Are Weight-Loss Pills Effective?

Are Weight-Loss Pills Effective?
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Studies show many doctors tend to overestimate the amount of weight loss caused by obesity drugs or were simply clueless.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Current options for weight-loss medications include the ridiculously named Qysmia, a combination of phentermine (the phen in fen-phen) and topiramate, a drug that can cause seizures if you stop it abruptly. It was “explicitly rejected” multiple times for safety reasons in Europe, but remains for sale here in the USA—or at least at the time I made this video. Belviq is in a similar boat, allowed here, but not in Europe, out of concerns about it possibly causing “cancers, psychiatric disorders, and heart valve problems.”

It’s sold in the U.S. for about $200 a month, but if you think that’s bad, there’s Saxenda, which requires daily injections, listed at the low, low price of only $1,281 dollars—and don’t forget the 96 cents—for a 30-day supply. It carries a black box warning, FDA’s strictest caution about potentially life-threatening hazards, for thyroid cancer risk. Paid consultants, and employees of the company that makes it, argue the greater number of breast tumors found among drug recipients may be due to “enhanced ascertainment,” meaning easier breast cancer detection just due to the drug’s effectiveness.

Contrave is another option, if you ignore the black box warning about a potential increase in suicidal thoughts. And then there’s Alli. It’s the drug that causes fat malabsorption, and thereby causes side effects with names like “flatus with discharge.” It can be your “ally” in “anal leakage.” The drug evidently “forces the patient to use diapers and to know the location of all the bathrooms in the neighbourhood in an attempt to limit the consequences of urgent leakage of oily fecal matter.” A Freedom of Information Act exposé found that though company-sponsored studies claimed “[a]ll adverse events were recorded,” one trial apparently conveniently failed to mention 1,318 of them.

What’s a little bowel leakage, though, compared to the ravages of obesity? As with anything in life, it’s all about risks versus benefits. But in an analysis of more than a hundred clinical trials of anti-obesity medications lasting up to 47 weeks long, drug-induced weight loss never exceeded more than nine pounds. That’s a lot of money and risk for just a few pounds. Since you’re not treating the underlying cause—a fattening diet—when people stop taking these drugs, the weight tends to come right back; so, you’d have to take them every day for the rest of your life. And, people do stop taking them. Using pharmacy data from a million people, most Alli users stopped after the first purchase. Most Meridia users didn’t even make it three months. Taking weight loss meds are so disagreeable that 98 percent stopped taking them within the first year.

Studies show many doctors tend to overestimate the amount of weight loss caused by these drugs, or were simply clueless. One reason may be that some clinical practice guidelines go out of their way to advocate prescribing medications for obesity. Are they seriously recommending drugging a third of Americans—more than 100 million people? You may not be surprised to learn that the principal author of the guidelines has a “significant financial interest or leadership position” in six separate pharmaceutical companies that all (coincidentally) work on obesity drugs. In contrast, independent expert panels, like the Canadian Task Force on Preventive Health Care, explicitly “recommend against” weight loss drugs, given their poor track record of safety and efficacy.

Please consider volunteering to help out on the site.

Image credit: lecic via adobe stock photo. Image has been modified.

Motion graphics by Avocado Video

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Current options for weight-loss medications include the ridiculously named Qysmia, a combination of phentermine (the phen in fen-phen) and topiramate, a drug that can cause seizures if you stop it abruptly. It was “explicitly rejected” multiple times for safety reasons in Europe, but remains for sale here in the USA—or at least at the time I made this video. Belviq is in a similar boat, allowed here, but not in Europe, out of concerns about it possibly causing “cancers, psychiatric disorders, and heart valve problems.”

It’s sold in the U.S. for about $200 a month, but if you think that’s bad, there’s Saxenda, which requires daily injections, listed at the low, low price of only $1,281 dollars—and don’t forget the 96 cents—for a 30-day supply. It carries a black box warning, FDA’s strictest caution about potentially life-threatening hazards, for thyroid cancer risk. Paid consultants, and employees of the company that makes it, argue the greater number of breast tumors found among drug recipients may be due to “enhanced ascertainment,” meaning easier breast cancer detection just due to the drug’s effectiveness.

