Dear Alice,

I am looking for information on the weight-loss drug Meridia. I have trouble controlling cravings and heard this drug could help.

Dear Reader,

Kudos to you for doing a bit of homework about how to address your craving concerns. More to your question, in the past, sibutramine (the generic name for Meridia) was available by prescription and used for weight loss and maintenance in overweight or obese patients. However, it’s no longer available. As of October 2010, it was discontinued due to its use being associated with serious health risks and its relative ineffectiveness — people taking the drug only lost a small amount of body weight compared to those taking a placebo. In light of this, Reader, you might first consider what could be causing these cravings and adopting or modifying some lifestyle behaviors before seeking out a prescription. But, before getting into specifics on those strategies, keep reading for more information about why this medication is no longer on the market.

Initially, sibutramine was prescribed to help control appetite and worked by blocking the reuptake of neurotransmitters (specifically serotonin, norepinephrine, and dopamine) in the brain that are responsible for feelings of hunger and satiety. And, while some did find benefit with its use, in 2009, the U.S. Food and Drug Administration (FDA) began making recommendations against the drug. This was because research demonstrated that among users there was a 16 percent increase in risk of adverse cardiovascular events (such as heart attack, stroke, and cardiac arrest), as compared to patients taking a placebo. Based on this data, the FDA concluded that the increased risk to a user’s health outweighed any benefit from the drug and requested that it be taken off the market in the United States.

Though the drug is no longer available, there are other ways to control your cravings — sans prescription — that you might consider trying, including:

  • Try to understand your habits. Try keeping a food diary so you can see if there are any patterns to your food cravings.
  • Eliminate temptation. If you're constantly craving certain foods, try keeping them out of sight, or better yet, off your grocery list!
  • Eat in moderation. Sometimes the only way to cure a craving is giving in, so treat yourself every now and then to keep the cravings at bay.
  • Be your own cheerleader. If you slip up, try not to dwell on it; instead, focus on how you plan to move forward and get back on the plan!

If your interest in controlling your cravings has to do with losing or managing your weight and these strategies are not working, there are a few other factors that could be making it more difficult to lose weight, including:

In addition to taking these into consideration, you may want to ask yourself a few questions: Are you within a healthy weight for your height and build, or is it medically recommended that you shed some pounds? How do you feel about your body in general? Do you eat nutritious foods, such as fruits and vegetables? Do you get enough physical activity and sleep? When it comes to addressing cravings, making adjustments to some lifestyle behaviors, such as eating a balanced diet, getting plenty of quality z’s, and being physically active can be a great place to start. Talking over your answers to these questions with a health care provider or perhaps even a registered dietitian can further shed light on how best to address your concerns. Hopefully with a few do-it-yourself strategies and some expert assistance, you can get a handle on your cravings and feel more comfortable about your eating habits.

Best of luck!

Alice!

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