Cost, Side Effects Accompany Options for Medical Weight Loss

Losing weight is a frequent New Year's resolution but for many people it involves more than pledging to skip snacks to drop an unwanted 15 pounds.

Nearly one-third of Louisianians and 37.5 percent of New Orleans residents are obese, which is generally defined as being 20 percent or more above the average weight for a particular age, height and bone structure.

Diet and exercise are the staples of most weight loss plans, but extra measures are often needed in obesity cases.

Dr. Vivian Fonseca, an endocrinologist and professor of medicine and pharmacology at Tulane University Health Sciences Center, leads a weight loss clinic that incorporates prescription medication with diet and other lifestyle changes.

Fonseca said many people embarking upon a weight loss program have unrealistic expectations. They should know there is no wonder drug that will melt the extra pounds without possible negative consequences.

There is no drug without side effects, Fonseca said. Aspirin has side effects.

Like any physician who prescribes medicine, Fonseca and other doctors who supervise weight loss clinics are bound by the rules of the Louisiana State Board of Medical Examiners. Its bylaws maintain that no physician shall dispense any medication except in the usual and ordinary course of his medical practice for a legitimate medical purpose.

Prescription medication for weight loss is intended for short- term use, said Fonseca.

Appetite suppressants help patients through the initial stages of the weight-loss regimen, said Fonseca. But manufacturers of the most popular prescription appetite suppressants advise against using them beyond 12 weeks. Phentermine, the most commonly prescribed appetite suppressant, can cause irritability, sleeplessness and blurred vision.

Cost is also a consideration. A survey of local independent and chain pharmacies revealed that a 30-day supply of Adipex, a brand of phentermine, sells for between $50 and $75.

Insurance coverage for prescription weight loss medication varies by state and insurance company, but there is an ongoing effort to convince insurance companies to cover weight loss programs.

The National Institutes of Health, an agency of the U.S. Department of Health and Human Services, is pushing for laws to mandate insurance coverage for bariatric surgery. This operation, which reduces the size of the stomach or intestines, costs around $25,000.

Virginia Moore, coordinator for the Louisiana Council for Obesity Prevention and Management, wants emphasis placed on preventive measures when it comes to weight loss. The Legislature created the council in 1998 to research Louisiana's obesity problem. The state spends $1.4 billion a year to combat health problems with ties to obesity, according to council research.