mysimba. gelesis100 main article: gelesis100 gelesis100 (sold under the brand name "plenity") is an oral superabsorbent hydrogel used for weight loss in the treatment of obesity and overweight. as gelesis100 absorbs water, it expands in the stomach and small bowel, which may result in satiety. gelesis100 was approved in april 2019 by the us food and drug administration as a medical device. in 2022, the american gastroenterology association recommended the use of gelesis100 be limited to clinical trials due to limited evidence. lorcaserin lorcaserin (belviq) was approved 28 june 2012 for obesity with other co-morbidities. the average weight loss by study participants was modest, but the most common side effects of the medication are considered benign. it reduces appetite by activating a type of serotonin receptor known as the 5-ht2c receptor in a region of the brain called the hypothalamus, which is known to control appetite. this drug has now been withdrawn from the market because a safety clinical trial shows an increased occurrence of cancer. sibutramine sibutramine (meridia), which acts in the brain to inhibit deactivation of the neurotransmitters, thereby decreasing appetite was approved in 1997 and withdrawn from the united states and canadian markets in october 2010 due to cardiovascular concerns. as late as 2004, some held that meridia was a harmless medication for fighting obesity: the us district court of the northern district of ohio rejected 113 cases complaining about the negative effects of the medication, stating that the clients lacked supporting facts and that the representatives involved were not qualified enough. in october sibutramine was withdrawn from the market for cardiovascular side effects like stroke or heart attack, sometimes fatal, in the united states, the uk, the eu, australia, canada, hong kong and colombia. rimonabant rimonabant (also known as sr141716; trade names acomplia and zimulti) was an anorectic antiobesity medication that was first approved in europe in 2006 but was withdrawn worldwide in 2008 due to serious psychiatric side effects; it was never approved in the united states. it works via a specific blockade of the endocannabinoid system. it has been developed from the knowledge that cannabis smokers often experience hunger, which is often referred to as "the munchies". rimonabant is an inverse agonist for the cannabinoid receptor cb1 and was the first medication approved in that class. off label and experimental medications metformin in people with type 2 diabetes mellitus and for those taking clozapine for schizophrenia, the medication metformin (glucophage) can reduce weight, but in others it is not approved as an anti-obesity medication. metformin limits the amount of glucose that is produced by the liver as well as increases muscle consumption of glucose. it also helps in increasing the body's response to insulin. tesofensine (ns2330) a serotonin–noradrenaline–dopamine reuptake inhibitor from the phenyltropane family of medications, which as of 2009, was being developed for the treatment of obesity. tesofensine was originally developed by a danish biotechnology company, neurosearch, who transferred the rights to saniona in 2014. tesofensine has been evaluated in phase 1 and phase 2 human clinical studies with the aim of investigating treatment potential with regards to obesity. amylin analog pramlinatide pramlintide, originally developed by amylin pharmaceuticals, now owned by astrazeneca pharmaceuticals, is an injectable analogue of amylin (secreted by the beta cells of the pancreas in a fixed ratio when insulin is released and activated) an approved for treating diabetes type 1 and 2. it is in testing for treating obesity in non-diabetics. nutraceuticals, herbal and alternative medicine dietary supplements, foodstuffs, or programs for weight loss are heavily promoted through advertisements in print, on television, and on the internet. the us food and drug administration recommends caution with use of these products, since many of the claims of safety and effectiveness are unsubstantiated, and many of the studies purporting to demonstrate their effectiveness are funded by the manufactures and suffer a high degree of bias. individuals with anorexia nervosa or bulimia nervosa, and some athletes, try to control body weight with diet pills, laxatives, or diuretic medications, although the latter two generally have no impact on body fat and only cause short-lived weight-loss through dehydration. both diuretics and laxatives can cause electrolyte abnormalities which may cause cognitive, heart, and muscle problems, and can be fatal. canadian clinical practice 2006 guidelines state that there is insufficient evidence to recommend in favor of or against using herbal medicine, dietary supplements or homeopathy against obesity. some botanical supplements include high dosages of compounds found in plants with stimulant effects including yohimbine and higenamine. quality control many products marketed as botanical weight loss supplements actually contain unapproved stimulants including analogues of amphetamine, methamphetamine and ephedra. caffeine, coffee and green tea