My cousin had booked an amazing eight-day trip to Aruba. She had her passport ready, bags packed, and airline tickets purchased. Having about a month before her dream vacation, she wanted to do only one other thing: shed about 20 pounds quickly before her trip.

She called me, asking for tips and tricks — and my opinion on the latest medical weight-loss drugs.

Honestly, I hate answering these types of questions, because although you may lose weight quickly, it’s rarely sustainable, and rarely without serious consequences. The truth is, when it comes to permanent weight loss, it will likely be arduous, slow, require time commitments in the gym and the kitchen, energy, and persistence. None of which my cousin wanted to hear.

With that said, I told her that although I had no direct experience with medical weight-loss drugs, throughout the years I’ve had various clients who’ve tried them all. So, yes, indirectly I had some knowledge of both the rewards and risks of these prescribed weight-loss drugs.

So, I told her, to date, the Food and Drug Administration has approved just four drugs for weight loss: phentermine, orlistat, lorcaserin, and Qsymia. With the exception of orlistat, these drugs primarily perform a combination of either appetite suppression, metabolic acceleration, or both. Orlistat is a gastrointestinal lipase inhibitor that works by blocking the absorption of 25 percent of the fat in a meal.

She was thrilled when I told her that all of the FDA-approved drugs would produce relatively quick weight loss results — that is, until I told her about the risks and consequences. For example, I reminded her that the drug phentermine had been the drug in the fen-phen duo, which was extraordinarily popular in the ’90s, until it was pulled after patients developed serious heart problems. And that, while orilstat may absorb 25 percent of the fat in your meal, it’s also recommended that you carry an extra pair of pants, in case you have a gastrointestinal accident.

Without a doubt, the risks outweigh any short-term rewards. After persuading her to ditch the weight-loss drug ideas, I gave her more sensible quick-fix weight-loss methods she might be inclined to give a try:

Clean house

First, get rid of such obvious culprits as cake, cookies, candy, starchy foods, and alcohol. Get back to basics and commit to eating clean and lean (think fish, egg whites, steamed or grilled vegetables, and good fats such as avocado).

Back to basics

Drink plenty of water. Get enough sleep. Skip the midnight snack. Ask your best bud to walk with you several mornings or evenings a week. The little things that really add up.

Give intermittent fasting a try

Intermittent fasting has become quite popular in recent years. Intermittent fasting is a pattern of eating that is characterized by periods of fasting and eating. It’s not a conventional diet, so you can eat what you want, but you do adhere to a specific time when you do your eating. For example, you may decide to fast from sunrise to sunset, or between dinner and breakfast the next day. Basically, that’s about 12 to 14 hours.


Sorry, it’s not a sexy answer, but for either short- or long-term weight loss, I highly recommend daily commitment to exercise, diet, and behavioral modification. Ultimately, I hope my cousin doesn’t waste too much time obsessing about her weight, but, instead, makes practical healthy choices while having the vacation of her life.