Contrave is another option, if you ignore the black box warning about a potential increase in suicidal thoughts. And then there’s Alli. It’s the drug that causes fat malabsorption, and thereby causes side effects with names like “flatus with discharge.” It can be your “ally” in “anal leakage.” The drug evidently “forces the patient to use diapers and to know the location of all the bathrooms in the neighbourhood in an attempt to limit the consequences of urgent leakage of oily fecal matter.” A Freedom of Information Act exposé found that though company-sponsored studies claimed “[a]ll adverse events were recorded,” one trial apparently conveniently failed to mention 1,318 of them.

What’s a little bowel leakage, though, compared to the ravages of obesity? As with anything in life, it’s all about risks versus benefits. But in an analysis of more than a hundred clinical trials of anti-obesity medications lasting up to 47 weeks long, drug-induced weight loss never exceeded more than nine pounds. That’s a lot of money and risk for just a few pounds. Since you’re not treating the underlying cause—a fattening diet—when people stop taking these drugs, the weight tends to come right back; so, you’d have to take them every day for the rest of your life. And, people do stop taking them. Using pharmacy data from a million people, most Alli users stopped after the first purchase. Most Meridia users didn’t even make it three months. Taking weight loss meds are so disagreeable that 98 percent stopped taking them within the first year.

Studies show many doctors tend to overestimate the amount of weight loss caused by these drugs, or were simply clueless. One reason may be that some clinical practice guidelines go out of their way to advocate prescribing medications for obesity. Are they seriously recommending drugging a third of Americans—more than 100 million people? You may not be surprised to learn that the principal author of the guidelines has a “significant financial interest or leadership position” in six separate pharmaceutical companies that all (coincidentally) work on obesity drugs. In contrast, independent expert panels, like the Canadian Task Force on Preventive Health Care, explicitly “recommend against” weight loss drugs, given their poor track record of safety and efficacy.

Please consider volunteering to help out on the site.

Image credit: lecic via adobe stock photo. Image has been modified.

Motion graphics by Avocado Video

Doctor's Note

In case you missed the previous video, check out Are Weight Loss Pills Safe?

As with all lifestyle diseases, it’s better to treat the underlying cause, which in the case of obesity is a fattening diet. Here’s an example of what’s possible with a healthy diet intervention: The Weight- Loss Program That Got Better with Time.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

44 responses to “Are Weight-Loss Pills Effective?

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  1. It still amazes me the people, even doctors, who advocate that most health problems are the result of genetics and ageing and the only thing that can be done involves a prescription drug or surgery.

    Most people in the USA are eating themselves to death yet a great majority of those people insist they are doing everything they can right. Even people who eat WFPB get it wrong. Portions matter too. When a recipe says 6 servings that does not equal one or two meals because you can eat that much. More healthy food is just excess calories and is no longer healthy.

    1. Jumbo,

      Portion control certainly matters if not eating PBWF; my husband and I both lost weight, separately, practicing portion control and making healthier choices as vegetarians (we ate dairy products and eggs). Once we transitioned to PBWF we each lost more weight, but without really practicing portion control, and in fact without meaning to.

      But I am reminded of making a batch of brownies for an evening meeting several years ago, adapting a recipe from my 1972 Better Homes and Gardens cookbook to be vegan; I cut the batch into 16 squares or servings, as per the directions, each 2” x 2”. I had calculated the number of calories as about 192 per square (a lot, I know!), and let the attendees know this. What happened next was fascinating. A few folks had none, several had one, a few had two squares — but the hostess had 5! No surprise, this appeared to be her usual eating behavior.

