Buy Meridia

Five teens lost weight by using what’s known as a meal replacement approach, in which you use special drinks or bars in place of some meals. Two of them used Slim-Fast products this way-one did so under her physician’s supervision, and the other checked with her doctor but was advised against using this method of weight loss. Karen D., who was supervised by her doctor, used Slim-Fast to lose her first 20 pounds, then switched to Weight Watchers to lose another 100-plus pounds. (Slim-Fast recommends that those under eighteen see a doctor before following its diet.) Another teen consumed a soy-based shake or bar for breakfast and lunch. A small number of other teens used drinks and bars in place of some meals, but such use seemed to be more sporadic.

Two teens used meal replacements as part of the medically supervised weight management program Health Management Resources (HMR). Matt A. went this route because he was very overweight-280 pounds at his heaviest and just 5′7" tall-and because he was impressed with the success of an adult friend who’d lost a lot of weight with the help of HMR. Nearly two years later, Matt stands 6′ tall and weighs 220 pounds. He still goes to the program. Joe M., a 6′ sixteen-year-old who weighed 270 pounds, also used meal replacements as part of the HMR program. Having kept off his weight for more than a decade, he now weighs 210 pounds, stands 6′5" tall, and is twenty-seven years old.

Although it’s certainly healthier to have a nutritious drink or bar than to skip meals entirely, meal replacement approaches are not advised for teens who are trying to lose weight on their own. However, James Anderson, M.D., a prominent obesity researcher from the University of Kentucky, has treated more than 150 teenagers using a low-calorie diet of several liquid meals per day along with generous servings of fruits and vegetables. He says that this approach can be effective for weight loss in teens when it’s used as part of a comprehensive, medically supervised weight management program involving trained educators, lots of physical activity, and support from parents. He uses this approach only with very overweight teens who are past the peak adolescent growth spurt as determined by a physician.

Dr. Anderson believes that such programs should be used before very obese teens resort to weight loss surgery. It is unknown how effective this approach is for keeping weight off, particularly in teens. Although none of the young people in his studies have experienced eating disorders, Dr. Anderson feels that teens who are considering this or other intensive treatment for weight problems should be screened to assess whether they have such disorders or other psychiatric problems.

Three of the teens, two of them sisters, reported that they were part of a study involving the use of the prescription appetite suppressant sibutramine, commercially known as Meridia. Of the two, Mia R., fifteen and a half, and Dahiana R., seventeen and a half, only Dahiana was actually on the drug. Mia got the placebo, a fact she learned when I had her ask the program she attended about the treatment. She says, “The whole time, I thought I was on the drug.” Both sisters lost weight. About two years after the study ended, Mia was maintaining a 65-pound loss, while Dahiana was keeping off 80 pounds, although she had stopped taking the drug. (Mia was taller and less overweight to begin with.) Both young women also received instruction from a dietitian about how to eat more healthfully and were encouraged to exercise.

James G. took sibutramine as part of a comprehensive, medically supervised weight management program for teens. He no longer takes the drug but has kept off the 90 pounds that he lost more than two years ago.

Sibutramine, which works by increasing the levels of certain brain chemicals that help reduce appetite, is approved for use in adults by the U.S. Food and Drug Administration (FDA), but it is not approved for young people under the age of sixteen. Physicians can, however, prescribe the medication to a young person if they deem that it is in the child’s best interest or if the child is taking part in a study. Other prescription appetite suppressants approved for use in adults for short periods of time are not recommended for teens.

One well-designed study involving teens, conducted by University of Pennsylvania researcher Robert Berkowitz, M.D., and colleagues, found that sibutramine had a significant weight loss advantage over a placebo for obese teens who took part in an intensive behavior modification program that emphasized making dietary changes, walking, and keeping eating and activity journals, in conjunction with parental involvement. However, the drug had to be discontinued or the dose lowered in more than 4 out of 10 study participants because it raised their blood pressure. The researchers concluded that until more is known about safety and efficacy, weight loss medications should be used only on an experimental basis with adolescents and children.

The only weight loss drug that’s approved by the FDA for use in young people age twelve or older is orlistat (Xenical). None of the teens I interviewed used the drug, which works by blocking the body’s absorption of dietary fat, causing it to be excreted in bowel movements. The drug’s notorious side effects include oily bowel movements and possible spotting in underpants. A recent report published in the Journal of the
American Medical Association showed that orlistat had an advantage over a placebo in a large study involving teens who were taking part in a comprehensive, medically supervised weight management program.

Contrary to the experiences of Dahiana R. and James G., studies show that these drugs generally do not lead to dramatic weight loss. Any weight loss that does occur tends to level off after about six months of taking the drugs. When people go off the drugs, they tend to gain the weight back. It is not known how safe or effective the drugs are if used for a long time, particularly in young people.
In summary, studies supporting the use of medications for weight loss in teens are limited. These drugs should be prescribed only to seriously obese teens who have not had success with diet and exercise alone -and then only as part of a comprehensive weight management program under the guidance of a doctor or a team of experts specializing in the treatment of child and adolescent obesity.