Review of the best according to the editors. About the selection criteria. The the material is subjective, is not advertising and is not serves as a guide to the purchase. Before purchase is needed consultation with a specialist.
Which is easier: get better, or lose weight? Definitely get better much more complicated, and sometimes it’s simply impossible. Increase your weight lighter after a serious illness, for example, after pneumonia or tuberculosis, if before that in a person he, of course, was higher. After all the body has a genetic memory. But if a person initially was a lean physique, and all his relatives too, then gaining weight is sometimes very difficult. Organism according to the second the law of thermodynamics as an open system, trying to move on to state with the least energy. Therefore he is trying to get rid of excess energy without translating it into mass and without spending its own forces. This can be done by increasing metabolism, a slight increase in body temperature, activation of thyroid hormones, and finally, by reducing intestinal absorption.
Therefore, compared with those who want to gain weight, want lose weight, and cure obesity, in general, in terms of physics, nothing to do. Losing weight is much easier than get better. You need to observe only one very important, but simple principle. Daily energy intake should be slightly less than its costs.
But, alas, obesity is the social scourge of mankind. Obesity is not just a disease or addiction, but global epidemic. So, by 2010, about one and a half billion adults were overweight. Over 200 million men and 300 million women have had clinical obesity and there is a constant and alarming tendency to increase the frequency of this pathological condition in a civilized population.
Obesity must be treated, but, as in many cases, violations exchange, the use of drugs and tablets should be in last place, after all non-drug ways. Naturally, you need to start with a diet and image modification life, then connect the increase in physical activity, and only only then turn to medicines and drugs for obesity.
In fact, in a natural, physiological way and turned overweight into energy throughout the history of human civilization. However, the development of medical science has constantly offered improved ways to deal with obesity, because it’s human nature not to work on oneself, not to test your willpower, but simply apply these or those medicines, following the path of “least resistance”. Therefore, doctors went forward, gradually began to be used laxatives, and then the use of thyroid hormones glands.
This method of treatment was very rude and consisted of increasing the main metabolism, but there were significant side effects, associated with the appearance of a hyperthyroidism clinic. In the thirties XX centuries, amphetamines appeared that are banned in our country, but perfectly suppress appetite and enhance physical activity, causing euphoria. However, the use of amphetamines is fraught with subsequent serious disorders, which, above all, expressed in a complete breakdown, the development of depression and formation addictions.
Study of the effect of various drugs on lipid metabolism in to find a safe and effective medicine for weight loss The body continues continuously. Medicines already exist which can enhance metabolism, prevent absorption fats, stimulate the production of insulin, improve mood. But before still all these drugs can reduce food intake, or make her energy intake less profitable. But anyway the cornerstone remains the creation of such a substance that would controlled weight by reducing appetite, and did not cause side effects associated with metabolic changes.
Appetite is not just a feeling or desire. Satisfying hunger is a deep and ancient instinct, which, along with the satisfaction of feelings of thirst, is on the first a place among all aspirations and interests except instinct self preservation. In order to get enough and survive, a person must take a number of specific actions. Therefore the nerve mechanism underlying appetite and its gratification is extremely complex. In clinical practice, such preparations were tested, which reduced and even completely suppressed appetite, but all of them had a high risk, even deaths, and could not be used to treat obesity.
The situation is further exacerbated by the fact that the accumulated with great difficulty, the reserves of fat in the human body are protected from irrational use, and set aside in reserve. On guard our reserves of fat are hormones, enzymes, a change in the scheme behavior.
Therefore, at present, there is still no single and complete a drug that is guaranteed to allow lose weight without changing lifestyle and diet, and would not have no contraindications for use. Perhaps the closest to this – RDT, or therapeutic fasting. However, there are a number of medicines that can be used in short courses strictly according to the doctor’s testimony along with gymnastics, diet, increase physical activity and other known methods of weight loss body. Very few products can be used safely for a long time, in for a year and longer. Consider some groups of medicinal drugs that are used in our country and also abroad to reduce body weight.
