I have prescribed it to more than 250 overweight or obese patients. If you are a physician with little experience with Belviq or a patient thinking about taking Belviq maybe my patients  experiences will help you with your understanding of this medication. Here are some of my observations from these patients:

1.New drug:  I offered the drug to about 250 patients overweight(BMI > 27) or obese patients.(BMI. 30) About 30 did not want to try a “new drug.” Several fearing the phen-fen troubles of 199 or were concerned
with unknown side effects.

2. Contraindicated: Ten  were taking SSRI’s or lithium and thus could not be treated.  prescribed the medication.

3.Free Trial: All of my patients were exceptionally pleased with the free trial of 15 days. They thought this was a excellent introduction to the drug.

4.Side effects: As indicated in the literature the side effects were minimal. Only 10 patients out of 250 complained of any side effect. The most common was fatigue and sleepiness occurring in 10 patients. A single patient had such significant fatigue she split the pill in half and took ½ in the morning and ½ at night. Five patients complained of mild depressive feelings, but not enough to stop the medication. At least 25 patients told me they felt better on the Belviq. Six patients complained of headaches in the first week, again not severe enough to stop the medication. All were surprised by the lack of side effects especially the racy heart, insomnia, anxiety and dry mouth so commonly seen in older appetite suppressors. Many patients were anxious to try the Belviq specifically because they could not tolerate the side effects of phentermine. 

5.Diabetics and Hypertension: At least 25 of the patients had either diabetes or hypertension or a combination of both. Most were on multiple medications.
No difference in weight loss was seen in this group. In the majority of these patients blood pressures and blood sugars were reduced as early as the end of the first week. Diabetic and hypertensive medications needed to be reduced in several patients. 

6.Completing the first 15 days: Almost all of the patients completed the 15 day trial period. A few patients had reduced the dosage after the first 10 days to 1 a day.

7.Not Effective: 55 patients decided to stop the medication after 4-6 weeks because they had no weight loss. Neither of these patients were taking any other drug. Their comment was , ‘the pill had no effect on my appetite, weight or feeling of fullness.” Two patients complained of bloating.

8.Number of patients purchasing the first month Belviq after the trial: About 75% of my patients went and purchased the medication after the trial period. The reasons some did not were the cost of the mediation and the fact that they did not lose as much weight as they expected. 

9.Number of patients taking a single dose of Belviq a day: At least 30 patients elected to take only a single dose of Belviq per day usually at about 11 AM. The reason for this was to reduce the cost of further treatment or to reduce the side effect of fatigue.

10.Dietary Intervention: All of the patients on Belviq were instructed in the 1000-1100 calorie, low carb diet as presented in the Lose Weight with Belviq booklet.

11.Exercise: Exercise was encouraged in all patients including aerobic gym activities, sports, biking and walking.  

12.Weight Loss: One must remember that it takes at least 3 to 4 days to each the full effect of the Belviq. Thus, the weight loss in the first 7 days was a little lower than in the next 7 days. The average weight loss in the 15 to 20 day trial period was 5-6% of their starting weight. A few patients lost 10%, and a few lost 3%. Only lost no weight at all. After 2 months more than 90% of patients lose more than 10% of starting weight. 

Richard Lipman M.D.

Dr Lipman's First Observations on Treating Overweight Dieters on Belviq