Claim: Weighing effectiveness versus risk in obesity drugs
Verdict: REFUTES

Retrieved passages:
title: Management of obesity
text: National Institutes of Health recommend a weight loss goal of 5% to 10% of the person's current weight over six months. One medication, orlistat, is current widely available and approved for long term use. Weight loss however is modest with an average of at 1 to 4 years and there is little information on how these drugs affect longer-term complications of obesity. Its use is associated with high rates of gastrointestinal side effects. The most effective treatment for obesity is bariatric surgery. Surgery for severe obesity is associated with long-term weight loss and decreased overall mortality. One study found a

title: Management of obesity
text: commonly used medications. Some are only approved for short term use, others are used off-label, and still others are used illegally. Most are appetite suppressants that act on one or more neurotransmitters. Racemic amphetamine, phendimetrazine, diethylpropion, and phentermine are approved by the FDA for short term use, while bupropion, topiramate, and zonisamide are sometimes used off-label. Recombinant human leptin is very effective in those with obesity due to congenital complete leptin deficiency via decreasing energy intake and possibly increases energy expenditure. This condition is, however, rare and this treatment is not effective for inducing weight loss in the majority of

title: Management of obesity
text: people with obesity. It is being investigated to determine whether or not it helps with weight loss maintenance. The usefulness of certain drugs depends upon the comorbidities present. Metformin is preferred in overweight diabetics, as it may lead to mild weight loss in comparison to sulfonylureas or insulin. The thiazolidinediones, on the other hand, may cause weight gain, but decrease central obesity. Diabetics also achieve modest weight loss with fluoxetine, orlistat and sibutramine over 12–57 weeks. Preliminary evidence has however found higher number of cardiovascular events in people taking sibutramine verses control (11.4% vs. 10.0%). The long-term health benefits of

title: Anti-obesity medication
text: Anti-obesity medication Anti-obesity medication or weight loss drugs are pharmacological agents that reduce or control weight. These drugs alter one of the fundamental processes of the human body, weight regulation, by altering either appetite, or absorption of calories. The main treatment modalities for overweight and obese individuals remain dieting and physical exercise. In the United States orlistat (Xenical) is currently approved by the FDA for long-term use. It reduces intestinal fat absorption by inhibiting pancreatic lipase. Rimonabant (Acomplia), a second drug, works via a specific blockade of the endocannabinoid system. It has been developed from the knowledge that cannabis smokers

title: Anti-obesity medication
text: been evaluated in Phase 1 and Phase 2 human clinical studies with the aim of investigating treatment potential with regards to obesity. Dietary supplements, foodstuffs, or programs for weight loss are heavily promoted through advertisements in print, on television, and on the internet. The US Food and Drug Administration recommends caution with use of these products, since many of the claims of safety and effectiveness are unsubstantiated, and many of the studies purporting to demonstrate their effectiveness are funded by the manufactures and suffer a high degree of bias. Individuals with anorexia nervosa or bulimia nervosa, and some athletes, try

title: Obesity
text: rejected the latter two drugs in part because of associations of heart valve problems with lorcaserin and more general heart and blood vessel problems with phentermine–topiramate. Orlistat use is associated with high rates of gastrointestinal side effects and concerns have been raised about negative effects on the kidneys. There is no information on how these drugs affect longer-term complications of obesity such as cardiovascular disease or death. The most effective treatment for obesity is bariatric surgery. The types of procedures include laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, vertical-sleeve gastrectomy, and biliopancreatic diversion. Surgery for severe obesity is associated with

title: Childhood obesity
text: Orlistat and sibutramine may be helpful in managing moderate obesity in adolescence. Metformin is minimally useful. A Cochrane review in 2016 concluded that medications might reduce BMI and bodyweight to a small extent in obese children and adolescents. This conclusion was based only on low quality evidence. As of 2015 there is not good evidence comparing surgery to lifestyle change for obesity in children. There are a number of high quality ongoing studies looking at this issue. From 1980 to 2013, the prevalence of overweight and obesity in children increased by nearly 50%. Currently 10% of children worldwide are either

title: Anti-obesity medication
text: limited evidence of small benefits in weight reduction especially in obese children and adolescents, it is recommended that anti-obesity drugs only be prescribed for obesity where it is hoped that the benefits of the treatment outweigh its risks. Current and potential anti-obesity drugs may operate through one or more of the following mechanisms: Anorectics are primarily intended to suppress the appetite, but most of the drugs in this class also act as stimulants (e.g., amphetamine), and patients have abused drugs "off label" to suppress appetite (e.g. digoxin). The first described attempts at producing weight loss are those of Soranus of

title: Lorcaserin
text: panel voted 19-4-1 to recommend lorcaserin to the FDA. The FDA stated that the weight loss data passed FDA standards for efficacy and that the drug did not have cancer risks based on clarifications in the data. The FDA panelist recommended that postmarketing studies regarding potential heart valve issues be completed. The FDA has not stated one way or the other whether they believe this is necessary at this time although no related safety markers have been indicated during clinical studies. On 27 June 2012, the FDA officially approved lorcaserin for use in the treatment of obesity for some adults.