- Drugs for the treatment of obesity
- Overview of popular drugs for the treatment of obesity
- Digestive Blockers – Orlistat (Xenical, Xenalten, Orsoten)
- Hormonal stimulants of insulin production: liraglutide (Victoza, Saxenda)
- Metformin (Glyformin, Glucofage, Siofor, Formitin)
- Baeta, Baeta Long (Exenatide)
- Sibutramine (Meridia, Reduxin, Slimia, Goldline Plus)
- About prospects and foreign drugs
- Rimonabat (Acomplia, Zimulti)
- Lorcaserin (Belvik)
- Ximia (Phentermine + Topiramate)
Drugs for the treatment of obesity
There are very few such drugs, and almost every one of them is the only representative of his group. Among drugs to treat obesity, or rather, allowing a little reduce body weight, we will not meet a large abundance of medicinal funds. If we turn to pharmacology, then there are whole series and generations of drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs). This is meloxicam and nimesulide, ketoprofen and celecoxib, paracetamol and diclofenac. All they are effective, but completely different.
The same variety can be found among hormonal drugs, among cough remedies, among antiulcer drugs and medicines for headaches. But for treatment Obesity, unfortunately, has not yet been able to find the desired abundance. IN in the event that the drug is used in Russia, then for him commercial names are given, as well as the price range, which relevant for the fall of 2019.
All drugs are arranged according to their mechanism of action. IN the proposed list has no rating, no location for possible effectiveness. The order is arbitrary.
Before describing drugs, it should be recalled that self-medication is dangerous, and attempting to use these funds without purpose a doctor can turn into a serious illness. In addition, even a doctor, and specialist in the field of dietetics and treatment of overweight, be sure to use drugs before try non-drug methods. And only then, in the absence of result, some drugs given may be prescribed below.
Like many medicines, they have a number of side effects, e.g. agitation, insomnia, high blood pressure, tendency to chronic diarrhea.
Overview of popular drugs for the treatment of obesity
|Nomination||a place||Name of product||price|
|Drugs for the treatment of obesity||1||Digestive Blockers – Orlistat (Xenical, Xenalten, Orsoten)||759 rub|
|2||Hormonal stimulants of insulin production: liraglutide (Victoza, Saxenda)||9 200 rub.|
|3||Metformin (Glyformin, Glucofage, Siofor, Formitin)||168 rub|
|4||Baeta, Baeta Long (Exenatide)||3 450 rub.|
|Antidepressants||1||Sibutramine (Meridia, Reduxin, Slimia, Goldline Plus)||2 035 rub.|
|About prospects and foreign drugs||1||Rimonabat (Acomplia, Zimulti)||–|
|2||Lorcaserin (Belvik)||18 240 rub.|
|3||Ximia (Phentermine + Topiramate)||–|
Digestive Blockers – Orlistat (Xenical, Xenalten, Orsoten)
A remedy that impairs the absorption of fat in the intestines is, perhaps the most harmless drug of those that used to treat obesity. For example, in the USA you can buy this is a non-prescription drug, and all other drugs for obesity treatments will be prescription. What is this medicine? This is Xenical, or Orlistat.
It is known that the pancreas normally produces a special an enzyme that breaks down fats (pancreatic lipase), and bile, which is produced by the liver, helps to emulsify these fats and transfer to a convenient phase for the action of lipase. Therefore, in the case if you somehow inactivate this lipase, then fats, coming from food will not be broken down in the intestines, but will excreted unchanged with feces.
If Xenical is used in therapeutic recommended dosages, then the absorption of fats in the intestines decreases by a third, and the metabolism does not change. As a result of the decline the intake of fat in the blood decreases, and the body’s ability store them in the form of a reserve in adipose tissue. There are many clinical studies with which it was found that the use of this drug without changing the diet and without physical loads allowed to reduce patients on average about 6 kg of weight per 4 years. Naturally, this suggests that the drug works, but if a person will monitor nutrition and increase his physical load, then the same number of kilograms can be dropped in not 4 years, and in 4 months, I’m even faster, without prejudice to health.
Xenical, or Orlistat has a fearless, but unpleasant side effect. If fat is not absorbed, it should be excreted with feces. And if the stool contains excess fat, then fat, accumulating on the walls of the colon, will cause it mechanical irritation, and on the surface of the intestine oily stool will be literally glide out. This phenomenon of steatorrhea is well known. patients with chronic pancreatitis. They, due to deficiency enzymes oily stool constantly leads to the need use a brush in the toilet, as fat is poorly washed off water.
