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Suggest treatment for weight loss

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Practicing since : 2001
Answered : 1663 Questions
Hi I am under the hosp for back problems and was sent to a dietician to lose weight she said that i should ask the doctor for pills to help as i arent very XXXXXXX at the moment along with the advice she gave for weight loss. if pills could help what would they be and is it wise to take them
Posted Wed, 6 Aug 2014 in Diabetes
Answered by Dr. Shehzad Topiwala 3 hours later
Brief Answer:
Weight loss pills

Detailed Answer:
Sorry to hear about your back problem.

I have perused your attached reports.

Back pain can be from the fibroids too so check with a back ache specialist or a gynecologist to see if it is a contributory factor, in addition to the spine condition diagnosed on the CT scan.

Further, it is advisable to have routine labs like
Liver and kidney function tests, electrolytes
25 hydroxy vitamin D
Free T4

These tests will also give insight into potential problems making it difficult to lose weight such as an under active thyroid.

Regarding pills, there are a few formally approved by the US FDA. I would not know which of these are available in Australia. I use them sparingly in my practice.

When a individual like you comes to me, after ordering blood tests I rule out couple other rare endocrine diseases that cause weight gain such as Acromegaly and Cushings disease.

Then I have them see the dietitian. The I have them read about various medications that have been approved for weight loss and give me their feedback at the next visit only if they feel comfortable starting on any of those.
The reason is that they all have some side effects that prevent wider public use.
Some names include short term phentermine, followed by orlistat, lorcaserin, topiramate-phentermine combination.
if they have diabetes, I offer them metformin and liraglutide/exenatide (daily/ weekly injections) and dapagliflozin/canagliflozin.
Obviously I evaluate them in person too first, to ensure they dont have conditions that make use of these medications unsafe. For example, if the kidney function test as mentioned above suggests significant kidney problems then I avoid metformin.
In my opinion, the world is yet to identify a safe and effective weight loss pill
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