If after 6 months of diet, exercise, and lifestyle changes you have not lost weight, you and your doctor should consider a trial of drug therapy. Drug therapy is only for:
• people with a BMI greater than 30
• people with a BMI greater than 27 who have either high blood pressure, diabetes, or high cholesterol.
The two drugs currently available for weight loss are Meridia® (sibutramine) and Xenical® (orlistat).
Meridia works directly on the appetite control center in the brain to suppress your appetite.320 Meridia combined with a low calorie diet and exercise has been shown to help people lose weight and maintain weight loss. On average, people lose about 10 pounds after taking Meridia for a year.321 Whether patients taking Meridia maintain their weight loss for longer periods of time is not known. The long-term side-effects of Meridia are also not known.
Many people cannot take Meridia. Meridia substantially increases the blood pressure in some patients, and blood pressure needs to be monitored carefully. Meridia can also cause a fast heart rate. Meridia should not be used by patients with a history of uncontrolled or poorly controlled high blood pressure, coronary artery disease, irregular heart rhythm, congestive heart failure, or stroke. Other patients who cannot take Meridia include patients who are taking monoamine oxidase inhibitors (which are a class of antidepressant medication), patients who have had anorexia nervosa or bulimia nervosa, and patients with severe liver or kidney disease. Patients who are planning to become pregnant, are pregnant, or are breast-feeding cannot use Meridia.
Meridia is a controlled substance. It can be abused and can cause physical or psychological dependence.
 
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