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Clarify 17 questions about medicines to lose weight

Clarify 17 questions about medicines to lose weight

The Senate approved the bill that releases the sale of inhibitors of appetite. The decision allows the sale of weight-loss medicines produced on the basis of the substances amfepramone, femproporex and mazindol. The proposal also releases the sale of drugs containing the substance sibutramine, its salts and isomers, as well as intermediates. The news made the doubts about these drugs triple. "All people who are going to start taking (or taking) a weight loss medicine should know that there is no magic formula, and that no single medicine brings a satisfactory weight loss," explains endocrinologist Vânia dos Santos Nunes, from Unesp.

On the one hand, experts argue that medicines are still an effective weapon against obesity. On the other, there is the team that condemns the indiscriminate use and mischief that this drug can cause. According to a recent report released by the United Nations Office on Drugs and Crime, the remedies for weight loss should be used, but only medical treatments. The report prepared by Jife (International Narcotics Control Board) encourages Brazil to continue to "take all necessary measures to ensure that anorectics are used only for medical purposes and to prevent them being misused and dispensed indiscriminately."

The first step in understanding the weight loss controversy is to know more about them. Next, My Life, together with endocrinologists Glaucia Duarte and Vânia dos Santos, clarify the main doubts about such controversial remedies.

Remedies for weight loss- Photo Getty Image

1.What are the types of remedies for lose weight? How do they work in the body?

There are three main groups of remedies for weight loss: anorexigenics, satietygenes and fat absorption inhibitors. The drugs in the first group inhibit appetite, and have in their composition substances known as amphetamines. Examples include amfepramone, fenproporex and manzidol. "Currently, specialists use this class only when the other two have not been successful, since it has more risks of side effects," says endocrinologist Gláucia Duarte, a member of the Brazilian Society of Endocrinology and Metabolism. The group (satietygenes) brings together the drugs that act to stimulate the sensation of satiety, that is, the individual feels hungry, but with a smaller portion of food is satisfied, stopping eating earlier. Sibutramine is the best known in the group, and may have a secondary effect on weight loss: increased energy expenditure.

The third group is fat absorption inhibitors, represented only by Orlistat and Cetilistate. It does not restrict the appetite, because it does not act on the brain or the nervous system. "They act to inhibit intestinal absorption of about 30% of the fat ingested. With a good fat intake control, they can be a significant help, but eating too much tends not to lose weight because 30% of fats that are no longer absorbed may not be a calorie deficiency sufficient for weight loss, "says the endocrinologist. <2> In which cases should they be used? Are they valid for both overweight and obesity?

All types of weight loss medicines should only be used when adopting a healthier diet and practicing physical exercises have not shown results in weight loss. "When body mass index (BMI) continues to exceed 29.9 after treatment with dietary reeducation, it is indicated the use of medicines to help in the process of weight loss," says endocrinologist Vânia dos Santos. To find the body mass index, simply divide your weight in kilograms by the square of your height. Calculate your ideal weight here.

Table of BMI according to the World Health Organization

Underweight - below 18.5

Normal - from 18.6 to 24.9

Overweight (pre-obesity) - from 25 to 29.9

Mild obesity - 30 to 34.9

Moderate obesity - 35 to 39.9

Severe or morbid obesity - over 40

3. What are the possible side effects? these remedies are safe if used the right way, they can cause a lot of side effects. "Each type of medication against obesity has specific side effects, which also vary according to the metabolism of each individual," explains the endocrinologist Glaucia Duarte.

Anorexigenics (amfepramone, fenproporex, mazindol) can cause irritability, insomnia or sleep shallow, shivering, or alternating periods of stimulation with periods of depression, increased blood pressure and heart rate. "All of these effects are linked to the nervous and cardiovascular systems, areas where anorectics have an effect," says Glaucia Duarte.

Saciethogens, which increase feelings of satiety, usually have milder side effects than amphetamines, causing insomnia or superficial sleep, agitation, irritability (which is not a frequent symptom). Even so, sibutramine, which falls within this group, was banned from being marketed in the United States and Europe because the organs responsible claimed that the medicine accelerates the heart rate, causing arrhythmias in those who already have the propensity for heart disease. In Brazil, sibutramine has been classified as a controlled remedy.

Inhibitors of fat absorption have side effects, especially if fat intake is exaggerated. It's like a red light. "The person will have diarrhea with pasty or liquid feces, and can even eliminate fat droplets after heavier meals, so even taking medicines to lose weight requires a balanced and healthy diet," says endocrinologist Vânia dos Santos Nunes.

Childhood Obesity - Photo Getty Images

4. Can children with obesity take medication to lose weight?

The indication of remedies for weight loss should be restricted, being prescribed in cases where obesity has become a factor of risk. According to Vânia dos Santos, dietary reeducation and the practice of physical activities normally alone can bring a considerable improvement in the health of obese children and adolescents under 16 years. However, sometimes the use of remedies is necessary. "The use of oslistat, a type of medicine that decreases the absorption of fat by the intestine, has already been tested and approved in children, while drugs that act on the central nervous system are not yet fully approved in children and adolescents," says Gláucia Duarte . And it is not for nothing.

