The Drug

The surest way to lose weight is to eat a little less and exercise more. If you take in just 500 to 1,000 fewer calories than it takes to keep your current weight, you'll lose 5% to 10% of your weight in four to six months. If you add exercise to your new moderate diet, you'll keep the weight off.

Some overweight people can do this. Most can't. That's why weight loss usually doesn't work without help to develop healthy thinking habits, healthy eating habits, and healthy exercise habits.

A minority of people needs something more. For some, surgery is the answer. Others need drug therapy.

The road to weight loss drugs is scattered with failures and frauds. Now, however, researchers are closing in on new drugs that just might do the trick.

A review article by National Institutes of Health researchers Susan Z. Yanovski, MD, and Jack A. Yanovski, MD, PhD, appears in the Feb. 21 issue of The New England Journal of Medicine. It looks at the past, present, and future of weight loss drugs.

An overview of the article follows. Here's the bottom line: weight loss drugs are not the answer for most people. They're only for people who can't lose weight any other way -- even though they've tried -- and whose obesity threatens their health.

No FDA-approved weight loss drug has been tested for more than two years. The drugs usually don't lead to dramatic weight loss -- on average, people lose about 5% of their body weight. And there are side effects. These can be very serious. Never take weight loss drugs without a doctor's supervision.