If you are obese then the chances are that you have considered taking some form of weight loss medication to help get you down to a reasonable weight. Many people get frustrated with lack of progress while following a reasonably strict regime of controlled diet and exercise and start looking for a fast track option. Unfortunately there really is no fast track option and even medications prescribed by a doctor have to be used as an adjunct to diet and exercise rather than in isolation.
There is only one type of weight management medication that is licensed in the UK and that is Xenical. Although this can be prescribed on the NHS, many doctors are reluctant to give it to patients as the treatment is expensive and not massively effective. For Xenical to work and to avoid gastrointestinal side effects, it is recommended that patients reduce the fat content in their diet so that no more than 30% of calories are derived from fat. There is a version of Xenical that is available in the UK over the counter at a lower dose of Orlistat (the active ingredient) but again, many people do not find this effective. You can get Alli from your local pharmacy but here is a very helpful website from the manufacturer – http://www.alli.co.uk
The issue that a lot of patients have with Xenical is that it does not affect appetite. Most people who are overweight will say that the biggest obstacle to losing weight is their appetite. Xenical works by filtering out fats that we consume in our daily diet and we excrete these fats rather than absorbing them. The reduced calorific absorption should then encourage the body to tap into fat reserves and this should lead to a loss of weight. Although this can be effective for some patients, the process is long and it does not deal with their day to day cravings for food, which can be irresistible.
A solution to this problem could be on the way as an American company has applied to the European Medicines Agency for its appetite suppressant known as Contrave to be licensed in the EU. Contrave contains Bupropion and Naltrexone and the combination of these two molecules on a sustained release basis apparently leads to a reduction in appetite and increased levels of energy expenditure. Naltrexone is an anti-addiction medication and it is said to reduce the reward system response associated with eating very tasty but bad foods like those containing refined sugar and fat.
Although Contrave has produced positive results in clinical trials, the weight loss achieved was not staggering and was not much in excess of the weight loss achieved by the people in the placebo control group in absolute weight terms but it was 47% higher so the medication provides a clear advantage. The question will be: Is the weight loss achieved balanced by the risks associated with taking the medication? The US Food and Drugs Agency thought that this question had not been answered so they demanded a cardiovascular study before a license can be granted. The cardiovascular study is known as the Light Study and this will be used by the European Medicines Agency when attempting to come to a decision.
Contrave is at least a year away from being approved and even if it gets a license, it is unlikely to be available until early 2015. There is at least one online clinic that has already said that they will prescribe Contrave online in the UK if the medicine gets a license. This sort of thing is bound to worry regulators as one of the concerns is the medication being taken by people for whom it is not intended but this is arguably the case with any medication. You can read the Contrave information page at this online clinic here.
If you wish to keep up to date with the progress of Contrave through the regulatory process then we recommend this UK website.