I see plenty of patients who aren’t severely overweight. They’ve put on 40 or 60 pounds, and just can’t get rid of it.
Even if they want bariatric surgery, it’s not an option for them. While the FDA has approved the lap band surgeries for patients who are considered obese with a body mass index (BMI) of 30 to 35, most insurance companies will not pay for it. The gastric sleeve and bypass are reserved for patients with a BMI greater than 35. This translates to being 80-100 lbs overweight. People who need to lose less don’t qualify.
That may be frustrating news, especially if they’ve tried diet and exercise—and still haven’t lost the weight.
Weight gain—and weight loss—are complicated. There are many factors involved. Certainly food and exercise are major factors. But at the heart of it all is your body’s metabolism—how efficiently it burns calories.
Here’s one factor most people don’t consider: Medications can affect your metabolism. Some can make you gain weight. Others will help you lose.
Let me explain.
Years ago, I used to get migraines. I finally saw a neurologist who was ready to prescribe medication. He asked if I wanted the pills that make you gain weight– or the ones that help you lose weight.
Guess what my answer was! Why would anyone pick anything else?
Many types of medications cause weight gain. Some types of cholesterol pills and antidepressants can cause weight gain.
Some of the most commonly prescribed medications that can cause weight gain:
- Tricyclic Antidepressants
- Clozapine
- Risperidone
At the Bariatrics Center, we pinpoint the cause of weight gain. And if the pills you’re taking cause weight gain, we may suggest a different pill. It probably won’t help you lose weight—but it will be what we call “weight neutral.” It will keep you from gaining.
Many of my patients have benefited from making this switch. With a healthy diet and exercise, they stop gaining and gradually start losing without surgery. It’s a beautiful thing.
Medications can also help you lose weight.
Medications like Qsymia (phenteramine/Topamax) work by decreasing your appetite. You’re less hungry because the medication decreases cravings. However, they’re not magic. You still have to change your relationship with food. You can’t eat just because you’re depressed or upset at your husband. The drugs won’t keep you from putting cookies in your grocery cart. But they can help keep you from craving them.
We have a handful of medications to prescribe for patients. Each one works differently. Some should be used in combination; some work alone.
For someone who needs to lose 40 to 60 pounds—and therefore doesn’t qualify for weight-loss surgery—medications are a very good option. They’re especially good for someone who has tried diet and exercise changes but find they are hungry all the time and needs a stronger tool.
In the past, the FDA only recommended prescribing these medications for short-term use—three to six months. Now, we’ve found that they are safe for longer use. Some people take them for many years to safely lose weight—and to maintain that weight loss.
Some of the more commonly used medications that promote weight loss are:
- Bupropion
- Venlafaxine
- Topiramate
Weight loss might come more slowly with these drugs—but with lifestyle changes, it will happen. You will lose, and you will get healthier.