What Can Be Done About Excessive Weight Gain?

By: Karen Cooper, DO • Posted on February 25, 2014

Weight Gain in Women

Excessive weight can be caused by a myriad of factors, including the following:

Stress
Fatigue
Lowered activity
Increased caloric intake
Insomnia
Menopause
Genetic predisposition
Certain medications
Sleep disorders

The risk of acquiring one of the diseases below is significantly increased with excessive weight gain:

Diabetes Mellitus type 2
Hypertension
Coronary artery disease
Sleep apnea
Depression
Osteoarthritis

What is it With Belly Weight and Menopause?

As a woman reaches menopause , however, it becomes increasingly difficult to prevent weight gain and to lose weight, especially around the belly area. To say the least, most women are not happy about this extra deposit of fat in their mid-section.

Belly weight is due to the hormonal shift, which allows weight to be gained more easily around the middle section, along with a reduction of lean muscle mass. Fatigue also increases weight gain promoting a more sedentary lifestyle and vicious circle.

Can Medications Target Weight Gain in That Area?

What is a woman to do? There is no magic pill to set things straight. While there are some medications which can be helpful, not everyone is an appropriate candidate for the small arsenal of weight loss drugs which are now available.

Medications approved by the FDA for weight loss include the following:

Orlistat (Brand name Alli previously prescription Xenical)
Phentermine (Brand name Adipex)
Phentermine and Topiramate (Brand name Qsymia)
Lorcaserin (Belviq)

All of the above medications have side-effects, some intolerable. None of the medications give the maximum desired effect of weight loss without positive lifestyle changes, such as increased exercise activity and a healthier, low-calorie diet.

Orlistat

Orlistat can be purchased over the counter in a lower dose form called Alli compared to the prescription drug Xenical. It does not suppress the appetite, but rather prevents approximately 30 percent of fat from being absorbed from your daily intake. Side effects include:

Flatulence
Bloating
Diarrhea
Interference with fat soluble vitamins (A, D, E and K)

You can expect about a 3-4 percent weight loss after one year.

Phentermine

Phentermine is a stimulant drug which works through the central nervous system and suppresses the appetite. It can cause the following symptoms:

Raise blood pressure
Cause heart palpitations in some individuals
Insomnia
Dry mouth
Constipation

Phentermine is a prescription medication. You can expect about a 4-5 percent weight loss after one year.

Qsymia

Qsymia, recently approved by the FDA, is a combination of two well-known medications, phentermine and topiramate (brand name Topamax). Together they suppress the appetite and reduce food cravings. Side effects include:

Numbness or tingling in the extremities
Dizziness
A change in the way foods taste
Insomnia
Constipation
Dry mouth

Qsymia is also a prescription drug. Expect about a 13 percent weight loss after one year.

Lorcaserin

Lorcaserin, also recently approved by the FDA, works on chemicals in your brain to help decrease your appetite. Side effects include:

Headache
Dry mouth
Nausea
Dizziness
Fatigue
Upper respiratory tract infection

Lorcaserin is also a prescription drug. Expect approximately a 5-6 percent weight loss after one year.

A medical evaluation is necessary to determine if you are a good candidate for any of the above medications as an adjunct to your weight loss. For permanent change in weight loss, a commitment to positively changing dietary habits and exercise activity are imperative for short and long-term success.

Steps for Real Weight Loss

For the most successful outcome with or without the use of medications, peri-menopausal and post-menopausal women should follow the steps below:

An adequate diet.
Regular exercise of moderate to high intensity.
Diligently pay attention to caloric intake.
Consume more protein in the diet for better satiety.
Engage in strengthening exercises to increase muscle mass and boost metabolism as well as lower fat mass accumulation.
Journal and/or use fitness apps to help you keep track and keep you aware and accountable.
Schedule an appointment with a dietician/nutritionist to help shape or improve your diet
Exercise regularly on your own, within a gym setting or with the help of a personal trainer to achieve positive results.

Don’t despair, there is help and many women are successful and in better shape in their 40s, 50s, 60s and beyond than they were in their 20s and 30s.

Be Strong. Be Healthy. Be in Charge!

-Karen Cooper, DO

To schedule an appointment with our physician weight management expert, Dr. Karen Cooper, please call 216-444-2240 in the Women’s Health Institute.

belly weight, healthy eating, menopause, midlife women, nutrition, weight gain, weight loss pills, weight loss tips, women

Columns