But from the use of Xenical there is an additional positive effect not associated with weight loss. Quantity reduction absorbed fat leads to a drop in total cholesterol, and reduces the risk of developing atherosclerosis. But again, much more effectively, you can reduce the risk of developing atherosclerosis and reduce plasma cholesterol by diet and increase physical activity.
Xenical is represented by an Italian company on the Russian market Roche, and a pack of 21 tablets will cost an average of 950 rubles. Krka’s Orsoten drug will cost a little less, about 800 rub It is necessary to apply this remedy one capsule together with a meal. Therefore, if we accept that daily man eats three times, then one package is enough for a week, and the monthly the course will cost 4000 rubles.
Hormonal stimulants of insulin production: liraglutide (Victoza, Saxenda)
Strictly speaking, there is no liraglutide among the official testimonies recommendations to use it to reduce body weight. He is appointed type 2 diabetes patients to normalize sugar levels blood, with the ineffectiveness of other drugs. The second testimony is this is a reduction in the risk of heart attack and stroke in patients with the same type 2 diabetes mellitus against the background of any cardiac pathology, as a means of additional treatment. But in the USA, liraglutide is still used to reduce body weight, although also in patients with type 2 diabetes. Unlike other medicines, these are not tablets or capsules, or even drops, but a preparation for subcutaneous injection.
Liraglutide is similar to the human glucagon-like peptide. To to create it, it took the help of genetic engineering and biotechnology. The corresponding section of human DNA that encodes the synthesis of this peptide has been incorporated into the hereditary material of ordinary yeast, then this yeast multiplied and began to produce it human substance in the factory. As a result became get liraglutide, which after purification has 97% similarity with human peptide. As a result of its association with receptors insulin secretion is stimulated and the barrier is overcome insulin resistance. Use this medicine necessary subcutaneously. On their own, at home an injection in the shoulder, abdomen, or thigh once a day as you like, regardless of the meal. But it’s better to put it in same time of day.
How much can you lose weight? According to existing research, it took more than a year, as much as 14 months, or 56 weeks interval so that the mean is reliably established weight loss in patients with diabetes to a maximum of 8.5 kg. On the one hand, this figure can really hit and interest. But on the other hand, you should know in advance about the cost of this drug. So, the drug Viktoza, which produced by Novo Nordisk from Denmark, costs an average of 10,000 rub. This is the cost of a two-day treatment. Same drug Saxenda, which is released by the same company, will cost an average of 25,000 rubles. for five syringe pens, that is, for the cost five day treatment. Accordingly, the cost of treatment liraglutide for 56 weeks will cost the patient almost 2 million rubles. Therefore, it is still much easier for healthy people reduce body weight in the gym or in the pool, or just limit the amount of fat received with food than pay such money.
There is one more very important circumstance. This drug intended only for people with diabetes. If liraglutide will use people with normal blood sugar then induction insulin can lead to a drop in sugar, the development of hypoglycemia and even coma. There are a large number contraindications, drug interactions with other medicinal products means and even an endocrinologist should be trained to work with this drug, and have experience with its prescriptions.
Metformin (Glyformin, Glucofage, Siofor, Formitin)
The second drug to treat type 2 diabetes which, we emphasize, as a side effect leads to a decrease in body weight in patients, is metformin. But, as in the previous case, he cannot used to treat obesity in people without type 2 diabetes, and Moreover: if the patient will take metformin, but with this will be a diagnosis of type 1 diabetes, then this medicine is simple to take dangerous.
But if a patient with type 2 diabetes is overweight body, then with the correct intake of metformin starts to work weight loss, with the risk of hypoglycemia, or a drop in blood sugar is negligible. Metformin is contraindicated in severe renal pathology and chronic renal failure, with heart, liver, respiratory failure, dehydration, chronic alcoholism. Siofor 850 mg tablets, 60 tablets (Berlin Chemie company) will cost inexpensively, from 260 up to 370 rubles., Domestic Gliformin manufactured by the company Akrikhin, will cost even cheaper – a maximum of 120 rubles. behind package (500 mg No. 60).