title: Obesity
text: Dietary and lifestyle changes are effective in limiting excessive weight gain in pregnancy and improve outcomes for both the mother and the child. Intensive behavioral counseling is recommended in those who are both obese and have other risk factors for heart disease. Five medications have evidence for long-term use orlistat, lorcaserin, liraglutide, phentermine–topiramate, and naltrexone–bupropion. They result in weight loss after one year ranged from 3.0 to 6.7 kg (6.6-14.8 lbs) over placebo. Orlistat, liraglutide, and naltrexone–bupropion are available in both the United States and Europe, whereas lorcaserin and phentermine–topiramate are available only in the United States. European regulatory authorities

title: Management of obesity
text: intestinal fat absorption by inhibiting pancreatic lipase. Lorcaserin has been found to be effective in the treatment of obesity with a weight loss of 5.8 kg at one year as opposed to 2.2 kg with placebo and it is approved by the Food and Drug Administration for use in the treatment of obesity. Side effects may include serotonin syndrome. The combination drug phentermine/topiramate (Qsymia) is approved by the FDA as an addition to a reduced-calorie diet and exercise for chronic weight management. Rimonabant (Acomplia), another drug, had been withdrawn from the market. It worked via a specific blockade of the

title: Anti-obesity medication
text: removed from the US market in 2004 over concerns that it raises blood pressure and could lead to strokes and death. Some patients find that diet and exercise is not a viable option; for these patients, anti-obesity drugs can be a last resort. Some prescription weight loss drugs are stimulants, which are recommended only for short-term use, and thus are of limited usefulness for extremely obese patients, who may need to reduce weight over months or years. Orlistat (Xenical) reduces intestinal fat absorption by inhibiting pancreatic lipase. Some side-effects of using Orlistat include frequent, oily bowel movements (steatorrhea). But if

title: Management of obesity
text: States and Canadian markets in October 2010 due to cardiovascular concerns. Weight loss with these drugs is modest. Over the longer term, average weight loss on orlistat is , sibutramine is and rimonabant is . Orlistat and rimonabant lead to a reduced incidence of diabetes, and all three drugs have some effect on cholesterol. However, there is little information on how these drugs affect the longer-term complications or outcomes of obesity. In 2010 it was found that sibutramine increases the risk of heart attacks and strokes in people with a history of cardiovascular disease. There are a number of less

title: Management of obesity
text: developed and published evidence-based practice guidelines in 2006. The guidelines attempt to address the prevention and management of obesity at both the individual and population levels in both children and adults. The European Union published clinical practice guidelines in 2008 in an effort to address the rising rates of obesity in Europe. Australia came out with practice guidelines in 2004. Temporary, controllable gastric pseudo-bezoars (swallowable, swellable foreign bodies in the stomach meant to reduce gastric volume from inside the organ) are being tested. Treatment with naltrexone plus bupropion in a phase three trial resulted in a weight lose of 5–6%

title: Obesity paradox
text: before death, and classifying those individuals as lean greatly inflates the mortality rate in the normal and underweight categories of BMI, while lowering the risk in the higher BMI categories. Studies that employ strategies to reduce reverse causation such as excluding sick individuals at baseline and introducing time lag to exclude deaths at the beginning of follow-up have yielded estimates of increased risk for body mass indices above 25 kg/m. Critics of the "paradox" have also argued that studies supporting its existence almost always use BMI as the only measure of obesity. However, because BMI is an imperfect method of

title: Broselow tape
text: the lighter zone below, with < 1% outliers falling greater than 1 zone from predicted. If the healthcare provider incorporates a visual estimate of body habitus into the prediction, the accuracy of the estimate of actual patient weight is improved as confirmed in multiple studies. Specifically, for drug dosing the patient’s length-based dosing zone can be adjusted up one color zone if the child appears overweight. Thus incorporating a visual estimate of whether the child is over-weight provides a simple method to predict actual patient weight that appears to be clinically relevant given the rise in obesity in the U.S..

title: Anti-obesity medication
text: stools that occur with orlistat. The development stalled as Phase 1 trials were conducted in 2004 and there was no further human clinical development afterward. In 2011, Peptimmune filed for Chapter 7 Liquidation. Anti-obesity medication Anti-obesity medication or weight loss drugs are pharmacological agents that reduce or control weight. These drugs alter one of the fundamental processes of the human body, weight regulation, by altering either appetite, or absorption of calories. The main treatment modalities for overweight and obese individuals remain dieting and physical exercise. In the United States orlistat (Xenical) is currently approved by the FDA for long-term use.

title: Lorcaserin
text: On 10 May 2012, after a new round of studies submitted by Arena, an FDA panel voted to recommend lorcaserin with certain restrictions and patient monitoring. The restrictions include patients with a BMI of over 30, or with a BMI over 27 and a comorbidity such as high blood pressure or type 2 diabetes. On 27 June 2012, the FDA officially approved lorcaserin for use in the treatment of obesity for adults with a BMI equal to or greater than 30 or adults with a BMI of 27 or greater who "have at least one weight-related health condition, such as

title: Anti-obesity medication
text: using herbal medicine, dietary supplements or homeopathy against obesity. Conjugated linoleic acid is claimed to help reduce obesity but it is ineffective for this use. The ECA Stack cannot be marketed in most developed countries but used to be marketed as a weight loss; it provided modest short term weight loss but evidence for the long term was lacking. Additionally there was a risk of adverse effects on the cardiovascular, mental, digestive, and nervous systems. Some anti-obesity drugs can have severe, even, lethal side effects, fen-phen being a famous example. Fen-phen was reported through the FDA to cause abnormal echocardiograms,

title: Management of obesity
text: these treatments remain unclear. Fenfluramine and dexfenfluramine were withdrawn from the market in 1997, while ephedrine (found in the traditional Chinese herbal medicine "má huáng" made from the "Ephedra sinica") was removed from the market in 2004. Though hypothesized that supplementation of vitamin D may be an effective treatment for obesity, studies do not support this. Bariatric surgery ("weight loss surgery") is the use of surgical intervention in the treatment of obesity. As every operation may have complications, surgery is only recommended for severely obese people (BMI > 40) who have failed to lose weight following dietary modification and pharmacological