THE BLOG

What Is Belviq, the New Weight Loss Drug?

06/19/2013 04:02 pm ET | Updated Aug 19, 2013

Belviq is a new weight loss drug that just became available by prescription this past week, one of only two new weight loss drugs approved by the FDA in the last 13 years. (The other is Qsymia, which I have already written about.) It is made by Arena Pharmaceuticals. Belviq is the trade name, Lorcaserin is the generic name, and it was called Lorqess during its development.

Belviq affects the serotonin receptors in the brain, changing the neurotransmitter action of serotonin, the brain chemical you hear about related to mood. SSRIs (selective serotonin reuptake inhibitors) are a group of drugs that are mainly used to treat depression, but it has been found that many of the drugs that affect neurotransmitters have lots of other affects, change in appetite among them. Drugs that change the action of the neurotransmitters serotonin, dopamine and norepinephrine are used to treat many psychological conditions, even psychotic disorders, because they change the way we think and feel. They can create experience in the psyche like hallucinations, expansive thoughts or euphoria (good mood or feeling), or quell it, like reducing cravings and dark thoughts, or quieting hallucinations and mania. The antidepressant Wellbutrin was found to quiet the cravings of people trying to quit smoking and was then marketed also as Zyban. Some of these drugs were found to increase appetite, cravings, and drive to eat, and some have been found to reduce appetite and cravings. Pharmaceutical companies create new drugs, experiment with them, then market them for the effects that they produce. Belviq is sold as a weight loss drug, a drug to reduce appetite.

Does it work?

Reliable clinical studies have shown that people given the drug lost weight slightly more than people given a placebo, even without instruction in weight loss protocols. In studies where people were instructed in weight loss technique, people taking the drug did about twice as well as those taking the placebo. In almost all cases, the weight loss was slight, and the weight was regained after the trials. I have seen no reports that relate the subjective experience of appetite or craving suppression by the study subjects, which is the main thing I would like to know about. One would assume, based on the results of the clinical studies, that eating drive was reduced by the drug.

What value would any weight loss drug have?

Everyone familiar with my work knows that there is no mystical magic to successful weight loss. We must establish new behavior where we eat less, to the degree that we lose weight and keep it off. My method has been so successful because of the use of psychological techniques that are so effective in managing thoughts and feelings and so effective in changing habits by "deleting" damaging habits and "installing" healthy habits.

I know, from personal experience, as well as my work with clients and patients, that we are all different in many ways, and we have different psychological experience, like appetite, cravings and compulsion.

For those who experience uncontrollable drive that results in life-threatening bingeing and uncontrollable compulsive eating, I pray that we find a drug that can mitigate outrageous eating drive without presenting unwanted and dangerous side effects. People would still have to manage their behavior with the methods I teach, but it would be so much easier if one were not tormented by the compulsion that I know some people experience. Is Belviq such a drug? I hope to find out.

Is Belviq safe?

There are so many bad side effects being reported that it is scary, even to a mental health counselor who has seen it all. Not only are psychological side effects being reported, but risk of medical problems seems high. Both the University of California's Wellness Letter and Consumer Reports have published critical reviews that would discourage just about anyone but the most desperate from taking it.

The Anderson Method recommendation:

To solve your weight problem, you will have to create new habits of behavior and thinking, no matter what. You will need to maintain them for the rest of your life. Many people have used The Anderson Method to do just that, some saying it was easy. If you can do that without drugs, that will be the best solution. After all, you don't want to be taking these drugs for the rest of your life, even if they are safe.

If you are unable to manage compulsive eating and bingeing and the experience of craving is an absolute torment, drugs might help. There are a number of drugs that have helped people with unwanted eating drive, such as Wellbutrin, Lexapro and Topamax. And they have been around for a while. My advice, if you want to try a drug to help with weight control, is to find an expert in these drugs (psychiatrists or psychiatric nurses) and try one that is known to be safe. Remember that no matter what, no drug is going to make you lose weight or solve your weight problem. The solution is in behavioral therapy science. A drug may make it easier to do the work, but you will still need to do the work. If you want to try a drug, try one that's known to help some people and been around for a while. Let someone else be the guinea pig with Belviq.

For more by William Anderson, MA, LMHC, click here.

For more on weight loss, click here.