Lorcaserin Approved for Weight Loss and Obesity – Is It Safe & Effective?

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lorcaserin lorqess The FDA recently approved a new drug for the treatment of obesity called lorcaserin, which will be sold under the brand name Lorqess. So let’s find out if lorcaserin is safe and effective! NOTE: If you don’t like the details, skip right to the Key Points at the end.

How Does Lorcaserin (Lorqess) Work?

Deep in the brain is a very important structure called the hypothalamus, which, among other things, is responsible for appetite regulation. Lorcaserin is a drug, called a selective 2C receptor agonist. This drug binds to special cells in the hypothalamus responsible for hunger and works to decrease activity within the appetite centers of the brain.  Theoretically, this should result in a decrease in food consumption and a loss of weight.

Simple enough…

Does Lorcaserin (Lorqess) Work?

Well, I guess it depends on how you define success. According to the FDA, a drug can be approved for the treatment of obesity if it achieves two objectives:

At least 33% of the subjects in the studies lose 5% of their bodyweight over the placebo group
 
OR…

At least twice as many of the treatment group (the people who received the drug) experience a 5% weight loss as compared to the placebo group (the people in the study who received a sugar pill).

By these pathetic standards, then yes, lorcaserin works…let me ask it another way, if you took a drug, with an unproven safety record, for an entire year and lost 12 pounds…would you be satisfied with the results? How about if you had to pay hundreds of dollars a month and deal with a chronic headache to achieve this result?

Onward…

If You Start Lorcaserin Today, How Much Weight Loss Can You Expect?

Great question…here’s what the research shows:

Early research showed that after 12 weeks of taking lorcaserin, you could expect a weight loss of between 4 and 8 pounds depending on the dose of medication that you use. Ok, not so bad…

Onward to bigger and better studies…

In a 52-week study in just over 3,000 subjects, the group that took the lorcaserin (Lorqess) lost a whopping 12.7 pounds of weight, which amounted to approximately 5.8% of their bodyweight. The placebo group lost an average of 4.7 pounds of weight (2.2% of total bodyweight). Ok, let’s give the drug the benefit of the doubt and loosely call that a “win”…It’s important to note that less than half of the group who received the drug lost their required 5% of bodyweight; this means that greater than half of the subjects failed to meet the ridiculously pathetic standards set forth by the FDA to call this an FDA Approved treatment for obesity.

Another study, this time on diabetics, confirmed the dismal findings of the previously mentioned research. In this 1-year study, diabetic patients were randomized to either lorcaserin or placebo. At the end of the study, 44.7% of the treatment group managed to reach a goal of losing 5% of their weight, compared to 16.1% in the placebo group. Once again, Lorqess outperforms doing nothing, but not my much…

It bares mentioning that lorcacerin did result in a significant and meaningful decrease in fasting blood sugar and hemoglobin a1c, probably due to a decrease in total food consumption. Unfortunately, the treatment group was also more likely to develop hypoglycemia (low blood sugar). Most patients, however, can achieve a similar benefit to their blood sugar by cutting carbs out of their dinner and going for a walk each night.

So, does lorcaserin produce significant results? Is it worth taking?  

Lorcaserin causes weight loss to about the extent that the ocean’s water-level drops when I get out of it…does the water level drop, mathematically, yes it does, is it a significant/meaningful drop, no it isn’t.

In other words, and without the sarcasm, I feel that lorcaserin does not provide meaningful weight loss.

Risks and Side Effects Associated with Lorcaserin

Lorcaserin works by a similar mechanism as its older brother fenfluramine, the drug from Fen-Phen that was banned due to the pesky side effect of causing heart damage and death.

That being said, Lorcaserin appears to be safer than fenfluramine due to it specificity for a particular receptor. No heart problems have been reported in the studies to date, although I will mention that Fen-Phen was approved by the FDA and prescribed to thousands of people before proving itself to be a potentially deadly drug.  By the time it was removed from the market hearts had already been damaged and young men and women were already in the grave.

The most common side effect associated with lorcaserin are headache, which has been reported in greater than 18% of the subjects in some studies. Other side effects include nausea and dizziness. All in all, lorcaserin is well tolerated in comparison to other drugs such as phentermine, Alli, and Meridia. Lorcerin is not a narcotic and therefore does not carry a risk of dependence or abuse.  

Do Results Last?

As I mentioned, less than half of people who take Lorqess achieve a 5% weight loss. Of those who lose weight on the drug, greater than 30% gain the weight back by the end of the 2nd year. Unfortunately, we do not have data past 2 years.

Take Home Points:

  1. Lorcaserin results in approximately 12 pounds of weight loss over a year’s time. If you took a sugar pill, you would lose approximately half that (around 5 pounds).
  2. Less than 50% of those who take Lorcaserin lose 5% of their body weight within a year; in other words, greater than 50% fail treatment.
  3. Of the 50% who do manage to lose 5% of their weight, 30% will gain the weight back by the end of the 2nd year despite continuing to take the drug.
  4. The subjects in the studies also received nutrition counseling along with treatment, so simply prescribing the drug without counseling may not produce the same benefits.
  5. Almost 20% of the people who use the drug experience a headache. Other common side effects are dizziness and nausea.
  6. Diabetics may suffer more episodes of low blood sugar while on the lorcaserin, but also enjoy lower fasting blood sugar and improved a1c’s
  7. Although lorcaserin appears to be safer and better tolerated than other anti-obesity drugs, it has not yet stood the test of time. 
  8. Lorcaserin does NOT have narcotic effects

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