      Moreover, this serving size of 2” x 2” for a brownie appears to be about 1/4 the current serving size of commercially sold brownies at about 4” x 4” — so you can calculate the calorie count of this single brownie! And nowhere is it stated that a 4” x 4” brownie serves 4, or contains 4 servings. Portion sizes in this country have exploded in the past 40 years! And so has average weight. And yet, individuals are only consuming “one” brownie.

    2. I disagree. Unless you eat high fat whole plant foods like nuts and avocados, on a low fat WFPB diet, you can eat as much as you want and you will not be overweight. You can eat to satiety and still remain lean and trim.

    3. Jimbo, I agree about being mindful of portion sizes even when eating wfpb meals. We had this discussion in the forum under this video (about the CHIP program) https://nutritionfacts.org/video/The-Weight-Loss-Program-That-Got-Better-with-Time/ It is my pet peeve that some plant-based doctors say often that we can eat all we want. First, many of us run on fewer calories, and second, it is still to my mind encouraging volume eating and the idea that if it’s plants, we’re fine calorie-wise

      1. Barb,

        What I am going to say is that most people failed on trying to do lower-calorie diets with healthier foods and doing something like the Starch Solution, which people do tend to eat until they are full, is why people can often succeed with this diet.

        Dr. Lisle talks about stretch receptors and most people have stretch receptors, which tell them when to be full and that is why it works.

        I guess, the question is: Is it better to not go Whole Food Plant-Based and maybe go Keto to be full versus a calorie-restricted Plant-Based diet, because my friends do not believe they would be full enough is a big reason they don’t do the diet.

        If it had been focused on counting calories or on portion sizes, I don’t think I would have done it.

        The fact that I didn’t lose much weight, and may have to lower fats and maybe even do exercise to lose weight is not normal.

        Dr. Lisle doesn’t have a lot of people who fail when they eat the right foods.

        Post-Menopausal women with sedentary lives and slow metabolism from calorie-restricted diets past are the exception, not the rule.

        Dr. Barnard didn’t have people count calories or portions on his Diabetes diet and the researchers were the ones who did count the calories for them and they all lost weight without keeping track of anything.

        There are other examples where that is the case.

        It is NOT the case for a Dr. Fuhrman Nutritarian style diet. You do have to measure fats and figure in fat calories.

        1. All of the people around me who went Keto did it because they could lose weight without being full.

          That is the same reason I went Whole Food Plant-Based.

          I have a friend who as of last night is willing to try Whole Food Plant-Based after not treating her Diabetes for the past 2 years. It is already hard to change your food preferences.

          Over the course of the past year and a half+, I saw that I was so satisfied when I just ate, but when I focused on lowering calories too much and lowering the portion size of my salad or my beans or lentils, I end up food-focused and would start looking for something to munch on around 10:00 at night and when that happened, it was ice cream or a chocolate nutrition bar.

          It didn’t happen often, but it did happen.

          Adding exercise has been the x-factor because it is easier for me to increase to an hour of walking on a treadmill rather than lowering calories by the same 200 calories.

          I am still waiting to see what happens. My scale reading is 8 pounds lower than before I went off the fats, but I do go up and down, even when I am just eating salads and beans and lentils.

        2. Deb, re: “I guess, the question is: Is it better to not go Whole Food Plant-Based and maybe go Keto to be full versus a calorie-restricted Plant-Based diet,”

          I don’t understand your comment on going Keto makes one feel full. I would think that a WFPB would be much more filling than a Keto diet.

          What works for me is soup! I take a small portion (1/3 cup) of a green smoothie and add a few tablespoons of mixed beans & mixed whole grains, a few chunks of sweet potatoes, then a few spices, and fill the rest with water to make a big bowl of soup. The added water makes the stomach stretch, so I have a nice feeling of being full. Seems to work for me.

          1. Hal,

            Both diets do make people feel full.

            That is what I remember about Atkins. I was never hungry.

            I haven’t been hungry on WFPB either, but I might have to severely restrict my calories to actually lose weight and I am not sure by how much.

