Sibutramine
A Medicine To Help With Weight Loss

How can I lose weight?

To lose weight, the best chance of long term success is to eat a healthy diet and, if you are able, to exercise regularly. See separate leaflet called 'Weight Reduction - How to Lose Weight' for details. There is only a limited role for medicines to help with weight loss.

Sibutramine is a medicine that is sometimes advised. However, it is no 'wonder-drug', it only partially helps, and you still need to eat less to lose weight.

How does sibutramine work?

Sibutramine mainly works by making you feel more 'full' with less food (it reduces appetite and enhances satiety).

How effective is sibutramine?

Studies have shown that, on average, sibutramine plus a weight-reducing diet and exercise causes more weight loss than a weight-reducing diet and exercise alone. Some people lose up to 7% or more of their body weight within 6-12 months with the help of sibutramine. In others, it is less effective.

One reason why sibutramine may not work is that you may think that you can relax your weight-reducing diet, and the sibutramine will 'do it all'. This is not true. Sibutramine does not make you lose weight. It will only partially suppress your appetite. You still have to continue to eat a healthy weight-reducing diet, and to exercise more if possible.

Guidelines for using sibutramine

Doctors are expected to follow guidelines when prescribing sibutramine. These include:

• It is only advised if you have had difficulty in losing weight over a three month trial with weight-reducing diet and exercise alone.
• Your BMI (Body Mass Index - see below)
  • must be 30 or above, or
  • must be 27 or above, and you have a medical condition that would benefit from losing weight (such as diabetes).
• You must lose at least 2 kg in weight at four weeks, and 5% of your initial weight by three months from starting sibutramine. If not, it should be stopped.
• You must be between the ages of 18 and 65 years.

If you continue to lose weight, sibutramine can be continued for a maximum of one year.

Who should not take sibutramine?

You should not take sibutramine if you have: high blood pressure, heart disease, heart failure, peripheral vascular disease, arrhythmias (abnormal heart rhythms), or have had a stroke.

Are there any side-effects with sibutramine

Most people have no side-effects. Those that may occur include the following (but read the packet leaflet for a full list of possible side effects).

• Constipation, dry mouth, and difficulty with sleeping are relatively common.
• Your blood pressure and pulse may become raised. This is why your doctor will want to monitor your blood pressure if you take sibutramine. You will have to stop taking this medicine if your blood pressure or resting pulse rate increase after you start taking it.

BMI, mentioned above, is a good estimate of how much of your body is made up of fat. It relates your weight to your height. You can work out your BMI by dividing your weight (in kilograms) by the square of your height (in metres). So, for example, if you weigh 70 kg and are 1.75 metres tall, your BMI is 70 / 1.75 x 1.75, which is 22.9. Alternatively, your practice nurse can measure and weigh you, and tell you your BMI.

Keeping to a reduced weight

A number of people who lose weight with the help of sibutramine put the weight back on once the sibutramine is stopped. Try to anticipate this.

Once you have lost some weight, you are more likely to keep your weight down if you stick to a healthy diet, exercise regularly (if you are able), and weigh yourself once a week.

Further help

See your practice nurse for further help and advice about a healthy diet and exercise. There are also more detailed leaflets in this series called 'Weight Reduction - How to Lose Weight', 'Healthy Eating', and 'Obesity and Overweight'.

© EMIS and PIP 2005   Updated: August 2005   PRODIGY Validated