"Anorexigenic and satietygous remedies should not be used by people with decompensated arterial hypertension, cardiac arrhythmias, type 2 diabetes, psychiatric illness"

If they already cause unpleasant effects on an adult's body, 5. Does this type of medication have any contraindications?

Because of changes in the functioning of the nervous system and cardiovascular system, anorexigenic and sachetogenic remedies should not be used by people with decompensated arterial hypertension, cardiac arrhythmias, diabetes type 2, psychiatric disorders (depression and mood disorders, compulsive impulses), and glaucoma. "Although the main contraindications are related to satietyogens and anorectics, drugs that decrease fat absorption also have a group of risk, which are the patients with inflammatory bowel diseases, "says endocrinologist Vania dos Santos.

6.O Can prolonged use cause dependence (physical or psychological)?

Even if the level of dependence is low (they are level one on a scale of up to four), weight loss medicines can cause physical and psychological dependence if they are used for a very long time (more than four months without further evaluation). "Since these drugs should only be used in the last case and still as a support for a program of dietary reeducation and practice of physical activities, once the patient is no longer in a state of obesity, the use of the remedies must be stopped" , says Vânia dos Santos

Obesity- Photo Getty Images

7. Do they need to be taken constantly so the weight stays under control?

"In fact, they should be used for a short time, doctor makes a new monthly assessment if the remedy remains necessary), to not cause any degree of dependence, "says Vânia dos Santos. Weight loss drugs should be part of the weight loss treatment, not to keep it low. According to the endocrinologist, the maintenance of good form must be made from a healthy diet and practice of physical exercises. Otherwise, the chances of regaining weight again are enormous.

8. If you stop taking double fattening?

According to endocrinologists, who slims with the help of drugs that act on the central nervous system actually regain all the lost fat if they do not care

9.Is it dangerous to take them and do intense exercise because of heart rate?

As with eating, physical exercise should be controlled after prescribing weight-loss pills "Physical educators usually suggest exertion testing before starting physical activity, ideally to keep track of heart rate variations to diagnose any changes," says Glaucia Duarte.

Sweat - Photo Getty Images

10. Do they cause excessive sweating?

Thermogenic remedies, a type of substances that act primarily by increasing the organ's caloric expenditure can cause this side effect in some people. But for reasons of safety and side effects (increased heart rate, increased blood pressure, increased thermogenesis), this type of medicine has been underused.

11.Your results are better than food re-education and practice of physical exercise?

The use of medication can only facilitate weight loss, but if there are no lifestyle changes there are chances of regaining lost weight. "The medicine alone will not bring positive results.You need to control your diet and practice physical activities along with the medication to achieve weight loss," says Vânia dos Santos.

12. Do they speed up metabolism?

According to Vânia, people with obesity tend to have the slowest metabolism, and therefore, the body takes to consume all the energy that has been accumulated through meals. What some remedies cause, as a side effect, is to increase caloric expenditure.

13. How to ensure that the medical prescription of the remedies is the most appropriate for the "my"

According to nutritionists, the best way to protect yourself from a medical prescription error is to seek only qualified and nominated professionals from other trusted doctors. Another tip is to always try to hear a second opinion.

14. What is the danger of taking those manipulated formulas that make a cocktail of drugs? In this case, what is the most appropriate medicine bought at the pharmacy?

Because this type of medicine can have many side effects, doctors prefer medications from the laboratories, which are sold in common pharmacies. "The doctor can not predict what side effects a manipulated formula can bring to the patient, so good doctors always prescribe medications to lose weight in consecrated laboratories that undergo a quality test," explains Vânia dos Santos."The doctor can not predict what side effects a manipulated formula can bring to the patient."

15. Are they diuretics?

"Most weight-loss pills also have diuretics to increase fluid loss in the body , and thus increase the sense of slimming, "says Gláucia.

16. Is weight loss illusory, ie lose more lean mass than fat?

A fast weight loss process without worrying about physical activity or food to keep lean mass tended not to hold up. In this case, there is loss of muscle yes. "The weight loss measured in a complete treatment, with food reeducation and physical exercises, guarantees the exchange of fat mass by lean mass", explains Glaucia Duarte.

17. Over time, the body gets used to the medicine and the dosages? Who takes medicine for a long time has a harder time losing weight without it?

Over time, especially with amphetamines, the body can develop tolerance, that is, need to increase the dose so that the effect is the same . "Most likely who becomes a chemical dependent of amphetamines, expects an easy way to lose weight, without the commitment to dietary reeducation and physical exercises, which makes the sustainability of lost weight difficult," says Glaucia Duarte.


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