Overview of Weight Loss Products: Types and Representative Drugs of Western Medicine Weight Loss Drugs

**Overview of Weight Loss Products**

Currently, weight loss products on the market include the following categories:

Obesity is a chronic disease requiring lifelong treatment. Drug therapy is not the primary treatment for weight loss; lifestyle modifications, increased exercise, and correction of unhealthy eating habits should be the main approaches. While weight loss from medication is usually moderate, it can significantly improve obesity-related conditions such as diabetes and cardiovascular disease. Insufficient data demonstrate the safety and effectiveness of long-term drug use. Therefore, weight-loss drugs must be administered with extreme caution to patients with medically confirmed obesity. "A balanced body should not take medication indiscriminately, as the effects of medication can be unbalanced and cause internal imbalances, making one more susceptible to external ailments." If medication is needed, please follow your doctor's instructions. Do not purchase or try medications without consulting a doctor, and be aware of the potential for adverse reactions.

Weight loss drugs can be broadly categorized as follows:

1. Drugs that inhibit intestinal digestion and absorption

Orlistat, an intestinal lipase inhibitor, can cause 30% of fat to be excreted in feces; acarbose, a glucosidase inhibitor, reduces the absorption of carbohydrates; threo-citric acid and its derivatives can inhibit gastric emptying, thereby affecting digestion and absorption, and reducing intake by increasing satiety. Dietary fiber contains polysaccharides, lignin, hemicellulose, resins, and alginate, which can prolong gastric emptying time and reduce the absorption of nutrients.

2. Appetite suppressants

Sibutramine inhibits the reuptake of serotonin and norepinephrine in the brain, increasing satiety and accelerating fat metabolism. Benzocaine, a local anesthetic, numbs the oral and gastrointestinal mucosa, alters taste sensitivity, and thus affects appetite; its action is that of a non-centrally acting appetite suppressant. Some bioactive peptides and their agonists or inhibitors can affect satiety and alter appetite, such as neuropeptide Y receptor antagonists, leptin agonists, saturates, enterostatin, and cholecystokinin.

3. Medications that increase energy expenditure

Examples include ephedrine, theophylline, caffeine, thyroid hormones, nandrolone phenylpropionate, growth hormone, and insulin-like growth factor 1.

4. Herbal weight loss pills

Foods such as ephedra, hawthorn, and rhubarb, as well as tea and cocoa, also have weight-loss effects.

5. Other medications for treating obesity

Insulin sensitizers include thiazolidinedione derivatives such as troglitazone and cycloglitazone, and metformin, a biguanide. The antitumor drug hydroxyborane can inhibit fat synthesis and cholesterol absorption, lowering LDL and raising HDL, thus exhibiting anti-obesity effects.

6. Other drugs currently under investigation

Examples include leptin, a product of obesity genes; dual PPARα/γ agonists; glucagon-like peptide-1 inhibitors such as exenatide and DPP-IV inhibitors; protein tyrosine phosphatase-1B inhibitors; selective cannabinoid receptor antagonists; and β-3 adrenergic receptor agonists.

Currently, the main weight-loss drugs on the domestic market are divided into Western medicines such as sibutramine and orlistat, and traditional Chinese medicines such as Qixiaowan, which are introduced below:

1. Sibutramine

Sibutramine is one of the most widely used raw materials in the current weight loss drug market. It is a central nervous system depressant that can simultaneously control excess fat intake and increase fat breakdown to enhance energy consumption. By suppressing appetite and increasing satiety, it can reduce food intake and thus reduce weight.

It is recommended for obese patients with a body mass index (BMI) ≥30 kg/m², or ≥28 kg/m² and other risk factors such as diabetes or dyslipidemia.

Adverse reactions:

Common adverse reactions include: dry mouth, loss of appetite, insomnia, and constipation.

Other adverse reactions with an incidence of ≥1% include fever, increased heart rate, increased blood pressure, dyspnea, diarrhea, and gastroenteritis.

This product can cause abnormal liver function, which usually disappears with further treatment, and there is a clear dose-response relationship.

Other possible reactions include limb spasms, increased tension, abnormal thinking, epileptic seizures, interstitial nephritis, menstrual disorders, peripheral edema, arthritis, pruritus, paresthesia, and amblyopia.

Precautions:

Treatment for obesity should be based on diet control and exercise.

Obese individuals with Cushing's syndrome or hypothyroidism should be excluded from the use of this product.

Patients with a history of hypertension should use this product with caution.

Because it may increase or aggravate the formation of gallstones, patients with cholelithiasis should use this product with caution.

This product can cause pupil dilation and should be used with caution in patients with angle-closure glaucoma.