            Most people don’t have to.

            But I am one of the ones who isn’t losing all that much weight. I lost about 8 pounds at the beginning and then didn’t lose weight for a year and a half. I went off avacodo and nuts and my soy green tea latte and added in some exercise. I may have lost a few mpre pounds, but it is up 2 pounds yesterday and back down the same 2 pounds this morning, so I am not sure.

            I am eating a big salad with no oil dressing and beans and lentils and hummus and Wasa Light rye crisps and haven’t even been eating my blueberries and yogurt. I stopped those because I needed a little honey and cacao to eat it and I know that I am not losing much weight.

            1. Hi Deb – I, too, have had a bit of a hard time losing weight on a WFPB diet. I have figured some things out for myself and will share what I’ve learned about my situation and you can see if anything is helpful to you.
              Let me start with the fact that I’ve been WFPB for 10 years following McDougall and Greger, no added oils, salt, etc. I am 66, post menopausal, do not exercise formally but I have a garden business that pushes me to be active and strong for half the day (don’t work in the afternoon sun). I concentrate on keeping my muscles strong (since strong muscles burns fat more and longer) so I do some strength training moderately.
              For a number of years I watched my cholesterol and LDL creep up to 243 and 145, respectively, while on the WFPB diet. My weight, also, was about 10 lbs higher than I would like although not in the overweight category.
              Something that helped me adjust was that I saw a video of Dr. Craig Mcdougall, John McDougall’s son who is a physician and practices in Oregon, talk about weight on a WFPB diet. I still cannot find that video otherwise I would link it for you. But what he said was that in his experience, and in general, that those folks who had a harder time with their weight on a WFPB diet did better if they increased their green and yellow vegetables (including salad) and reduced the starches. He felt that the ratio of green vegg to starches was out of balance and that people who ate more grains and beans compared to the green and yellow vegetables may have had a harder time with their weight. He suggested going 3/4 of the plate green and yellow vegg and 1/4 of the plate beans to lower weight. So, using this information, I’ve been able to peel off weight by following this advice. Also, for my evening meal, I refrain from grains (including bread, pasta, etc) and eat a whole plate of green and yellow vegetables (steamed or raw) along with a huge salad. If I get hungry later on, I eat another salad. The heavier starches – grains, beans, potatoes,etc – I save for breakfast and lunch (if I’m having any) so that I can burn them off during work. I also practice a 12 hr fast window at night.
              Also, . . .and this may not affect you . . .but I had to take a serious look at my alcohol intake. I am one who has enjoyed a glass or two of wine with dinner for years. When I could no longer reduce my weight or lower my cholesterold/LDL, etc., I stopped the alcohol for 6 months. This made a huge difference in both my bloodwork numbers as well as my weight. My cholesterol went from 243 to 185; my LDL went from 145 to 111, having changed only my alcohol intake. I mention this because we don’t see much discussion on how alcohol can affect our cholesterol-LDL numbers.
              I hope that something I’ve shared is helpful to you.
              I also love that this site is patient and understanding, for the most part, with those of us who are still trying to figure out what works best for our individual circumstances. Good luck to you Deb.

              1. Thanks Ruth,

                I don’t drink alcohol at all, except for wedding toasts.

                I do eat a lot of beans. Right now, I am closer to Dr Fuhrman’s diet, but without the nuts.

                I am kale, arugula, watercress, mushrooms, beans, broccoli sprouts, lentils, hummus, rye crisps and sometimes other veggies.

                I don’t really do corn or potatoes or sweet potatoes or root vegetables yet or bread or pasta.

                Beans and greens and mushrooms and no-oil hummus are my biggest intake.

                For pasta, I was doing Shirataki “miracle” noodles, but I haven’t had those since March.

                I like salads. I find them so filling and I like not being hungry.

                Krocks in the Kitchen talked about how much hungrier they were when they ate veggie burgers, rather than salad and that is true for me, too.

