Brenda Khan
Diet pills are a popular product in Australia, with thousands of weight-loss products on the market. However, it is important to note that the current evidence for the effectiveness and safety of these products is questionable. While some pills may assist in weight loss, they are typically designed to be used in conjunction with an energy-controlled diet and regular exercise. There are four medications approved by the Therapeutic Goods Administration (TGA) for the treatment of obesity in Australia: phentermine, orlistat, liraglutide, and naltrexone-bupropion. Phentermine suppresses appetite, orlistat reduces dietary fat absorption, liraglutide suppresses hunger, and naltrexone-bupropion is an antidepressant that may increase cerebral serotonin. Other notable diet pills include PhenQ, PhenGold, and Trimtone, which are dietary supplements that combine various fat-burning ingredients.
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What You'll Learn
Approved medications for obesity management
In Australia, medications for obesity management are indicated for adults with a body mass index (BMI) of ≥ 30 kg/m2 or those who are overweight (BMI ≥ 27 kg/m2, or ≥ 25 kg/m2 for phentermine) with at least one weight-related complication. These medications are to be used in conjunction with lifestyle interventions, such as dietary therapy and regular exercise. It is important to note that the majority of these medications are not subsidised in Australia, and patients need to be informed about the cost, efficacy, and safety of these drugs.
Currently, there are four medications approved by the Therapeutic Goods Administration (TGA) for obesity management in Australia. These include:
- Phentermine (Duromine): Phentermine is a sympathomimetic amine that acts on the brain to suppress appetite and inhibit hunger. It has been approved for use for over 60 years and is one of the most commonly used medications for weight loss. However, it is important to note that phentermine is typically indicated for short-term use.
- Orlistat (Xenical): Orlistat is an intestinal lipase inhibitor that reduces dietary fat absorption by slowing down fat digestion. While orlistat is available without a prescription in Australia, it is recommended that individuals taking this medication also take a multivitamin supplement due to the reduced absorption of fat-soluble vitamins.
- Liraglutide (Saxenda): Liraglutide is a glucagon-like peptide-1 (GLP-1) agonist that suppresses hunger and increases feelings of fullness. It is a synthetic version of the hormone GLP-1, which plays a crucial role in appetite regulation.
- Semaglutide (Wegovy): Semaglutide belongs to the same drug class as liraglutide and has been approved by the TGA for weight loss. However, it is not yet physically available in Australia and cannot be prescribed.
It is important to consult a medical professional before taking any weight loss medication, as they can provide guidance on the potential benefits, risks, and appropriate treatment plans for each individual. Additionally, a combination of drugs may be required for effective obesity management, and a personalised approach is necessary to consider possible contraindications and adverse effects.
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Natural diet pills
While there are prescription weight loss pills available in Australia, this answer will focus on natural diet pills. It is important to note that people considering the use of weight-loss supplements should talk with their doctor to discuss the products' potential benefits and risks, especially if they have an underlying health condition.
PhenQ is a natural diet pill that has been described as a "genius" product that combines past successful mechanics of action, including fat burning, fat blocking, and
Trimtone is another natural weight-loss supplement that contains green tea, coffee, glucomannan, caffeine, and grains of paradise. This supplement can help burn body fat, boost energy, promote metabolism, and curb cravings. The thermogenic components of the mix have a scientific basis and have been shown to assist in weight reduction.
Glucomannan is a soluble dietary fibre derived from the konjac root that can absorb up to 50 times its weight in water. It is touted as an appetite suppressant that works by increasing feelings of satiety and fullness. While it has been shown to have beneficial health effects such as lowering cholesterol, there is little to no proof that it helps with weight loss. Significant safety concerns have been reported for tablet forms of glucomannan, and they have been banned in Australia, although the capsules and powdered forms are still available.
Chitosan is a natural substance found in the cell walls of fungi, soil, and sediments, but it is usually derived from the powdered shells of crustaceans. It binds to dietary fat in the digestive tract to stop absorption. However, clinical studies on chitosan have been small and of low quality, showing varying and minor weight loss results that are likely clinically insignificant. If it does work, it can cause the malabsorption of nutrients and loose, oily stools, as well as side effects such as flatulence, bloating, constipation, indigestion, nausea, and heartburn.
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Safety concerns
While diet pills are an integral part of Australia's billion-dollar weight-loss industry, there are significant safety concerns surrounding their use. Firstly, it is important to note that the current evidence for the effectiveness and safety of these products is limited and inconclusive. Many studies have found it challenging to isolate the effects of individual ingredients in weight-loss supplements, as they often contain multiple components. As a result, it is difficult to ascertain the specific impact of each ingredient and how they interact with one another.
One ingredient that has raised concerns is yohimbe extract, which has been banned in numerous countries due to its potential adverse effects. Yohimbe can increase blood pressure and lead to headaches, hypertension, anxiety, agitation, tachycardia, myocardial infarction (heart attack), cardiac failure, and even death, depending on the dosage. Consequently, yohimbe is considered a prescription-only medicine in Australia and is prohibited from being imported.