Baeta, Baeta Long (Exenatide)
Another glucagon-like peptide analogue may be Bayeta-Long drug, exenatide. Honors Baeta Long from liraglutide can be considered the need for not daily administration drug under the skin, and once a week. In addition, exenatide may not be used alone, but as an addition to metformin. This provides better blood sugar control. Baeta Long, which is manufactured by Astra Zeneca, is used in Europe with 2011, and in the Russian market he appeared only 2 years back in 2017.
Despite subcutaneous administration, the drug is in microspheres, which, getting under the skin, gradually dissolve, and the drug is gradually withdrawn from the injection site. But nonetheless, there is a risk of producing specific antibodies to this drug the drug, and according to the laws of the immune system, the less commonly means, the higher the risk of such neutralizing antibodies, reducing the entire clinical effect. In that case, if applied ordinary short-acting liraglutide once a day, then such the risk of antibodies is much lower. How much does Baeta Long cost? IN Moscow pharmacies can buy a package of 4 pieces, designed for month, applications for 11000 rubles.
After reading about hormonal drugs, people with overweight, but without the presence of diabetes. How do they to be? Very simple. If the doctor advises, then you can apply, however, very carefully, strictly according to indications and in the absence of contraindications, drugs from the group of antidepressants. Long it is known that drugs to improve mood from the group are especially selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, paroxetine and others, have as side effect of decreased appetite. Some have this effect. more pronounced, and some less. One of the leaders in degree severity of inhibition of appetite from antidepressants is considered sibutramine preparation.
Sibutramine (Meridia, Reduxin, Slimia, Goldline Plus)
Although this drug is effective directly to the main center of appetite regulation in the head brain, it belongs to antidepressants, and not to anorectics. I.e nevertheless, its antidepressant effect is considered the main thing, since it blocks the reuptake of neurotransmitters.
We’ll say right away that it’s been forbidden to use it in Europe for 9 years, due to the high risk of cardiovascular complications. IN The United States of America it is approved for use, but with a binding reservation from the manufacturer in the instructions that if the patient has a cardiovascular disease, then his can not be used. In our country, it is sold, although it is impossible buy on a free sale, and only with a prescription, and he is included potent drugs. But if you want to get it can.
Some weight loss fanatics combine the use of sibutramine with the above metformin for the treatment of type 2 diabetes. it categorically contraindicated and harmful combination. Sibutramine has side effects associated with the risk of high arterial pressure. Constipation, insomnia, irritability, headaches. A large number of even deadly outcomes usually associated with self-medication and improper prescribing the drug.
Sibutramine may be part of various nutritional supplements, which are offered for weight loss, and at the same time the dosage in these additives can be many times higher than the maximum permissible, but the fact the presence of sibutramine may be hidden. Therefore need to be extremely picky in choosing slimming drugs, especially freely available, purchased on the Internet and brought from China.
One of the most purified preparations is Meridia, which manufactured by Abbot and sold in capsules of 15 mg per Pack of 28 capsules. It is necessary to assign it when the mass index body exceeds indicator 27. The result can be considered a decrease body weight 10% after 6 months.
Briefly list the main official contraindications to taking sibutramine:
- organic obesity, that is, when the cause is related to any disease;
- the presence of eating and eating disorders – malnutrition caused by anorexia or the presence of bulimia;
- psychical deviations;
- taking MAO inhibitors;
- cardiovascular disease or the presence of arterial hypertension
- increased thyroid function;
- chronic kidney and liver failure;
- prostate adenoma, adrenal gland tumor, glaucoma;
- children’s age, pregnancy and lactation;
- chronic alcoholism and drug addiction.
Thus, not all obesity can be treated with sibutramine.
Russian sibutramine drugs on the market – Reduxin and Goldline plus, in addition to sibutramine, have microcrystalline cellulose. It is not absorbed by the body, not has a medicinal effect, but it swells and creates a false a feeling of satiety, as bran or ordinary fiber does. Therefore, in the event that you really want to lose weight, but rightly afraid of the side effects of sibutramine, then just take in ordinary bran food. This is both useful and low cost, and in the end Finally, lead to weight loss.
