What’s the deal with appetite suppressants?

Let’s talk about hunger and specifically, appetite suppressants. There are quite a few on the market today – that require prescriptions and are approved by the FDA (Food and Drug Administration).  And let’s face it, with weight loss, increased hunger often becomes a fact of life. I talk about why this is in a previous post here. You may have seen over the counter options at your local drug store. In my opinion, there are too many available that have actually gone through the necessary testing and research and have been around for a while to just blindly pick up something off a shelf that could be sawdust for all you know. Don’t do it.

As a weight loss expert, I want to assure you that I’m not against using weight loss aids for help. Not at all.  That might surprise you, but I know the physiology you’re up against when the body’s natural defense mechanisms kick in. Having said that, I’m not a doctor and this is a decision only you and your doctor can make because they aren’t appropriate for everyone. But I am writing this post because I want to give you some facts on what’s available and remove some of the stigma that’s associated with getting medical help for weight loss.

Like I said, there are several FDA-approved options on the market that all primarily do one thing – they suppress your appetite. The most widely used options are phentermine (brand name Adipex) and diethlypropion (brand name Tenuate)- both central nervous system stimulants. There is a newer one (brand name Qysmia) that combines phentermine with the anticonvulsant, topiramate, thought to lessen the occurrence of creating a tolerance as with using phentermine alone. And then there is locarserin HCL (brand name Belviq), that reduces appetite by specifically activating brain receptors for serotonin, a neurotransmitter that triggers feelings of satiety and satisfaction.

In my opinion, they are most helpful for maintaining weight already lost and/or giving you an extra “push” once you’ve already started to succeed with weight loss and hit a plateau. That’s right, helpful for MAINTAINING lost weight, not actively LOSING weight. If you have ever successfully lost weight, you may have noticed the hardest part was actually keeping it off. One of the main reasons for this is increased hunger is caused by a natural increase in the hormone, ghrelin, which is naturally stimulated by weight loss. It’s designed to “protect” you from starvation.

Not everyone can take these medications and not everyone can tolerate their side effects – they can cause increased heart rate, restlessness, insomnia, anxiety, etc. And you can’t take them forever because eventually you will build up a tolerance and they will become less effective over time. Unfortunately for many, this can  mean weight regain long term. The biggest obstacle I have seen with patients and clients, however, is lack of insurance coverage and/or the ability to get a willing doctor to prescribe them in the first place. Although I have seen coverage improve since “Obesity” was recognized as an actual chronic disease in 2013 by the American Medical Association.

So what do you do? And what do you do if you simply aren’t comfortable with the idea? Here are some tried and true tips that I find myself repeating often:

  • Avoid allowing more than five hours between meals and/or snacks.
  • Include 30 grams of protein at each meal and 10-15 grams protein at each snack (you will most likely need to increase your breakfast protein and decrease your dinner protein). I give you ideas of what this looks like in this previous post.
  • Consume minimum 80-100 ounces water daily (closer to half your body weight (pounds) of water in ounces is preferable, but go for this minimum).
  • Include plenty of fiber at each meal – half of your plate should consist of fruits and vegetables. More fiber and water packed foods means more volume and less calories. Most people consume <10 grams of fiber daily when the recommended amount is at least 25 grams. Chances are you have a long way to go, too.

A final thought, consider natural appetite suppressants. Grapefruit, peppermint, and lemon all come to mind and are great for adding to your water for flavoring. The best part? They can be used at the start of your weight loss journey and during the weight maintenance phase long term – without worries of developing a tolerance. Effectiveness doesn’t wear off in nature.

Hopefully I’ve helped you relax a little bit on this topic if it’s something you’ve considered but were afraid to ask about or I’ve give you something to think about if you haven’t. Whatever you decide, you’ve got options!

P.S. If you’ve been looking for support, you’ve come to the right place, request to join my online support group for all things nutrition and weight loss support.

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Jillian McMullen, CSOWM, RDN, LDN