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What is Belviq? Well it’s one of just a couple of US Food and Drug Administration (FDA)-blessed weight-loss meds.
Belviq is the brand name of lorcaserin, an FDA-approved prescription drug recommended for the obese to lose weight. Patients who are likely to be able to get a prescription for this drug are those with a body mass index (BMI) of 30 or more or a BMI of 27 or more if they have other diseases simultaneously, like diabetes or high blood pressure.)
A quick note about BMI: it is possible that someone with a higher than acceptable BMI is just really muscular. That said, there’s a really quick and easy way to determine your BMI here. 
Known as Lorqess while going through the research and approval phases, Belviq is not without its controversy; Belviq side effects run the gamut. Like essentially any drug, there will be side effects—some mild, some more serious—and those ill effects will vary from person to person. Like other approved drugs, Belviq comes with a long list of warnings and potential interactions. 
We’ll get to that shortly. But what about the claims of weight loss? Does it work?
Belviq has a very specific purpose and outcome, which clinical trials and years of research back up. It affects serotonin in the brain—the “good mood” chemical—like any selective serotonin reuptake inhibitors (SSRIs) used as antidepressants. Belviq sends a chemical message to the part of your brain that controls appetite: “You are full. You can’t eat another bite,” after consuming a much smaller meal than your usual plateful. 
Belviq is taken twice daily, 10 mg tablet each. The drug is also available as a once-daily 20 mg extended release called Belviq XR.
That’s basically it. Combining the drug with a smart meal plan and exercise, obese adults are supposed to lose 5% of their body weight within the first three months.
The Science (or Lack Thereof) Behind Belviq
One in every three Americans is obese. That’s a fact. Not an “alternative fact”—a FACT. The obese are more likely to suffer heart disease, diabetes, high blood pressure and stroke. 
According to a study published in Pharmacy & Therapeutics in 2013, Belviq has “established efficacy in clinical trials and its safety profile, lorcaserin may be considered a possible alternative among the available weight-loss agents.” 
So it works. But at what cost?
The benefit of using an FDA-approved dietary aid or drug is you know exactly what you’re getting yourself into. The science is part of the public record, like any FDA-approved drug, and in this case the process took several years. The drug is shown to be effective, based on the research. But the warnings, side effects, and interactions are voluminous.
For starters, make sure to triple-check (or at least check with your doctor about) your current medications for interactions; the list of drugs that adversely interact with Belviq include meds for you-name-it: from cold and headache medications to many that are used to treat any kind of mental illness.
Belviq combined with some medications can cause “agitation, hallucinations, confusion, or other changes in mental status; coordination problems; uncontrolled muscle spasms; muscle twitching; restlessness; racing or fast heartbeat; high or low blood pressure; sweating; fever; nausea; vomiting; diarrhea; or stiff muscles.” 
Geez. But there’s more. A lot more.
There’s evidence that people with known—or unknown—heart problems can suffer valvular heart disease. 
The other biggie is the cognitive consequence: Belviq can “slow your thinking.” Honestly, that’s a deal-breaker for me. 
Then there’s the mental health issues, including new or increased anxiety and/or depression, and the “feelings of standing outside your body” sounds scary. For diabetics it can cause low blood sugar and for men, painful erections. 
Biologically, the changes to your body are pretty consequential, in my opinion. Slow heartbeat, decrease in red and white blood cell counts, increase in the hormone prolactin (“man boobs”) . Someone taking Belviq can pretty much bank on one or more of these less serious and super common side effects like: “headache, dizziness, fatigue, nausea, dry mouth, constipation, cough, low blood sugar (hypoglycemia) in patients with diabetes, and back pain.” 
There’s reams of study on the effectiveness of this weight loss drug, but it’s a trade-off. What’s the weight loss worth?   
Word on the Street About Belviq
What about Belviq reviews? We went right to the patients, but not on the official Belviq page, although the testimonials there sound very convincing.