                Though I haven’t had Dr. Greger’s black bean burgers yet. He talked about them recently. Someone compared his burger to an Impossible burger, which I did go totally off my program to try and never will try it again. It tasted very good and felt so yucky after.

                This Winter, I will be making those black bean burgers at least once.

                1. I did break with my daily diet tonight and I had a bag of cut leaf spinach.

                  Yum.

                  I say, yum, because it was cooked and it tastes so comforting to me when it is cooked.

                  Yes, I ate it out of the microwave bag.

                  Not so good for conservation, but I don’t eat heated vegetables almost at all and it tasted comforting.

      2. Well, there have been several people including Penn Jillette who have lived on unlimited amounts of potatoes and still lost weight. That’s a starch based diet approach

        There have also been some experiments where people have eaten 5 kilos a day of fruit and vegetables on a wholefood plant (WFP) diet – rather than a WFPB diet – and lost weight.
        http://www.bbc.co.uk/sn/humanbody/truthaboutfood/healthy/evodiet2.shtml

        It seems to depend on what a whole food plant based diet consists of … and how close it is to a whole plant food diet for that matter.

        1. Tom,

          That is the truth for sure.

          It also does depend on the person.

          Dr. Lisle talks about the stretch receptors and how some people have very sensitive stretch receptors and some don’t. That is particularly true for fats, and that might be why some people can lose weight on Eat To Live and other people may need The Starch Solution and some people may have such out of whack hormones like Ghrelin and Cortisol, that they can’t rely on that process.

          People lose weight on each of the diets.

  2. Instead of putting natural, healthy plant based foods in their mouths, people opted for supposedly a ‘quick fixed’ pill to solve their problems. Instead of looking within themselves for a natural and healthy solution, some people resort to unhealthy measures. It’s so sad…..

  3. Psychiatric disorders and thyroid tumors and heart valve problems, oh my.

    I watched some of “Bring the Funny” and they had a skit where moles under the bed of a girl had to scare her and while the other moles said things like “I will poke your eyes out.” there was one who kept saying things which weren’t scary, like “You will get Alzheimer’s.”

    Those aren’t the exact quotes, but it made me laugh.

    The other moles would stop him and they would argue whether the things he was saying were scary or not.

  4. Went to the doctor’s office today and every patient in the waiting room except for me was obese. There was a TV show playing in the waiting room. It featured obese people in cooking contests of hamburgers, bacon, rich desserts, etc. What a world! Lol. I suggested to the doctor that perhaps the Discovery channel would be a better thing to have on the TV. He agreed.

  5. Loren,

    People have a sense of having “tried everything” and of not believing that they can lose weight.

    Ironically, I have been on a WFPB diet for over a year and a half and had gotten rid of junk food and soda the year before and I have maybe now after getting rid of avocado, nuts, and my green tea latte and adding in an hour of exercise per night, I have possibly lost 16 pounds in a year and a half, but I would still not make any doctor happy.

    I just have to grow taller.

    1. I think I would have quit any other diet, but I invested almost 2 years in Dr. Greger videos. Two years on Thanksgiving.

      The year before, after going off junk food and soda and I went off things like potatoes and wasn’t eating bread and other refined carbs, and didn’t lose even a pound and that maybe why I didn’t quit this. What does it matter in the end.

      If I am not going to lose weight, I might as well at least eat healthier anyway.

      I like kale and arugula and watercress and find them filling and I like beans and lentils and turmeric and broccoli sprouts and pomegranate seeds and mushrooms.

      Are mushrooms fattening? They are so filling that I do eat a whole package and a box of beans every day.

      I don’t want to go lower is the truth. I like feeling satisfied.

    2. Deb,

      What is a green tea latte? Is it made with soy milk? Do you make it at home, or buy it in a coffee shop?

