Contrave: A Solution for Emotional Eating and Weight Loss?

Contrave is one of the few drugs approved by 
the FDA and available in Canada specifically for treating obesity.
But how effective is it realistically? And what should you know before taking it? Hi! I'm Dr. Brian Yeung, 
a naturopathic doctor in Toronto, and I manage weight loss patients who have used 
and are currently using Contrave, and from all their experiences I'm here to shed some light 
into what you might expect if you try it yourself. Contrave is a combination drug of both bupropion 
and naltrexone. Bupropion itself is mostly used as an antidepressant, actually one of the 
few that doesn't seem to cause weight gain. Naltrexone is an opioid antagonist, that is a 
drug that blocks the effect of opioid drugs. It's used by itself often to help recovering 
opioid addicts or alcoholics to reduce their addiction to those substances. Now this may seem like a somewhat strange
combination for a drug used for weight loss, but it all started when 
researchers initially noticed that both drugs individually seemed to cause weight loss as a side 
effect. After combining the two they came up with Contrave, and after studies showed that it both 
worked synergistically to help with weight loss, the FDA finally approved its use in 2014.

You'd be surprised how many uses
for drugs are discovered by simply observing and using the side effects. I mean that's how the popular hair loss drug, minoxidil also known as Rogaine, was discovered. Actually it was initially used to see if it would 
help with ulcers, which it didn't, but it sure had an interesting
side effect of hair growth! But I digress. How does it work? The mechanism 
by which it works is unclear, but it's believed to target certain areas of the brain related 
to eating, such as the pleasurable sensations derived from eating delicious food or feeling full.
It seems to focus on reducing the brain's feeding habits rather than increasing fullness signals. The end result is people may end up eating less
and lose weight as a result.

Side effects. Headaches and dizziness are some of the
most common issues I've observed. It can even become debilitating to the 
point of causing some people to nearly pass out. Nausea is also common, alongside other 
gastrointestinal issues like constipation, stomach pain, or vomiting. Contrave may also make you feel
real jittery or even nervous and anxious. This isn't surprising given that Contrave 
contains bupropion, which is considered a stimulant.   This means it may worsen certain neurological 
and mood disorders, for example by potentially   increasing the risk of seizures, or worsening 
existing anxiety or panic disorders.  For this reason, Contrave is not to be used 
in those with seizures or with any sort of condition that increases seizure risks.

It may also affect blood pressure
and is also not to be used in those with uncontrolled hypertension. Contrave may also interact with a
number of different drugs, especially other psychiatric medication,
so if you're taking other medication, you'll need to let your doctor know. There are some concerns about seizure risks
with drinking alcohol while on Contrave, but this risk appears to only be the case
if you we're a heavy drinker beforehand, then suddenly stop drinking while 
on Contrave, since sudden alcohol withdrawal is   well known to increase seizure risks.
Having a few drinks by itself while on Contrave doesn't appear to increase these seizure 
risks, based on the available evidence. However, some people who do drink alcohol while 
on Contrave report that it makes them feel sick or that the alcohol doesn't seem to have the same 
effect, and even though many people are still able to drink small amounts on Contrave without feeling 
any side effects, I recommend just staying away   from alcohol while on the drug. So if you tend to 
binge drink or drink heavily throughout the week, you will need to work closely with your doctor 
first to see if it's safe for you to use.

Is it effective? It definitely does not work 
for everyone, but the patients I've observed in practice for which it does work, it works mostly 
like an appetite and craving suppressant. It's a kind of different type of appetite suppressant in 
that it seems to be more effective at suppressing cravings rather than hunger. Check out my video 
for a more detailed breakdown between the two, but the difference between cravings and hunger is kind 
of like the difference between wanting to eat and needing to eat. Cravings are a desire to eat your 
body may not eat it but you still want to eat it.

Hunger is your body telling you it needs to eat 
to function properly. Contrave seems to reduce this desire to eat, however, you are still able 
to eat normally if you wish to. Also if you're actually hungry, Contrave may not do much to 
reduce that hunger. I do notice that sometimes it takes a few weeks to actually take effect, so 
unlike some of the other weight loss tools that   start working right away, you might have to take 
it for a while before anything happens. Also I find that rebound craving and appetite increases 
can be very strong upon discontinuing the drug, especially for those who found
the drug to be very effective. Should you do it? Contrave appears to be most effective as a craving suppressant.
That means that if you have problems controlling yourself with eating things you know you shouldn't, like 
constantly snacking or constantly eating fast food, it may help give you better control over yourself.
If you're an emotional eater and tend to reward yourself with food or eat as a way to soothe 
negative emotions, Contrave may help you break this emotional connection with your food and might 
allow you to look at food as a form of nutrition, rather than a form of comfort.

If you do decide to use it
keep in mind these 4 things: First, you will need to have an effective weight loss diet 
you are already following or plan to follow. Your selected diet should also be effective at managing 
hunger properly since Contrave doesn't seem to be too effective at suppressing hunger. I recommend 
following a stricter dietary routine since Contrave can help you to more easily follow and 
make the right dietary decisions during your diet. Second, you will need to be screened thoroughly 
by your doctor since Contrave interacts with and causes problems with numerous drugs and 
health conditions particularly neurological or psychiatric issues. Third, even if Contrave is safe 
for you to use, a lot of people starting Contrave are not willing to continue it for too long due 
to the heavy side effects they experience. If you're just starting out, the doses are usually 
titrated up slowly to help reduce these effects.

Also many of the side effects do tend to settle 
down or even go away after the first few weeks.  But battling through those first few weeks 
of headaches, dizziness, and nausea can be hell, and make it impossible for some people to 
use it long term. Fourth and finally, when you stop taking the drug, you may find that the 
strong cravings will return and if you fail to implement any longer term dietary or lifestyle 
habits to deal with cravings and emotional eating, you might find yourself regaining the weight 
much faster than you lost it. Don't forget to continually build good dietary and lifestyle 
habits while you're on Contrave. For example by taking steps to reduce your idle snacking, 
especially since the drug should help make it easier for you to initially implement those steps 
and transition them over into lifelong habits. Overall, Contrave may be helpful for emotional 
overeaters and people with strong cravings to   overcome these issues and more easily follow a 
weight loss diet. The first few weeks of taking it will likely
be the most difficult part, since the adverse effects are worse during that time,
and the drug may not even be working yet.

Let me know in the comments down below
if you have any other questions about Contrave, or if you have 
any experiences yourself you'd like to share, and if you found this video helpful please 
leave me a like! As before, I'm Dr. Brian Yeung, bringing you weight loss info
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