Patients with a history of epilepsy should use this product with caution, and patients experiencing epileptic seizures should discontinue its use.

It may affect judgment, thinking, or motor skills.

Taboo:

Patients receiving treatment with monoamine oxidase inhibitors.

Patients receiving other centrally acting appetite suppressants.

Patients with anorexia nervosa.

Patients allergic to any of the ingredients in this product.

Hypertensive patients whose blood pressure cannot be controlled or is poorly controlled.

Patients with coronary heart disease, heart failure, arrhythmia, and stroke.

Patients with severe liver or kidney dysfunction.

Use in pregnant and lactating women: Animal studies have shown that this product has teratogenic effects, but no carcinogenic or mutagenic effects have been observed. It is recommended that pregnant or women planning to become pregnant and lactating women do not take this product.

Medication use in elderly patients: Due to the reduced heart, kidney, and liver function and the increased likelihood of medication use for other co-existing diseases in the elderly, dosage selection for the elderly should be done with caution.

Pediatric use: The safety and efficacy of this product in children under 16 years of age have not been established, therefore it is not recommended for use in children under 16 years of age.

2. Orlistat

Orlistat is a lipase inhibitor that achieves weight loss by blocking the absorption of dietary fat by the body. It is suitable for long-term treatment of obese and overweight individuals who are on a low-calorie diet, including those who already have obesity-related risk factors.

Common adverse reactions include: oily spots, increased flatulence, defecation urgency, fatty stools, steatorrhea, increased bowel movements, and fecal incontinence. Acute gastrointestinal reactions commonly seen in patients taking Xenical include: abdominal pain/discomfort, flatulence, watery stools, loose stools, rectal pain/discomfort, dental discomfort, and gingival discomfort. Other less common adverse events include: upper respiratory tract infection, lower respiratory tract infection, influenza, headache, menstrual disorders, anxiety, fatigue, and urinary tract infection. There are occasional reports of hypersensitivity to this product. The main clinical manifestations are itching, rash, urticaria, angioedema, and allergic reactions. Furthermore, orlistat can affect the absorption of fat-soluble vitamins A and E.

In recent years, new plant-based weight-loss preparations with natural plant ingredients as the main component, known as "green weight-loss drugs," have emerged as a dark horse in the international market, with sales increasing year by year, creating a "green storm." Traditional Chinese medicine (TCM) is a treasure of Chinese medical culture passed down for thousands of years. Influenced by the "TCM complex" among Chinese obesity patients and the marketing hype of TCM weight-loss drug manufacturers, coupled with repeated exposures of toxic side effects caused by chemically synthesized weight-loss drugs such as the "Nomeiting incident" and the "Yuzhitang incident," many consumers believe that TCM weight-loss drugs have fewer side effects, are reasonably priced, and are easily acceptable. Because TCM mainly relies on various folk remedies and prescriptions, there are not many commercially available products. Currently, the approved TCM weight-loss drugs on the market mainly include:

1.Shixiaowan

The main ingredients include Rehmannia glutinosa (processed), Rehmannia glutinosa, Adenophora stricta, Atractylodes macrocephala, Paeonia lactiflora, Prunus mume, Chaenomeles speciosa, and Cyperus rotundus. It nourishes Yin and tonifies the kidneys, strengthens the spleen and stomach, and promotes diuresis and reduces swelling. It is suitable for simple obesity, edema, and menstrual irregularities caused by spleen and kidney Yin deficiency and dampness. Clinically, it is used for simple obesity, edema, and menstrual irregularities due to kidney Yin deficiency and spleen deficiency.

2. Slimming pills

The main ingredients include Astragalus membranaceus, Stephania tetrandra, Atractylodes macrocephala, Alisma plantago-aquatica, Hawthorn fruit, Buffalo horn, Salvia miltiorrhiza, Ligusticum chuanxiong, Artemisia capillaris, and Rheum palmatum. It promotes weight loss, invigorates qi and strengthens the spleen, promotes blood circulation, removes blood stasis, and relieves chest congestion. It

Many people know about using traditional Chinese medicine for weight loss, but these natural plants are not as simple as they seem; targeted treatment is crucial. For example, while herbs like cassia seeds and lotus leaves have weight-loss effects, their effectiveness varies depending on the cause of obesity and the individual's constitution. Furthermore, weight-loss drugs containing traditional Chinese medicine ingredients are not without problems. For instance, herbs like Aristolochic acid, which contain arbutin, can cause varying degrees of liver and kidney toxicity. We should view weight-loss drugs with a critical eye and avoid blindly trusting advertisements or trying them without proper guidance. The correct approach is to seek scientific medical diagnosis, follow medical advice, use medication cautiously, and closely monitor changes after medication use to ensure safety.