      I drink the very occasional soy milk cappuccino at a coffee shop when I meet with friends, but I consider it dessert. I looked at the ingredients of the “soymilk’
      that is used, and it’s full of additives, especially sugar! Which is the reason why I don’t drink very much of it (only a small) and only infrequently.
      I’ve made soy milk cappuccino at home, using my own homemade soy milk, or commercial soy milk made from only water and soybeans (I foam the soy milk with an aerolatte), so I know it’s possible to make it without so much sugar and other additives in the milk. It’s too bad there are no other options in the coffee shop

      1. Yeah, I agree.

        They do it 2 different ways. One has pumps of syrup, which they accidentally made once for me.

        I got the less sweet version, but I know that it probably did have sweetener and possibly oil.

        I really loved being there.

        It was such a sweet community and after my brain problems, a lot of people ran away, but these people would come out from behind the counter to give me hugs.

        I liked all of them.

  6. I just wanted to post a link to a video about Dr Greger’s Daily Dozen for newcomers that might be confused about what we are eating. It’s such a well balanced plan that really works beautifully when you can get those boxes checked. The serving sizes are not large and can be down-sized.
    https://nutritionfacts.org/video/dr-gregers-daily-dozen-checklist/
    https://m.youtube.com/watch?v=Y9nNa81dSoY

    The second link is Dr Greger himself in a demo video on how to transition to a plant based diet. I personally feel it’s very important to spend the time in developing menus that you really enjoy. Plan a couple of days or week’s worth of meals that you can repeat while developing more.

  7. Barb,

    Thanks for posting it.

    Well, I am not eating any fruit or nuts right now.

    But I got some whole grains in my Wasa rye crisps and flax seeds in the 6 Mary’s Gone Crackers and a little bit of ginger in my salad dressing.

    I lost the turmeric when I went off of the berries and I lost the green tea.

    I do still like eating salad and that is something positive.

    I have eaten it pretty much every day since the end of March.

    1. salad dressing
      green tea lattes
      packaged foods like crackers and rye bread

      Probably not what you should be eating is you wish ti achieve weight loss?

      1. Maybe not.

        Though the salad dressing is no-oil and the rye bread crisps are 40 calories for 2 crisps.

        The green tea latte, yes, you got me on that one.

        1. The Mary’s Gone Crackers is no added fats or sugars. Seeds and grains. I get the seaweed and black sesame one. Mostly, it has flaxseed and I wasn’t getting any flaxseed and didn’t want to pour it on my salad. I guess I could mix it in the dressing, but I do like Mary’s Gone Crackers crunch. 6 crackers tends to be my snack.

          It is 150 calories if I eat 12 crackers

          I guess I don’t know yet what I can eat and what I can’t eat.

          It is so mysterious to me. I feel like I should have learned that part by now, too, but maybe not.

  8. There is, however, a weight loss pill which is very safe and been proven to work in many Randomized Controlled Trials.
    When on a weight loss program which includes calorie restriction or exercise, those who vitamin D lost on average 12 – 19 lbs more than those not getting the vitamin D

    Lost more weight on diet if added 50,000 IU of vitamin D weekly – 2 RCTs 2018
    https://vitamindwiki.com/tiki-index.php?page_id=10066

    This Common Vitamin Doubles Weight Loss– July 2019
    https://vitamindwiki.com/tiki-index.php?page_id=11014

    Lost 19 lbs more if add vitamin D to calorie restriction and walking program– July 2018
    https://vitamindwiki.com/tiki-index.php?page_id=9827

  9. Well Deb, seems to me that you are probably doing better than what you realise! You’ve got grains in there, flaxseeds, greens and a couple of servings of cruciferous, probably allium veg (onion and garlic ) in the dressing and/or hummus, fruit (pomagranate), your bean servings, beverages and exercise! That’s great! You’ve pretty much got it covered – maybe the new fall apples or pears will interest you, or perhaps the sweet mandarins? I am eating flax in my porridge, and if I remember, half a walnut. Our lunch and dinners are either a thick veg soup or chili type thing with fruit for dessert. I put 1/8 tsp of tumeric, ginger, amla, cinnamon in a small glass with a tbsp or 2 of water and just drink it down.

