Weight Loss Caution: The Truth About Diet Pills' Risks and a Scientific Selection Guide

Weight-loss pills:
Can high risk yield high returns?

Many people have tried weight-loss pills before. Even I, during my university days, felt my thighs were too thick at one point and was tempted to buy them.

So do these long-established weight-loss pills actually work?
I'll answer directly: almost all weight-loss pills ‘work’ because it's far too easy to make people see a drop in their weight figures!

For instance, some suppress appetite, making you eat less and lose weight rapidly; others stimulate bowel movements, causing diarrhoea that prevents food digestion and leads to significant water loss.

Thus, weight loss pills generally deliver weight reduction, but the question remains: are you willing to bear the risks and side effects?

Weight loss pills broadly fall into these categories:
One type regulates nerves to suppress appetite, another alters hormones, and a third reduces the body's energy absorption.

Let's begin with the first category. The most notorious example is Sibutramine, which works by inhibiting serotonin and noradrenaline in the brain to curb appetite. This creates a feeling of fullness, leading to reduced food intake and subsequent weight loss.

Many will recall the early 2000s craze for ‘Qumei’ (Sibutramine), hailed as a miracle weight-loss drug. Advertisements flooded television, featuring celebrity endorsements from Gong Li and Fan Bingbing. Numerous acquaintances tried it, with one friend even earning the nickname ‘Qumei’.

Its primary ingredient was sibutramine, approved for sale by the US Food and Drug Administration at the time. Its purported weight-loss efficacy was said to be remarkable, fuelling its immense popularity. Despite being a prescription-only medication in the US, sibutramine-based slimming pills were readily available in pharmacies in China, with some retailers even offering buy-one-get-one-free promotions.

Before long, reports of severe side effects from Qumei began to surface in the news. It was later confirmed that sibutramine caused significant damage to the heart and nervous system, potentially leading to symptoms such as dry mouth, loss of appetite, constipation, tachycardia, and insomnia. In the most severe cases, it could even cause cardiac arrest. Consequently, Taiji Group withdrew Qumei from the market nationwide.

The second category comprises hormone-regulating agents, such as metformin. Many recognise it as a medication for treating type 2 diabetes. It effectively lowers blood sugar while promoting weight loss, suitable for diabetic patients where diet and exercise alone prove insufficient. However, for perfectly healthy individuals, the risks far outweigh the benefits, with common adverse reactions including vomiting, diarrhoea, fatigue, and dizziness.

The third category involves drugs that reduce energy absorption, with Orlistat being the most prominent. It is currently the only over-the-counter (OTC) weight-loss medication available nationwide. Many may have heard of or used it. As a gastrointestinal lipase inhibitor, it directly blocks the body's absorption of dietary fats, thereby reducing energy intake and facilitating weight loss. In other words, consuming fatty foods after taking Orlistat prevents the absorption of dietary fats, which are instead expelled from the body.

This medication is relatively safer and gentler, making it suitable for occasional use as a remedy following social gatherings or rich meals. However, its drawbacks are pronounced: it induces frequent urges to use the toilet, and bowel movements may expel significant amounts of oily residue, which can be both unpleasant and difficult to clean up. Moreover, Orlistat fundamentally inhibits the body's absorption of dietary fats rather than directly burning stored body fat. Therefore, it is more accurately described as a weight gain prevention drug rather than a weight loss drug.

As previously discussed regarding weight loss principles, it should now be clear that weight loss pills essentially either cause temporary weight reduction through water loss, creating an illusion of weight loss, or create an energy deficit by ensuring energy intake falls below expenditure. Thus, achieving an energy deficit remains the fundamental mechanism for weight loss.

While severely obese individuals may use weight-loss medication under medical supervision, I strongly advise against it for women who are not significantly overweight yet pursue extreme thinness or beauty. The risks far outweigh any perceived benefits. As we've seen, such drugs carry widespread risks—some side effects manifest quickly, others develop gradually.

Moreover, while weight-loss medication may reduce your weight, it does nothing to improve your physique. Your skin won't become firmer, nor will your contours become more defined.