Weight loss drugs and diet prescription specialists:

Most available weight-loss medications are "appetite-suppressant" medications. Appetite-suppressant medications promote weight loss by decreasing appetite or increasing the feeling of being full. These medications decrease appetite by increasing serotonin or catecholamine--two brain chemicals that affect mood and appetite.
In 1999, the drug orlistat was approved by the Food and Drug Administration (FDA) as an obesity treatment. Orlistat works by reducing the body's ability to absorb dietary fat by about one third.

Most currently available weight-loss medications are approved by the U.S. Food and Drug Administration (FDA) for short-term use, meaning a few weeks or months. Sibutramine and orlistat are the only weight-loss medications approved for longer-term use in significantly obese patients, although the safety and effectiveness have not been established for use beyond 1 year. (See table 1 for the generic and trade names of prescription weight-loss medications.)

While the FDA regulates how a medication can be advertised or promoted by the manufacturer, these regulations do not restrict a doctor's ability to prescribe the medication for different conditions, in different doses, or for different lengths of time. The practice of prescribing medication for periods of time or for conditions not approved is known as "off-label" use. While such use often occurs in the treatment of many conditions, you should feel comfortable about asking your doctor if he or she is using a medication or combination of medications in a manner that is not approved by the FDA. The use of more than one weight-loss medication at a time (combined drug treatment) is an example of an off-label use. Using weight-loss medications other than sibutramine or orlistat for more than a short period of time (i.e., more than "a few weeks") is also considered off-label use.

Table 1
Prescription Weight-Loss Medications

How to measure waist circumference:
With a tape measure, comfortably measure the distance around the smallest area below the rib cage and above the umbilicus (belly button).
How to measure hip circumference:
With a tape measure, comfortably measure the distance around the largest extension of the buttocks.


Waist circumference is a common measure used to assess abdominal fat content. The presence of excess body fat in the abdomen, when out of proportion to total body fat, is considered an independent predictor of risk factors and ailments associated with obesity.

What waist size is risky? Undesirable waist circumferences differ for men and women.

Men are at risk who have a waist measurement greater than 40 inches (102 cm)
Women are at risk who have a waist measurement greater than 35 inches (88 cm)
NOTE: If a person has short stature (under 5 feet in height) or has a BMI of 35 or above, waist circumference standards used for the general population may not apply.

Waist-to-hip ratio (WHR) is the ratio of a person's waist circumference to hip circumference, mathematically calculated as the waist circumference divided by the hip circumference. For most people, carrying extra weight around their middle increases health risks more than carrying extra weight around their hips or thighs. (NOTE: Overall obesity is still more risky than body fat storage locations or waist-to-hip ratio.)


What waist-to-hip ratio is considered risky?
For both men and women, a waist-to-hip ratio of 1.0 or higher is considered "at risk" or in the danger zone for undesirable health consequences, such as heart disease and other ailments connected with being overweight.