    I am keeping a lookout for weigh scales on sale around here. I think you should treat yourself too for the great job you have done :)

    1. Thanks, Barb!

      I have been working so hard at it.

      I realized tonight that I stopped eating or drinking soy, except in the dressing.

      I am wondering if that is enough for post-menopausal women.

      I really want to see the scale get out of that 8 pound range. Then, I want to not think about weight loss until Dr Greger’s book comes out.

      I was doing so much better focused on health conditions. Weight focus is so much more discouraging.

      I was thinking about Colin,s Whole teaching again and if I had not been following Dr Greger’s teachings, and if I hadn’t learned so many things, if I had only had a weight loss focus, I would probably have thought it was a scam.

      I have learned too much to believe that, but it helps me to understand the failed vegan community.

      I really expected to lose weight.

      Logic tells me that I would have gained weight if I hadn’t done this process. I also might just be on a normal dieting track. People who diet only lose 5 pounds to 10 pounds per year. I wanted the other version.

  10. I am a semi-retired gastroenterologist with practice largely nutritional. As such I can say that Dr. Gregor is one of my two greatest resources and role-models. While as usual, I agree totally with his conclusions, I feel it important to point out that the review of 40 years of obesity drugs cited was published in 2002, therefore not directly relevant to any of the drugs he discussed which were all developed well after 2002. This is important because: 1) The newer drugs, with the exception of Orlistat, are beginning to make sense, being drugs already in use in the treatment of alcoholism and drug addiction, developed in tandem with powerful evidence that processed food addiction is the epi-center of the obesity pandemic; and 2) They are significantly more effective that the drugs reviewed in 2002; Here’s more recent data involving the newer drugs:
    Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events: A Systematic Review and Meta-analysis
    Rohan Khera, et alo
    JAMA. 2016;315(22):2424-2434. doi:10.1001/jama.2016.7602.

    Study drug Participants showing at least 5% weight loss (%) Average weight loss at year
    Phentermine-topiramate 75 19.4 lbs
    Liraglutide 63 17
    Naltrexone-bupropion 55 11
    Lorcaserin 49 7.1
    Orlistat 44 5.7

    As with the other addictions for which Phen/Top and Nal/Bup are used, even these somewhat greater effects will be transient if not coupled with structured long-term dietary “rehab” and support following the treatment paradigm well-established in those other addictions. In such a context, these newer drugs may have a place for the “anti-craving” properties inspiring their development. I am a vegan, but I believe fervently that NO diet—vegan, paleo, mediterranean. ketogenic, or whatever will curtail the obesity pandemic without addressing in an effective way the addictive properties of sugar and flour in p;rocessed food.

    1. This server jumbled the graphic above. Try again:
      Study drug Participants showing at least 5% weight loss (%) Average weight loss at year
      Phentermine-topiramate 75 19.4 lbs
      Liraglutide 63 11.7
      Naltrexone-bupropion 55 11
      Lorcaserin 49 7.1
      Orlistat 44 5.7
      If the server jumbles values again, please note that the first number after each drug denotes the per cent of those taking it that lost over 5% of their body weight in a year.The second number represents the average weight loss in one year for each drug. We need more data, but the “risk/benefit\” ratio so rightfully addressed by Dr. Gregor might prove favorable for a couple of these drugs IF coupled with proper long term RX/support as above!

      1. Stephen,

        I agree about sugar and flour and I would add dairy in, but I will say that Whole Food Plant-Based has taken the cravings away.

        I was junk-food, processed-food, fast-food, 2 liters of soda per day and more dairy than that type of person. Donuts or other equally sweet foods for breakfast, macaroni and cheese or pizza or lasagna with bread and butter for lunch and dinner was often fettucini alfredo or ravioli with cheese, ice cream for dessert. Candy bars or chocolate nutrition bars throughout the day.

        Yes, I started out almost entirely NOT Whole Food Plant-Based, except possibly for tomatoes in the sauce.

