"A prescription medication originally developed to treat epilepsy may help obese adults shed weight when combined with routine nutritional counseling researchers say. Patients who took  milligrams of the antiseizure drug zonisamide daily for a year lost nearly . pounds more on average than those assigned to dietaryand lifestyle changes alone the new study found. But they also suffered more side effects than patients not taking the medication. The question was to see if more weight loss could be achieved if we provided decent quality lifestyle intervention mostly dietary counseling along with this medication said study lead author Dr. Kishore Gadde director of the Obesity Clinical Trials Program at Duke University Medical Center in Durham N.C. And the answer was yes Gadde said. The research funded by the U.S. National Institutes of Health appears online Oct.  in the journal Archives of Internal Medicine. For obese men and women who cant control their weight through diet and lifestyle changes nonsurgical options are limited the study authors noted. Just a few prescription medications are approved in the United States for longterm treatment of obesity including orlistat brand name Xenical and lorcaserin hydrochloride Belviq.  Gadde and colleagues set out to follow up on a week investigation they conducted in  that had indicated that zonisamide Zonegran at a dosage of  milligrams a day might offer an alternative. Between  and  the study team randomly assigned more than  obese men and women to one of three groups. One group took  milligrams of zonisamide daily another got  mg of zonisamide daily and one received a dummy pill. The participants average age was  and their average bodymass index BMI was nearly . BMI is a calculation of body fat based on height and weight and a BMI of more than  is considered obese. None had diabetes. All study participants followed their treatment plan for one year. During this time they all also received monthly individualized nutritional counseling which Gadde described as not intensive to help them reduce their overall caloric intake. Those on the higherdose zonisamide protocol fared the best in terms of overall weight loss while the lowerdose regimen was not much more effective than the placebo. Although nearly  percent of those on the higherdose medication shed  percent or more of their prestudy weight that figure was  percent among the lowerdose group and  percent among the nonmedication participants. But patients in both drug groups faced a higher risk for side effects including diarrhea headache fatigue nauseavomiting concentration and memory difficulties anxiety and depressionrelated symptoms. The authors said such side effects were typically mild. They concluded that the higherdose zonisamide showed promise as a weightloss aid but advised clinicians to carefully weigh the pros and cons on a patientbypatient basis. Theres no medicine that is a panacea for obesity cautioned Gadde. The important thing to keep in mind is that although we diagnose obesity on the basis of a mathematical formula  a BMI of  and up  the basis for obesity may differ from one individual to another. Psychological factors or lifestyle factors may play a role he said. But for about a third of patients biological issues are at play such as not easily experiencing satiety signals from the gut to the brain which senses what your energy intake has been he said. And for those people medication can help. Lona Sandon a registered dietitian and assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center at Dallas agreed. Caution is vital when using any drug that has been approved for one condition for another Sandon said. But for many people this kind of drug might absolutely be of great help by doing something that helps the regulation of these appetite hormones and the regulatory pathway she said. More information For more on obesity visit the U.S. National Institutes of Health httphealth.nih.govtopicObesity. SOURCES Kishore Gadde M.D. director Obesity Clinical Trials Program Duke University Medical Center Durham N.C. Lona Sandon R.D. assistant professor clinical nutrition University of Texas Southwestern Medical Center at Dallas Oct.   online Archives of Internal Medicine"