藥物減重治療應注意事項

• 只適合不能透過飲食和運動控制體重的肥胖人士
• 藥物減重可輔助飲食和運動減重治療，改變生活方式
• 進行藥物減重療程之前，要接受全面身體檢查
• 適合於:
      1) BMI > 30 kg/m2
      2) BMI 23-30 + 腰圍 > 36 吋 男士和腰圍 > 32 吋女士
      3) BMI 25-30 + 肥胖相關疾病
  

減重目標:

• 減重第一個月目標為 2公斤 (4.5磅)
• 首三至六月減去 5% 身體重量
• 減 5% - 10% 體重可減輕糖尿及心臟病
• 一般藥物減重可減去 5% - 15% 身體重量
• 停藥後，體重可能回升，需長時期飲食佩合

以下兩種是常用減重藥物，可向醫生查詢

諾美亭 Reductil/Subutil ( www.reductil.com.hk ):

Dose : 10 -15mg daily
FDA approved :

• Reduce neurotransmitter uptake in brain -> enhance feelings of fullness so that you eat less and hence loss weight
• SE: palpitation, blood pressure increase by 1-3mmHg in average, restless, insomnia
• Effect: Achieve 5 - 15% weight loss in 1 year
  
Not suitable for:

• eating disorder, severe depression/mania
• Poorly controlled HT
• Existing heart disease, arrhythmias, previous MI
• Stroke / TIA
• Closed angle glaucoma
• Seizure
• Pregnant or lactating ladies

Xenical (Orlistat):

Dose : 1 to 2 tab 3 times daily immediate before or after meal
FDA approved :

• A lipase inhibitor
• Action : blocks the fat digestion enzyme in the gut, reduce 30% of fat eaten from being absorbed and passed out in stool
• Most effective for those if dieting and exercise alone can produced weight loss
• If continue to take for 12 wk -> no weight lost -> to discontinue
• Avoid high carbohydrate intake (eg. Desserts, cakes, chocholate, etc.)
• Effect : achieve 5 - 10% weight lost in one year
• Associated with improved lipid values
• SE : 15 - 30% oily stool, flatulence and even fecal incontinence 2 hr to 2 days after meal, may subside after first several weeks of treatment, interfere with absorption of Vit A, D, E, K. No increase in gallstones, renal stones, or cardiovascular events
In general, reductil more weight lost than orlistat, combination treatment did not show more weight lost than single treatment.