When you come to understand that being overweight or obese is a medical condition then you understand that medications to control the problem are paramount.  Just like you need to take medicine to control your diabetes or your hypertension you will need medicine to control your weight disease.  Like any other disease it has certain common characteristics:

1. It is Genetic.  This is why some people eat whatever they want in huge proportions and never gain a pound.  Meanwhile others are very careful with their diet and try to stay active, yet still have a weight control problem.
2. It is Progressive.  It will get worse in time.  Every year your weight problem will get worse and worse.  The pounds will pack on and you will find it more difficult to lose and control the weight...even with medication.
3. It is Chronic.  This why people will "Yo-Yo".  If you stop any part of your weight control therapy including diet, exercise, or medication you will gain the weight back.  This is absolutely unavoidable!  Patients need to understand that this is not their fault or under their control.

While the rare person can lose weight and keep it off with diet and excersies alone, the majority of people can not sustain weight loss without the use of medication.  They can't will themselves to be thin any more than they could will away their diabetes, hypertension, or high cholesterol.  There are many medications and combinations available; we have found the following to be the most effective and safe:

Phentermine	Zoloft
Phendimetrazine	Lexapro
Serzone	Effexor Xr
Wellbutrin	Topamax
Topamax	Prozac
Celexa	Glucophage
Lurox	Xenical

     We use these either singly or in combinations based on individual patient needs.  There are many considerations in deciding on medication choice, such as generic vs. brand name, dosages, frequency, length of time to stay on the medicines.