Patient Area: Medications


Amphetamines (amphetamine, dextroamphetamine, methamphetamine) are strong stimulants that are no longer recommended by most authorities for weight control because they are highly addictive. Potential side effects include heart palpitations, elevation of blood pressure, gastrointestinal disturbances, and insomnia. Amphetamines are prescribed for other problems than obesity, such as attention deficit disorder or narcolepsy. They are not used at Medical Bariatrics of Lexington.

Appetite Suppressants

Phentermine was first approved by the Food and Drug Administration in 1959 as a "short term (a few weeks) adjunct in a regimen of weight reduction based on caloric restriction." It is sold under the brand names Ionamin, Adipex, Fastin, Banobese, Obenix, and Zantryl. Among other drugs of this type are phendimetrizine (Bontril), mazindol, diethylpropion (Tenuate), and the over-the-counter diet aid phenylpropanolamine (Accutrim, Dexatrim). Sibutramine (Meridia), is a newer appetite suppressant which became available in February 1997, and was marketed for longer term use. Since many of these medications have been used by millions of people for 50 years, many bariatricians use them on an "off label" basis. This means that because the medications have been around for decades, they are now generic and the likelihood that pharmaceutical companies will go back and apply for long term use acknowledgement is little since physicians already know about their safety and often use them for much longer than a few weeks. Physicians are allowed to use medications on an off-label basis but should inform their patients on this.


Orlistat, which is being marketed as Xenical, became available in the US in May 1999. Not an appetite suppressant, Orlistat is a lipase inhibitor or "fat blocker" drug. It prevents the absorption of about 30 percent of dietary fat by the digestive tract. It is meant to be used in conjunction with a reduced-calorie diet. Alli is the over the counter version of this, which is half the prescription dose of xwnicol.Some side effects, which are generally mild and transient, may include oily spotting, flatulence with discharge, fecal urgency, oily evacuation, and fecal incontinence. Maintaining a diet of no more than 30 percent of calories from fat may minimize these side effects. The medication also reduces the absorption of fat-soluble vitamins; patients are advised to take a daily supplement that contains vitamins A, D, E and K as well as beta-carotene.


Leptin is a form of the human protein made in fat cells. It's currently in human clinical trials and may help reduce body weight and fat through curbs on metabolism and appetite. Always consult a licensed physician before taking any medication.

Always consult a licensed physician before taking any medication. Bariatricians at MBL are experts in the safety and proper use of these medicines, and guide patients as to which, if any, could be a potential aid to weight loss efforts.