“You need to know why you want to lose weight”: beware of the perverse effects of appetite suppressants

Hypoglycemia, fatigue, menstrual irregularity, anxiety, digestive discomfort... Here is the list of side effects of Orlistat, one of the only appetite suppressant drugs authorized in France, acting on the digestion of fats. “The others are prohibited because of their dangerousness,” specifies Laure Hyvernat, doctor of pharmacy and nutritionist. Since the Mediator scandal, marketing authorizations for so-called anorexigenic drugs (acting on brain processes) have all been withdrawn.

Amphetamines, antiepileptics… these molecules are not authorized to be prescribed for weight loss. If they are used for these purposes, this is a misuse of their use – strictly prohibited. Diversion also towards other drugs which are getting a lot of attention at the moment: antidiabetics which reduce the appetite. The best known of these: Ozempic, whose active ingredient is semaglutide. It belongs to a family of molecules called GLP-1 receptor agonists.

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Produced naturally by the small intestine, GLP-1 is a hormone that helps the pancreas secrete more insulin. It was found that it also had the power to reduce appetite and make you lose weight. Initially reserved for diabetic or obese patients, the product was diverted from its primary use in order to help people lose a few pounds, and, for this reason, it is touted on social networks. During the year 2021-2022, 215,000 French patients took this drug, including 2,185 non-diabetics according to health insurance estimates.

“In no case can a medication or diet, whether proposed by a professional or a pseudo-professional such as a nutrition coach, replace follow-up recommended by the High Authority for Health,” insists the nutritionist and endocrinologist Boris Hansel. Appetite suppressants are also not suitable for eliminating a few pounds for aesthetic or comfort reasons. “You need to know why you want to lose weight. It’s never trivial,” the doctor warns.

A common mistake is to jump on appetite suppressants which risk throwing the hormonal balance out of whack. And to lock the patient in a vicious circle. “I encourage women who have cravings or resistance to weight loss to carry out a hormonal assessment of the microbiota, because an imbalance of the latter or dysregulated hormones are often at the origin of their disorders” , indicates nutritionist Laure Hyvernat. Emotional suffering or stress also encourages people to seek refuge in food, and medication will not solve the problem(s).

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For those who want to eat less, there are natural techniques to accelerate the feeling of satiety. “To start, drinking at least two liters of water per day helps fill the stomach. Smoothies, by mixing fruits and vegetables, allow you to stock up on fiber and regulate blood sugar levels without stimulating insulin. Finally, to avoid overeating in the evening, it is interesting to treat yourself to a high-protein snack around 4 p.m.: chia seed pudding or cottage cheese,” suggests Laure Hyvernat.

His added tip? Konjac, an Asian plant that resembles rice, but contains no carbohydrates. “It’s low-calorie while still making you feel full…and with no side effects!” However, for certain patients, appetite suppressants can be prescribed under medical supervision. Boris Hansel concludes: “Apart from any support, taking these medications tires the body, metabolism and self-esteem. But when they are prescribed, at the right time and in the right way with supervision, they make perfect sense. »