A. When using weight loss drugs, you must strictly control the indications. Whoever uses which drugs should be treated under the guidance of a specialist. Patients with the following conditions should take diet pills:
(1) First, you use the formula mentioned above to calculate your ideal weight (standard weight), and then compare it with your actual weight to see if you are really obese, and only those who are more than 20% of the normal weight Really fat. The reason why this point is highlighted is that we see that today, with the slim body, the ideal weight in people’s minds is unrealistically reduced, and having a fashion model-like figure has become the pursuit of many young women. So, unless you are really obese, don’t over-diet, let alone take medicine to lose weight. Only those with moderate to severe obesity, that is, overweight by more than 30%, can take weight-loss drugs at the same time as diet and exercise treatment.
(2) Obese patients, after strict diet control and exercise treatment, began to be effective. However, due to various reasons, the patient could not stick to it, and the weight rebounded. At this time, it is wise to take some medicines in conjunction with the treatment.
(3) For some obese people with peptic ulcer, it is difficult to control with diet treatment, and some drugs can be added.
(4) Some people lose weight to a certain extent after diet control and physical exercise, but they regain weight after half a year. At this time can take diet pills.
(5) Those who fail to lose weight by dieting can take diet pills for treatment.
B. Choice of drugs
Over the years, various countries in the world have spent billions of dollars on the research and development of weight-loss medicines, and the weight-loss medicines on the market are also varied and numerous, especially the weight loss products that are officially sold on the Chinese market. . Faced with these endless weight loss products, consumers are often dazzled and do not know how to hobby, so they often “follow the advertisements”. However, some diet product advertisements often exaggerate and mislead consumers, and even consumers can’t tell the mechanism of action of diet products that have been eaten for several months. It is worth mentioning that there are many factors involved in weight loss. What we need is the consumption of fat, not the loss of muscle and water. There are many weight loss pills on the market that advertise how much weight you can lose in a week. Don’t be superstitious about these advertisements. Some medicines may contain cathartic or diuretic drugs, which may lose some weight in the short term, but lose water and electrolytes. . You may feel dizzy, dry mouth, and weak. And the “weight loss” effect of these drugs is not long-lasting. The choice of drugs for weight loss is very critical to the effect and safety of weight loss. Because some of the previously popular appetite suppressants such as fenfluramine have serious complications on the heart, they are currently banned in the United States. Therefore, obese people When losing weight, it is necessary to understand the ingredients and principles of various drugs. For those relatively “mysterious” weight loss products on the market, we must clearly consume them with a responsible attitude towards our own health.
C. Timing of medication
Appetite suppressants can be used in obese adults and selected obese adolescents. These drugs may be used when dietary restriction, exercise, and behavioral therapy have not been sufficiently effective. Appetite suppressants can reduce hunger and cause rapid weight loss. In combined therapy, if the weight has not been significantly reduced after 3-4 weeks after adjusting the dose or taking the maximum tolerated dose of appetite suppressants, the treatment of such drugs should be stopped; if the weight loss continues, it can be repeated. Continue to apply for a while.
D. Duration of medication
Some people advocate that appetite suppressants can only be used for a short period of time when the effect of diet control is not good, but others think that appetite suppressants can be used for a long time to maintain the effect of weight loss and prevent weight gain.
E. Combination medication
Most of the effective weight loss drugs have different degrees of adverse reactions, especially when used in large doses. Combining drugs with different mechanisms of action can enhance the efficacy of weight loss, reduce drug dosage, and reduce the incidence of adverse reactions. For example, the combination of appetite suppressant fenfluramine and phentermine has different effects on foraging behavior. When the two are used in combination, the dose of each drug is reduced, but the appetite-suppressing effect is enhanced, and the weight loss effect is no less than the sufficient application of either one, and the adverse reactions are reduced. Long-term application of wormwood can lead to hyperinsulinemia, so the efficacy of long-term use is reduced. If combined with insulin sensitizers such as troglitazone, metformin, etc., the adverse effects of wormwood can be corrected and the curative effect can be enhanced. The combination of traditional Chinese medicine diet pills and low-dose appetite suppressants, such as rhubarb tablets and low-dose fenfluramine 10-20 mg per day, can reduce the incidence of adverse reactions and achieve good weight loss effects.
F. Drugs for special populations
Adolescents are in the stage of growth and development, and their weight loss treatment must be strictly screened before they can be used, and strict medication monitoring must be carried out. Some studies suggest that fenfluramine, wormwood, growth hormone and low-dose thyroid hormones in the treatment of childhood obesity generally do not affect their growth and development. Appetite suppressants are contraindicated during pregnancy and breastfeeding, and other weight loss drugs are not recommended because they may affect fetal development and child growth. Be careful when choosing diet pills for obese people with heart disease, high blood pressure or fatty liver.
G. Adverse reactions and drug selection
It must be understood that all drugs have certain side effects, so do not blindly take them by yourself. It is best to see a doctor first and take it under the guidance of a doctor, which is safer and more effective. In order to avoid adverse reactions, it is generally necessary to start with a small dose and gradually increase the dose to guide to find a suitable dose that can effectively reduce weight without causing obvious side effects. The vast majority of appetite suppressants and weight loss drugs that increase energy consumption can produce varying degrees of central nervous system stimuli, showing symptoms of irritability, insomnia, and euphoria. Susceptible people and long-term medication may develop dependence, resulting in abuse. Sudden withdrawal of drug addicts will cause withdrawal symptoms, especially amphetamine is easy to become addicted, so amphetamine and compound preparations containing amphetamine cannot be used for weight loss, and others are also prone to Dependent amphetamine appetite suppressants such as methamphetamine should only be used as second-line drugs for weight loss. The main adverse reactions of fenfluramine are mainly sedative effects, which can cause depression, while large doses can produce excitatory effects. Sudden withdrawal after long-term medication can cause severe depression, so this product cannot be given in an intermittent course of treatment. medicine. Appetite suppressants, central stimulants that increase energy consumption, thyroid hormones, etc., can produce dry mouth, dilated pupils, blurred vision, dizziness, tachycardia, increased blood pressure, and arrhythmias by stimulating the sympathetic nervous system. Sweating, etc., so it is not suitable for patients with hypertension, angina pectoris, and hyperthyroidism. The incidence of these adverse reactions was lower with fenfluramine at usual doses. Generally, when patients experience definite weight loss with the above-mentioned weight loss drugs, blood pressure may decrease, and susceptible individuals may experience increased blood pressure and tachycardia. The use of lipase inhibitors and glucosidase inhibitors has many gastrointestinal reactions such as abdominal distension and excessive gas. The former can also affect the absorption of fat-soluble vitamins, so long-term application should be cautious.
H. Drug Interactions
Theoretically, most appetite suppressants can raise blood pressure and affect the action of antihypertensive drugs. However, the usual dose of appetite suppressants has no obvious clinical significance on the interference of general antihypertensive drugs. Nonetheless, blood pressure should be monitored weekly for the first 4-6 weeks of treatment. Concomitant use of appetite suppressants with MAO inhibitors can lead to hypertensive crisis, so appetite suppressants are contraindicated in patients who have used any MAO inhibitor within 2 weeks.
I. In the process of medication, pay attention to monitoring.
Body weight, blood sugar, blood lipids and other biochemical indicators must be detected before and when taking the medicine. Based on these indicators, adjust the dose of the drug. Once the drug is taken, do not stop at will, as this may cause discomfort or weight rebound, and the dose should be gradually increased until the drug is discontinued. Specific practices should be carried out under the guidance of a doctor.
