed as part of a program of lifestyle changes that includes cutting calories, changing behaviors and increasing activity.
• People with certain health conditions can't take them.
• Some of their side effects can be unpleasant or dangerous.
• The effects of long-term use are not known.

Most doctors only prescribe these drugs for people who have a body mass index (BMI) of 30 or higher.

Sibutramine

Sibutramine is an appetite suppressant. It works on the brain's appetite center, making it think the stomach is full.

Studies show sibutramine can average a net weight loss of four to 22 pounds. Most of the weight loss occurs within the first six months.

• Because the drug raises blood pressure, those who take it need to monitor their blood pressure. People who have uncontrolled high blood pressure, coronary artery disease, heart failure or have had a stroke cannot take sibutramine.
• Also, pregnant women or women who are nursing should not take this medicine. Neither should people with severe kidney or liver disease.

Orlistat

Orlistat works by blocking the body's absorption of fat from foods. Instead of being absorbed into the body, up to one third of the fat consumed is excreted in the stool.

But orlistat also keeps your body from absorbing fat-soluble vitamins A, D, E and K, as well as beta-carotene. So you need daily vitamins if you take the drug. If you don't follow the prescribed diet, side effects may include bloating, diarrhea, anal leakage and oily stools.

• Alli is an over-the-counter, nonprescription version of orlistat. Just like orlistat, Alli is intended for use with a diet and exercise program. Weight loss is slow and modest. If you take in 2,000 calories (30 percent in fat) per day, Alli will block about 150 of those calories.
• Possible side effects of Alli are the same as with the prescription form of orlistat. These include gas, oily discharge, cramps or diarrhea - sometimes uncontrollable. This mostly occurs if you eat too much fatty food while taking Alli.

Other medicines and herbal supplements

There are a few other prescription medicines for weight loss, but they are only approved for short-term use. These medications are related to amphetamines and can be habit-forming. They cannot be used by many people, including those with heart disease, high blood pressure or glaucoma. Some have been linked to life-threatening conditions such as pulmonary hypertension and heart valve problems. These medications include:

• Mazindol
• Diethylpropion
• Phentermine
• Benzphetamine
• Phendimetrazine

Herbal weight loss formulas are not recommended. They could be harmful, and they have unpredictable amounts of active ingredients.

Look out for bogus claims

The Federal Trade Commission has issued these "red flags" for spotting diet claims that are likely bogus and may be dangerous:

• You will lose two pounds or more each week (over a month or more) and you don't have to diet or exercise.
• You can lose more than three pounds a week for more than four weeks, and the weight loss will be safe.
• You can eat all you want, and the more you eat, the more you lose.
• Your weight loss will be permanent, even when you stop using the product.
• Your body won't absorb calories and fat if you use the product.

It's always best to check with your doctor before you try any new product that promises to help you lose weight.

View the original Weight-loss drugs: can you pop a pill to lose weight? article on myOptumHealth.com 

SOURCES:

• U.S. Preventive Services Task Force. Screening for obesity in adults: recommendations and rationale. American Family Physician. 2004;69(8):1973-1976. Accessed: 07/10/2008

• NHLBI Obesity Education Initiative. The practical guide: Identification, evaluation, and treatment of overweight and obesity in adults. Accessed: 07/10/2008

• Federal Trade Commission. Red flag: Bogus weight loss claims. Accessed: 07/10/2008