Contrave–New Weight Loss Drug

Prescription Contrave was just approved by the FDA in September 2014, making it the fourth prescription weight loss drug approved by the FDA for long-term use.

The other 3 prescription weight loss drugs include Qsymia and Belviq (approved for use in 2012) and Alli (Orlistat) the over the counter version of Xenical. But don’t forget that diet and exercise are still key components for any of these drugs to be most effective.

Last year, the weight loss industry in the U.S. brought in a wopping 60.5 billion dollars. Despite a small 1.8% dip in revenue last year, there’s no denying this industry is still booming.  From do-it-yourself diet books to weight loss surgery, the options for weight loss and maintenance are endless.

Contrave is actually a combination of two drugs that are already on the market, naltrexone, which is used to treat addictions, and bupropion, which is an anti-depressant.  The exact way that Contrave works is not fully understood, but it did outperform the placebo in clinical trials.

In order to receive a prescription for Contrave, adults must fall under the obesity classification with a body mass index (BMI) of 30 or more.  Overweight adults may also be eligible for a prescription if they have a health condition that can be related to their weight, such as type 2 diabetes or high blood pressure, in addition to a BMI of 27 or higher.

Before deciding whether or not to take a prescription weight loss drug, it’s important to consider a few other factors besides eligibility. Contrave is not a miracle drug.  Participants who took Contrave and followed a diet and exercise plan in the clinical trials, lost an average of 4.1% more weight than placebo users at the end of one year.  That’s right, diet and exercise are still part of the deal.  In fact, the FDA recommends that doctors stop Contrave if the patient doesn’t show a 5% weight loss in the first 12 weeks on the prescription.  In other words, you can’t just pop a Contrave and eat whatever you’d like.  Dust off your gym pass and be ready to skip the drive-thru, because if you’re thinking about asking for a prescription for this pill you’re going to have to back it up with health conscious eating and activity!

In addition to a lifestyle change, you will also need to consider possible side effects.  Contrave users reported experiencing nausea, vomiting, headache, and dizziness.  Constipation, dry mouth, diarrhea, and insomnia were also among the more common side effects reported.  Uncomfortable as these may be, they appear mild compaired to the list of risks associated with this drug.  The FDA warns that using Contrave can cause seizures, increase blood pressure, and raised heart rate.  When taken for other conditions, the two drugs that were combined to make Contrave have been associated with increased risk for suicidal thoughts and “serious neuropsychiatric events.”

Finally, even though it’s been approved for use, Contrave is still undergoing clinical trials.  The FDA is still evaluating cardiovascular risks that go along with its use, as well as performing studies on the relationships between Contrave and memory, impaired liver and kidney function, other drug interactions, and possible use in children.

Ultimately, the way you lose weight is up to you.  If you’re thinking about using Contrave or another prescription weight loss drug, be sure to talk with your doctor and a registered dietitian nutritionist in order to make the best, safest choice for you, and to make the most of your prescription.

Thank you to Meghan P., dietetics student at Eastern Michigan University, for her help with this blog!


Green Coffee Extract–Weight Loss Truth or Myth?

It is no new news that overweight and obesity rates continue to increase not just in the U.S but also worldwide. With concern for good health and hope to achieve faster and better weight loss results, the use of dietary supplements has also increased among consumers. Current scientific research finds most of the supplements to be ineffective for many reasons. Some may not contain the adequate dosage to produce a positive effect on health, some may be poorly absorbed and others may become inactive in the presence of other substances. One “slimming” supplement worth discussing because of the gained popularity among dieters in the recent past years is the green coffee extract (GCE) dietary supplement. After being endorsed by celebrity health experts and extensively marketed by well-known manufactures, the sales of green coffee extract as a weight-loss aid have skyrocketed.

But what is green coffee extract?
Green coffee extract (GCE) is present in green raw coffee beans. It is also present in the roasted coffee but much of the GCE is destroyed. The major GCE constituent is cholorogenic acid (CGA). It is estimated that 100 grams of raw coffee can provide about 5 to 12 grams of CGA. Besides coffee, CGA can be found in many fruits and vegetables. Research indicates that CGA is highly absorbed and metabolized in humans; however, there is large variation among individuals on how much is absorbed in the body.

Green coffee extract has been marketed as a weight loss supplement in the capsule form under a wide variety of brands using the patented name Svetol. In the U.S market, Svetol – manufactured by the French company Naturex, is listed as an active ingredient on 25 dietary supplements. Svetol is also found in Norwegian Coffee Slender products such as instant coffee, decaffeinated tablets and mints, and chewing gum.

What are some of the suspected benefits of cholorogenic acid (CGA)?
The chlorogenic acid in the green coffee extract is believed to have antioxidant properties and in animal studies, it has been shown to inhibit fat accumulation. In humans, the consumption of caffeinated coffee can lead to long-term weight loss; this is believed to be a result of the effects of caffeine intake possibly working along with green coffee extract on metabolism.

The findings of current research indicate, but not convincing evidence, that intake of green coffee extract fortified with chlorogenic acid may promote weight loss. These results must be interpreted with caution, as the methodology in many studies is poor and further investigation is needed. More rigorous trials with larger sample size and longer duration are required to assess the effectiveness and safety of green coffee extract as a weight loss supplement.

As a consumer, you have the power of your purchasing decision. However, informed choices can prevent you from wasting your money on products that may not give the expected results and that may have long-term adverse effects on your health and body. The best approach to avoid weight gain or promote weight loss, one must use all the calories consumed on a daily basis. Researchers, physicians, registered dietitians and dietary supplement industry agree that eating a variety of whole foods, practicing portion control and exercising regularly is the foundation to maintaining a healthy weight.

Thank you I.I. UTHSCSA Dietetic Intern, March–2013

1. Onakpoya I, Terry R, Ernst E. Use of green coffee extract as a weight loss-supplement: A systematic review and meta-analysis of randomized clinical trials. Gastroenterol Res Pract. 2011; 2011:1-6.
2. Vison J, Burnham Bryan, Nagedran M. Randomized, double-blind, placebo-controlled, linear dose, crossover study to evaluate the efficacy and safety of a green coffee bean extract in overweight subject. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2012; 5:21-27.