Belviq: The Belle of the Ball, the New Weight Loss Sweetheart

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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The Food and Drug Administration approved the obesity drug lorcaserin (Belviq) on June 27 despite concerns from physicians and others that it might increase the risk of valve disease.

It may be time to get excited about a new weight loss medication, but let’s get to know it. Previous weight loss medications like Meridia and Fen-phen (fenfluramine + dexfenfluramine) ended up a thing of the past.

Lorcaserin (Belviq) is a serotonin receptor agonist that stimulates the area in your brain to tell you that you are full.

Here is our hesitation. There were higher rates of heart valve problems associated with lorcaserin treatment in trials and this was the same problem with Fen-phen. Fen-phen contributed to pulmonary hypertension and valve disease in all valves of the heart (mitral, aortic, tricuspid) in a small number of people who took it, enough to get it pulled from the market.

Now, the patients treated with Belviq in these studies did have a higher incidence of valve problems seen on cardiac ultrasound but it did not reach statistical significance.

So, how well does Belviq work?

– If you take Belviq for a year you will have an average weight loss of 3% – 3.7%.

– Half of non-diabetic patients lost at least 5% of their body weight.

What were the common side effects reported?

Belviq (lorcaserin) may cause problems with thinking, sleepiness, confusion, and, in higher doses, hallucinations, euphoria, or disassociation.

– It may also cause priapism (an erection that doesn’t go away ouch).

As a primary care doctor I am on your side, the weight loss side, but I have concerns. In the 1990s I trained at UCSD medical center where our specialists were well known for treating pulmonary hypertension from Fen-phen, and it led to awful slow deaths in young women, some I will never forget as long as I live. Rare, yes, but remember weight loss of 5% is only 10 pounds if you weigh 200 pounds and that’s the BEST this drug can do for you. Worth it? I’m just not sure.


Dr O.

Belviq is approved by the FDA, but not yet available for prescription. It should become available in early 2013.

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