        No fruits, no vegetables, no whole grains, no legumes, no water, no spices or herbs, except in the sauce, which never was made by me.

        As much chocolate and cheese and milk and pizza as possible.

        Anyway, lack of food cravings is the best part about WFPB.

  11. The US NIH Office of Dietary Supplements has just made available a free printable sheet for people to record their medication, supplement etc use.

    It may be a good thing to take along to our next check-up.

    It includes a section for ‘who told me to use it’ – In my case, that may be a good way of citing/linking the studies that persuaded me to take eg the AREDS2 supplement for AMD.

    https://ods.od.nih.gov/pubs/DietarySupplementandMedicineRecord.pdf

    1. Tom,

      That is a good one.

      When I was caretaking, I always made an Excel sheet because some of them had so many meds, which had to be taken multiple times per day.

      I found a really cool med dispensing system, which I loved the design of.

      It had multiple alarms and had the date and any human being who walked into the house could tell at a glance if the meds were taken that day.

      https://www.amazon.com/MedCenter-70265-Organizer-Reminder-System/dp/B000

      It makes me laugh that I had that for them, but never remember to take my own supplements.

  12. Deb – In case you might miss it, I replied to one of your posts further up towards the top. I shared my frustrations at weight loss difficulty and what helped me. I’m mentioning it just in case you didn’t get back up there. Cheers.

    1. Thanks, Ruth,

      I will scroll up and look for it.

      That is so sweet of you.

      I can use all of the help I can get.

      Today was a good day. I was so happy to see a new number on my scale today.

  13. As a person who is currently taking phentermine (the number one most prescribed weight loss medication of all time, in use for 60+ years) I have a different perspective. You stated that the cause of obesity is a bad diet. And the implication is that if a person knows what the correct WFPB diet is, and follows that way of eating vigilantly, the problem will be solved. However, unfortunately, this was never the case for me. I am well versed on nutrition. I own all your books and have read them multiple times. I am also a big fan of Dr. Fuhrman and I have read all his books as well. I’ve been vegetarian since I was a kid the 1980s and vegan for a decade. Since 2013 I had been attempting to eat in the WFPB style recommended. So what’s the problem? I was unable to completely follow the right eating style. Since childhood I have suffered from binge eating disorder. I’ve been on several different antidepressants, I’ve seen multiple doctors, and I’ve had a boatload of expensive and utterly USELESS therapy sessions, and nothing touched it. No amount of nutritional knowledge fixed it. I have plenty of willpower and discipline in other areas of my life— in this area I had no control whatsoever. I wasted my life obsessing about food, what I should eat, what I shouldn’t eat, what I was eating, what I wasn’t eating, meanwhile my self-esteem went to the gutter and my weight went up and up and up. Finally two months ago I hit a 30 BMI and in my desperation accepted a prescription for phentermine. I am so glad that I did because phentermine did in ONE DOSE what nothing else had ever done for me in my life. It took the food-obsession monkey off my back. And every single morning that I get up and take my pill (which costs me $11 a month for the generic) I marvel at the fact that I never have to live that way again. Some days I cry because I wonder what I could have done with my life if I hadn’t spent all that time and energy fighting a losing battle against a part of my mind I could not control. And since that day I’ve had perfect adherence with very little effort to what I know is the healthiest possible diet. So thank you for all the good information you’ve given me over the years (and will hopefully continue to provide) but it was largely worthless to me without phentermine. I have lost over 20 pounds now and counting. Even if my weight loss dries up at some point my mind is still healed. My doctor will permit me to continue long-term phentermine therapy as recent evidence has shown it is safe and effective long-term. Everyone is not the same. We live in a world that is to those with food addictions something akin to making an alcoholic live in a bar. I feel very resentful when I hear messages that imply obesity is always about dietary ignorance or some kind of character flaw. I wish everyone who thought this way could try living for a single day going through what I used to have to deal with.

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