ASK THE PHARMACIST | Why do I need a prescription for weight-loss medicines?

Appetite suppressants or weight-loss medicines that have been clinically studied and proven to work are indicated for obesity.

Obesity or being overweight is defined as an abnormal or excessive build-up of fat that poses a risk to your health. It is diagnosed, among other things by calculating your body mass index (BMI).

You can calculate your BMI as follows: BMI=kg/m². Measure your weight in kilograms and height in metres. Calculate your squared metres by multiplying your height by itself, then divide your weight by the metres squared calculation. Or you can find an online BMI calculator that will do the maths for you.

A BMI over 25 is considered overweight, while over 30 is obese.

Lifestyle changes — for example, healthier eating and regular exercise — comprise the first-line treatment of obesity. However, when diet and exercise alone have not been successful and weight cannot be controlled with better lifestyle choices, the addition of prescription weight-loss medication can be considered.

Prescription weight-loss medication is reserved for patients who have serious health risks associated with being overweight. Examples of such health-risk conditions are: diabetes (high blood sugar), high blood pressure, high cholesterol, heart disease, difficulty breathing during sleep and risk of stroke. Being overweight can also have other serious results, such as blindness, limb amputation, joint or bone disease and some cancers.

Various types of prescription weight-loss medications are available, which work in different ways — for example, by suppressing appetite, inhibiting fat absorption in the small bowel or increasing metabolism. Sometimes exactly how a medication causes weight loss is unknown or the weight loss is a side effect of a medication which is used for a different reason.

Some products contain stimulants and have significant abuse potential. They are therefore termed controlled substances, which are only available if prescribed by a doctor. Weight-loss medication can be dangerous, such as in people with poorly controlled seizures, existing heart conditions or alcohol or substance abuse issues and in pregnancy and while breastfeeding. It can also interact negatively with other medications. Prescription weight-loss medication should only be used for short-term treatment in conjunction with a medically monitored weight-loss programme.

Some side effects of these medications are dizziness, headaches, sleeplessness and a racing heart. All medications have side effects, and one must weigh (no pun intended) the benefits versus the risks. Medication should never be used as a substitute for healthy eating and regular exercise.

In short: you have to meet certain criteria to qualify for prescription weight-loss medication, and unfortunately they don’t include feeling confident in your swimwear or fitting into those jeans.

While you may think that your weight is a severe circumstance, that is for your doctor to decide.

Reducing the number of kilojoules you take in by cutting down on sugars and fats, making a conscious effort to eat more fruit, vegetables, whole grains and nuts and getting at least two-and-a-half hours of physical activity per week are still the best way to prevent and control obesity. And that little bit of unwanted weight.

Do you have a question for our pharmacist? E-mail: pharmacist@timeslive.co.za

Unfortunately, not every question can be published and our pharmacist cannot enter into private correspondence with readers. If your question is not published, keep an eye out for information that relates to the topic in future columns.

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