Antidepressants for weight loss are medications that can be prescribed by doctors that are not approved for weight loss per se but can have weight loss as a side effect. An example for antidepressants for weight loss is bupropion [Wellbutrin]. Other antidepressants that have been known to cause weight loss include citalopram, fluoxetine, fluvoxamine, paroxetine and sertraline. These are called ’selective serotonin reuptake inhibitors’, a type of antidepressants. Even though it can cause weight loss, it is only short-term. However, there are other medications for weight loss that can be used for people who have a BMI of 30 or more, or a BMI of 27 to 29.9 with weight-related conditions (such as type 2 diabetes, cardiovascular disease, hypertension, or excess waist circumference), those with no contraindications with the use of the medication, and those who are ready to undertake a lifestyle change.

There are 3 main classes of medications used. Firstly, an amphetamine-like medication (phenteramine [Fastin or Ionamin]) is a therapy that is effective for some people in the short run but has not yet been proven effective in the long run. This medication prolongs the activity of epinephrine and norepinephrine (a type of neurotransmitter) in the brain. However, most state medical boards currently limit the use of the medication to 12 weeks. It should not be used by pregnant or nursing women or those under 18 years old.

Secondly, Sibutramine (Meridia) is a second class of medication that has been approved by FDA for weight loss. What it does is that, it enhances both norepinephrine and serotonin activity in the brain by reducing reuptake of these neurotransmitters by nerve cells. The neurotransmitters then remain active in the brain for a longer period of time and so prolong a sense of reduced hunger. Among the common side effects are constipation, dry mouth, insomnia, and a mild increase in blood pressure in some people (note: those who have a history of hypertension & cardiovascular disease should be cautious when using this). The main idea behind this medication is to make you reduce your appetite, therefore causing you to eat less. Studies have shown that this medication is effective in people who are eating healthy diets, but just eat too much. Sibutramine is safe and effective only when combined with a comprehensive weight-control program and when supervised by a physician.

Thirdly, the only other medication for weight loss that is approved by the FDA for long-term use is orlistat (Xenical). Orlistat inhibit lipase enzyme action in the small intestine ( it blocks the digestion of fats by enzymes in the small intestines), reducing fat digestion by about 30%. It reduces absorption of dietary fat by one-third for about 2 hours when taken along with a meal containing fat. This unabsorbed fat is deposited in the faeces. When taking orlistat, you must remember to control your fat intake because large amounts of fat in the faeces cause numerous side effects such as gas, bloating, and oily discharge. Orlistat is taken after each meal. zanaflex.

Overall, these medications can aid weight loss in some instances but they do not replace the need to reduce energy intake, modifying problem behaviours, and increasing physical activity, both during and after therapy. Any weight loss during drug treatment can be attributed mostly to the individual’s hard work at balancing energy intake with output.

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Source: ‘Perspectives in Nutrition’ by Gordon M. Wardlaw and Jeffrey S. Hampl, McGraw-Hill

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