Of the nearly eight hundred patient reviews of Belviq (some under “Weight Loss” filter and some under “Obesity”) on Drugs.com, the medication received an overall score of 8.1 out of 10, which is pretty high. 
A deep dive found that while the majority lost weight—and in some cases quite a bit of weight—a handful claim they didn’t exercise at all.
Like “JessST” (2017, 10 stars):
The first two days of being on Belviq were rough but after that I knew right away it was worth it. My insurance does not cover it but with the coupon it is $80. I did not get a refill thinking I would be fine without it but my weight loss has stalled and I am back to eating how I was before hand even tho I’m trying not to. My starting weight was 201 and my current weight after one month of taking it is 183 without exercise since I was healing from surgery! I just refilled it and will start going to gym with my next paycheck! 
However, most patients seem to have combined Belviq with diet and regular exercise. And for many, the exercise part not only helped them see more weight loss, it fended off side effects.
Patient and reviewer “Frank White” (2017, 7 stars) was one of them.
The drug works. I needed to exercise. Without exercise I experience headaches and weird dreams. But when I get out and walk, I feel much much better and the weight comes off faster to. I went from 265lb down to 195lb and my enthusiasm for walking and finally hitting the gym, increased. I lost all the cravings and especially the feeling that I’m hungry all the time. That helped me get started. Then eating very little each day and exercising is the key. However, don’t stop taking the drug cold turkey. I did that, and I turned lethargic and my hunger and cravings for fast food, doughnuts, ice cream and sugary drinks hit twice as hard and I gained back 85 pounds. Now I have to start all over. 
Patient and reviewer “DGG2017” (2017, 10 stars) praised Belviq.
I have been on Belviq for nearly 18 months. I take 10mg twice daily. My BMI was in the Obese range. I never had a single side-effect. Not one. I have lost 45 pounds. The medication just took away my cravings. I never even want dessert, and have no desire for sweets. Sadly, I am not an exercise person, so I’ve done very little of that. Some people might think that 45 pounds indicates a slow weight loss in that length of time, but I am thrilled. By the way, I just eat normal food, but much smaller portions. I just get full very quickly I’m sorry some people have had problems or side effects. For me, it was a lifesaver. I still have 25# more to lose, but I’ll get there. Then I have to figure out how to keep it off! 
Still, despite the very high marks, there are scores of complaints. Of the 50-plus negative reviews I read, bad headaches were the most common side effect, but people also experienced side effects like flu-like chills and tremors, and nightmares and/or insomnia.
Take reviewer “Diana-who-wants-her-life-back,” who says:
…This medicine is hell! I had horrible nightmares like I’ve never had in my life then the headache came back like someone hit me with a 2×4. I was a complete zombie the next day. The worst! No Belviq you are doing it wrong! 
The Bottom Line: Is Belviq Worth a Try?
Depends. If you qualify, and can take the side effects, go for it. But make sure to ward off some of the ugly and uncomfortable ill effects by exercising daily, even if it’s just a brisk 20-minute walk. You’ll sleep better and might just be less likely to suffer from insomnia and headaches, as many patients have reported.
Besides side effects and health-related problems, for many the Belviq cost is prohibitive. I found reviewers saying they were out-of-pocket several hundred dollars, especially without insurance. But many insurers do cover Belviq—it’s a smart preventative medicine to avoid the very high cost of treatment for obesity-related disease. Though co-pays can be rough. A number of reviewers said their doctor alerted them to Belviq coupons and the website has printable coupons. 
Like “Phat Girl from St. Louis” (2017, 5 stars) says on the Drugs.com Belviq review page:
…posting because of the price. I went online printed the coupon filled out all the info etc before using the coupon it was $88 out of pocket even with my insurance paying their part. With the coupon at CVS and Cigna HMO I paid $0 for mine. So just FYI on the price! 
So What Really Works?*
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*Individual results will vary.