Qsymia: New weight loss medication now available to Denver ResidentsPosted: Sep 18 in Weight Loss Medication by Dr. Lazarus
The first new FDA-approved weight loss medication, Qsymia, became available to Denver residents today.
This is huge news for the medical weight loss community! For the first time in over 13 years, individuals needing help with life-long weight control have a new, clinically proven, scientifically valid treatment. Clinical trials lasting 2 years have demonstrated very good weight loss with Qsymia, averaging over 10%, with many patients losing 11 to 14% of their body weight (some lose substantially more than this). This compares favorably with lap band surgery (20%), especially when you consider the significant regain potential after surgery (I’ll review the latest findings on lap band in a future blog article later this month, as reported last week in JAMA). I am hopeful that with treatment, weight loss with Qsymia at 5 years will be greater than weight loss with lap band surgery (this is my hope – only time will tell if it is true).
Qsymia is approved for long-term treatment of weight problems (no time limits are specified), so we will be able to maintain individuals achieving good weight loss with this treatment on Qsymia indefinitely.
Qsymia combines Phentermine and Topiramate in a unique way, capitalizing on the weight loss potential of both drugs, at a dose designed to maximize weight loss and minimize side effects. Nonetheless, we have to be very careful regarding side effects. In particular, Qsymia is NOT safe in pregnancy, so when used in women who have the possibility of becoming pregnant, it will be critical to monitor closely for pregnancy, and to use 1 if not 2 forms of contraception during Qsymia treatment. Also, it can increase heart rate, suicidal thoughts, or be associated with eye problems. Further, Qsymia should not be used by patients on a ketogenic diet (for example, our Protein Sparing Modified Fast program puts patients in to ketosis, and Qsymia used in this meal plan can increase the risk of kidney stones).
While Qsymia is very exciting and we will be prescribing it for patients in the greater Denver metro area immediately, it is important to note a few things. Qsymia is FDA approved only for the treatment of obesity (BMI >= 30), or for patients with a BMI >= 27 with a serious weight-related condition, such as Diabetes, High blood pressure, or High cholesterol. (If you do not know your BMI, please use the BMI calculator in the right column of this post to see if you are a reasonable candidate to be on Qsymia).
In clinical trials, Qsymia did not achieve these impressive weight loss results by itself. In fact, it is intended only to be used as part of a broader lifestyle intervention – i.e., a diet and exercise program needs to be used in conjunction with Qsymia if substantial weight loss is to be expected. In fact, the FDA has approved continuing Qsymia only in cases where significant weight loss is achieved. Patients not successfully achieving weight loss on Qsymia will need to discontinue treatment and pursue other weight loss treatment options.
In addition to weight loss, patients treated with Qsymia were less likely to develop diabetes (or if they had diabetes, had lower blood sugars and could often come off of diabetes medications), and was helpful to patients even if they had experienced difficulties with other weight loss programs.
We expect more treatment options to become available. Belviq, also approved by the FDA last month, is expected to be available in early 2013, and Contrave will have another chance at FDA approval, either in 2013 or 2014. So, stay tuned for more!
If you are interested in discussing whether or not Qsymia would be a good addition to your weight loss program, call Clinical Nutrition Center at 303-750-9454 and set up an office visit with Dr. Lazarus or Heather. We look forward to hearing from you.