Glucomannan, a soluble dietary fibre derived from konjac root, is another ingredient that has sparked safety worries. While it is promoted as an appetite suppressant, significant concerns have been reported regarding the tablet form of glucomannan. These tablets can absorb a substantial amount of water, leading to potential oesophageal obstructions. As a result, the tablet form of glucomannan has been banned in Australia, while the capsules and powdered forms are still available. However, even these alternative forms of glucomannan can cause digestive issues such as loose stools, flatulence, diarrhoea, constipation, and abdominal discomfort.
Additionally, there are concerns about the safety of compounded replica weight-loss products, which are not subjected to the same stringent safety regulations as TGA-approved medications. These compounded medications, tailored for individual patients, have raised community concerns in Australia and internationally due to their commercial-like scale and quality standards. The Australian government is taking steps to address these concerns by implementing changes to the regulation of compounding, aiming to protect Australians from the potential risks posed by these products.
Furthermore, certain drugs used in obesity management, such as topiramate, have not been approved by the Therapeutic Goods Administration (TGA) for the treatment of obesity in Australia. Topiramate has been associated with adverse effects at higher doses, including glaucoma, renal stones, paraesthesia, and confusion. It also poses teratogenic risks to the developing embryo.
When considering the use of weight-loss pills, it is crucial to consult with a medical professional to discuss potential benefits and risks, especially for individuals with underlying health conditions. While these pills may be marketed as a convenient solution, they are typically designed to be used alongside an energy-controlled diet and regular exercise regimen. Overall, it is important to approach these products with caution and be mindful of the potential safety hazards associated with their use.
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Lifestyle changes
While there are prescription medications available in Australia to aid weight loss, they are not typically a substitute for lifestyle changes. The most effective "diet pill" is therefore a holistic approach to health, incorporating dietary and lifestyle changes.
Dietary Changes
- Consume a low-calorie Mediterranean diet, emphasising minimally processed fruits, vegetables, legumes, nuts, and whole grains.
- Include moderate amounts of yoghurt, cheese, poultry, and fish.
- Use olive oil as the primary source of cooking fat.
- Consume red meat and foods with added sugars sparingly.
- Drink water instead of sugary drinks.
- Consume 5 portions of fruit and vegetables a day.
- Read food labels and opt for products with more green colour-coding.
- Consume tea and coffee with little to no sugar.
- Limit milk consumption to one or two servings a day.
- Get active for 150 minutes a week.
- Sign up for a weight-loss support group.
- Follow an instructor-led workout from home, such as dance or yoga.
- Try intermittent fasting, which involves restricting your eating to earlier in the day, aligning with your body's circadian rhythm.
- Share your weight loss plan with someone you trust for motivation.
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Surgery
Weight loss surgery is a common intervention in Australia, with around 12.5 million people considered overweight or obese. In 2007-08, there were 17,000 weight loss surgeries, a significant increase from the 500 procedures in 1998-99.
The main factor in determining eligibility for weight loss surgery is Body Mass Index (BMI). People with a BMI of 30 or higher who also have type 2 diabetes and a risk of cardiovascular disease can be considered for surgery. Those with a BMI between 35 and 39.9 must also have obesity-related health problems, and for a BMI over 40, no associated health conditions are necessary.
There are three main types of weight loss surgery offered in Australia: sleeve gastrectomy, gastric band surgery, and gastric bypass surgery. Sleeve gastrectomy is now the most common operation performed for obesity in Australia. Laparoscopic (keyhole) gastric bypass is considered the "gold standard" for obesity operations, especially for patients with Type 2 diabetes. The Allurion gastric balloon is a non-surgical option, a "swallowable" intragastric balloon that doesn't require surgery, endoscopy, or anaesthesia.
Weight loss surgery is expensive, ranging from AUD$12,500 to $20,000, depending on the procedure, clinic, and insurance status. Medicare covers a portion of the costs, but most patients still face significant out-of-pocket expenses unless they have comprehensive private health insurance.
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Frequently asked questions
There are four medications approved by the Therapeutic Goods Administration (TGA) for the treatment of obesity in Australia: phentermine, orlistat, liraglutide and naltrexone-bupropion. However, there is little evidence that over-the-counter weight loss supplements are effective.
Side effects vary depending on the medication. Phentermine, for example, can cause heart valve fibrosis when combined with bupropion. Topiramate has adverse effects at higher doses, including glaucoma, renal stones, paraesthesia and confusion. Glucomannan can cause oesophageal obstructions as the tablets swell with water, as well as loose stools, flatulence, diarrhoea, constipation, and abdominal discomfort.
Bariatric surgery is the most effective long-term treatment for severe obesity. The three most common bariatric procedures in Australia are sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB).
