Weight Management Interventions:

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When it comes to adopting a successful plan for weight loss, in addition to diet and non-pharmacological strategies, several medical options exist. These include,

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1. Medications which work as stimulants such as Phentermine:

With it's appetite suppression effect, phentermine can help lose up to 10 lbs/month if proper diet and exercise are followed. Phentermine should be used with caution or not at all if there is a pre-existing cardiovascular disease or if another stimulant such as adderall. modafinil etc. is being used. Typically, insurance companies cover this medicine. 

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2. Medications which work as hypoglycemic agents such as Liraglutide/Semaglutide:

These meds are used for lowering blood glucose in diabetes but due to their potent metabolic benefits, significant weight loss has been found to be a side benefit. Patients can lose up to 15-25% of their excess body weight over 6 months. Typically, insurance companies cover this medicine but approval process may take a long time.

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3. Medications to reduce cravings such as naltrexone and bupropion:

Naltrexone and Bupropion or Wellbutrin can help overcome eating behaviors which involve excessive cravings for specific foods or general oral intake. These medicines are helpful for people who find it difficult to control their cravings or are trying to overcome a different addiction and unhealthy eating behavior is replacing their previous addiction. Typically, insurance companies cover these medicines but naltrexone is a controlled substance and may require an approval process. 

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4. Medication to increase feelings of satiety such as plenity:

Although FDA approved, this medicine is not available through regular pharmacies. It is available on plenity website and can be purchased for about $99/month. A prescription is required which the company. Plenity is a capsule which is taken before meals. It increases feelings of satiety and typically patients lose about 5-10 lbs/month by eating less. Insurance companies do not cover this mediccine.

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5. Gastric Balloon Procedure or Orbera: 

Orbera is a gastric balloon and is inserted into the stomach via endoscopic procedure. It is left in place for 6 months and due to its satiating effects, patients loose approximately 50-60 lbs in 6 month. Insurance companies do not cover this procedure and it may cost from $3000 - $7000 depending upon type of center and/or patient specifications. 

 

6. Gastric Bypass Procedure:

Gastric sleeve, banding or Roux en Y surgical procedures can help lose approximately 60-70 lbs. These procedures are usually very successful but they do come with associated risks including nutritional deficiencies, dumping syndrome, psychiatric disorders and others. Some people gain a certain degree of weight back after the "honey moon" period of post surgery weight loss. typically, insurance companies cover this procedure but approval process can turn out to be as lengthy as 6 months involving multiple labs, therapy and a regimented diet and exercise program. 

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