It should be added that even domestic and not the most the world’s best sibutramine preparations such as Reduxin and Goldline plus is expensive. Minimum packaging cost Reduxine produced by the domestic company Ozone in quantities 30 capsules will cost from 1400 rubles.
Of course, there are other drugs from the group. antidepressants such as Prozac (fluoxetine), Velafax (venlafaxine) of the Croatian company Pliva, or reksetin aka paroxetine, a Hungarian company Gideon Richter. These are antidepressants which are used according to relevant indications, for treatment anxiety and depression. Decreased appetite and weight loss would be an appropriate side effect. In free sale, without recipe, they will not work and it’s right. However, even if these medicines are prescribed according to indications, then they there are specific adverse reactions characteristic of the group SSRIs. For example, dry mouth, restless legs syndrome by at night, as well as ejaculatory disorders in men.
About prospects and foreign drugs
In countries with advanced health care, ongoing testing and research of new drugs, as well as different old combinations that can be used to treat obesity. For example, there is the drug Contrave. In Russian Federation it is not registered and is not for sale, but is used for abroad. This is a combination of an opioid receptor blocker – naltrexone and bupropion serotonin reuptake inhibitor. IN the result of applying Contrave for the same long period of 56 weeks, volunteers lost about 5% of body weight.
Rimonabat (Acomplia, Zimulti)
There is a promising direction in the use of funds cannabinoid receptor blockers that can be used in as anorectics, or appetite suppressants. But while, alas, the “first pancake is lumpy.” The medicinal product has already been created Acomplia, or rimonabat. This is a pure antagonist. cannabinoid receptors, and he acted exclusively on the center appetite. Again, he was not without side effects, mainly from which was considered increased thermogenesis. In Russia, it was sold until 2010 called Zimulti, but then it was recalled first in Europe, and then in Russia, because it had even more serious side effects associated with neuropsychiatric disorders during the reception.
Of the funds that are used abroad to reduce appetite, the most commonly used lorcaserin, or Belvik. He is a soft relative in structure amphetamines, and works best for months reception, with long-term prescription (a year or longer), its effectiveness declining. It is known that patients with diabetes and over a year of treatment, obesity also lost about 5% of body weight. Lorcaserin is the only one of anorectics, that is, drugs, reducing appetite, which can be used for a long time and not addictive.
There are other drugs such as Tenuate, Bontril, Modeinex – real relatives of amphetamines. They can already cause true physical and mental dependence, especially in the case of long use. Therefore, even in the United States of America the circulation of these drugs is strictly controlled.
Ximia (Phentermine + Topiramate)
There is a medicine Ksimiya. This is a combination antiepileptic drug topiramate, which is also recently appeared on the market with phentermine. In our country, this is unlikely the drug will ever be used, since phentermine is included in list 2 of the list of narcotic and psychotropic drugs and their precursors. Phentermine is a pronounced psychostimulant, an amphetamine-like substance that suppresses appetite.
Why is it approved for use in some countries? Because unlike amphetamines, it does not cause euphoria and therefore does not forms a mental addiction. It is used as a drug Adipex, and in Australia and New Zealand there are prolonged forms this medicine. The compound of this substance with topiromatom allows to increase inhibitory activity gamma-aminobutyric acid, and thereby guarantee that still there will be no addiction.
Over the same long period of 56 weeks, patients reduced weight body up to 10 kg, and while this is an obvious record. But Ximia and its analogues also have side effects. So, in women it falls plasma concentration of estrogens and if they are used combined oral contraceptives, then they are no longer acting effective, while increasing the risk of bleeding. At long-term use significantly increases the incidence anxiety and depressive episodes, so before applying this funds need a full medical examination.
In conclusion, I want to warn readers not to treatment of obesity with drugs and various unregistered dubious food additives, over-the-counter drugs that can be easily purchased in online stores. It is hazardous to health. As show numerous clinical studies, 85% of patients, and in general, people with strong thoughts about losing weight do not need to apply medicines. They can do it themselves in a year or two. reduce your body weight to perfect with non-medication ways – diet, physical activity and image changes of life.
Attention! This rating is subjective, not advertising and does not serve as a guide to the purchase. Before the purchase consultation with a specialist is necessary.