2022 Update: Medications for Weight Loss 

Most people who have used medications to help them lose weight report making better decisions about food, thinking about it less, and feeling more in control. These medications work best when you use them with planned meals, exercise, and other healthy behaviors.

How do weight loss medications work?

When people lose weight, their body begins sending signals to the brain that there is a decrease in stored energy. The brain then sends hormonal and chemical messages that increase appetite, hunger, and cravings. Losing weight and keeping it off is difficult because these signals last until the person has regained most of the weight back. Weight loss medications target these signals and decrease their effect.

Are weight loss medications safe?

Weight loss medications are currently approved as safe by the FDA for long term use. Many of these are undergoing longer-term studies. Each medication has individual risks and benefits. The decision to start a weight loss medication should be individualized with the patient and the health care team.

Other benefits of medications:

Most medications ultimately lead to decreased blood pressure, blood sugar and cholesterol levels because of the weight loss  they cause. Some prevent diabetes.

Which medication is right for me?

Each of these medications has different benefits and side effects. They may cause problems with medications you already take. Your doctor can help you decide which is best for you. You might have to try several different medications until you get one that works well. The right medication will help you control portions, decrease snacking, and choose healthier food by decreasing your hunger or cravings.

When taking weight loss medications if you do not lose 5% of your starting weight in three months, there is unlikely to be further weight loss. An alternative medication should be discussed with your doctor as a next step.

Will I have to use them forever?

We are still learning about weight loss and keeping it off long term. Some people will benefit from using these medications to get started. Most will need to keep using them to maintain their weight loss. Talk to your doctor about what is best for you.

What weight loss medications are available?

Naltrexone-bupropion (Contrave)

2 pills twice a day

Targets the brain to decrease hunger and food cravings.

Side effects: May cause nausea, constipation, headache, insomnia, increased blood pressure.

 

Phentermine-topiramate (Qsymia)

1 pill a day

Targets centers in the brain involved in appetite and fullness.

Side effects: May cause dry mouth, metallic taste in the mouth, tingling sensation in the fingertips or toes, insomnia, dizziness.

 

Orlistat (Xenical, Alli OTC)

1 pill 3 times a day with meals

Decreases absorption of the fat you eat.

Side effects: May cause diarrhea, oily stools, gas.

 

Plenity

3 pills twice a day before meals with 16 ounces of water

Creates a hydrogel to fill the stomach and make you feel full.

Side effects: Diarrhea, distended abdomen, infrequent bowel movements, and flatulence.

 

Liraglutide (Saxenda)

1 shot a day

Targets centers in the brain to decrease hunger and increase fullness.

Side effects: May cause nausea, constipation, diarrhea, acid reflux, vomiting.

 

Semaglutide (Wegovy)

1 shot a week

Targets centers in the brain to decrease hunger and increase fullness.

Side effects: May cause nausea, constipation, diarrhea, acid reflux, vomiting.

 

Tirzepatide (Mounjaro)

1 shot a week

FDA approved for diabetes, not yet approved for weight loss.

Targets centers in the brain to decrease hunger and increase fullness.

Side effects: May cause nausea, constipation, diarrhea, acid reflux, vomiting.

 

Phentermine (Adipex, Lomaira)

Adipex: ½ or 1 pill a day

Lomaira 1 to 3 pills a day

FDA approved for short term use (12 weeks): Targets centers in the brain to decrease hunger.

Side effects: May cause dry mouth, constipation, insomnia, increased blood pressure, rapid heartbeat, anxiety.

 

Final Thoughts:

The best weight loss results are achieved when medications are combined with intensive lifestyle modification. The major benefit of weight loss is improvement of diseases caused by obesity such as diabetes, high blood pressure, high cholesterol and heart disease which can be seen with as little as 5% weight loss.

Medications are a tool to help you sustain healthy lifestyle changes. There is no perfect medication for obesity. A medication that may work for a family member or a friend may not be the ideal medication for you. Treating obesity can be complicated so it is best to work with a knowledgeable physician who is dedicated to working with you over the long term.

If you’d like to learn more about permanent weight loss, please feel free to call us or schedule an appointment with Dr. Isaacs using the online booking tool on this website.

Author
Scott Isaacs, MD Endocrinologist and Weight Loss Specialist

You Might Also Enjoy...

Addressing weight regain after bariatric surgery

The average weight loss for patients who undergo bariatric surgery is around 33% of initial body weight compared to an average weight loss of 10% with anti-obesity medications and 3-5% with a low-calorie diet and lifestyle modification.

Tirzepatide vs. Semaglutide (Mounjaro vs. Wegovy)

The approved indication for tirzepatide is diabetes although studies have found that it is a highly effective weight loss medication. My experience has been that insurance companies will only cover tirzepatide for a diabetes diagnosis and not for obesity.

What You Need to Know About Fatty Liver

Fatty liver or nonalcoholic fatty liver disease (NAFLD) is a disorder in which too much fat builds up in the liver. Nonalcoholic steatohepatitis (NASH) occurs when that extra fat causes inflammation and scarring of the liver.

If It's Not My Thyroid Then What Is It?

Fatigue, weight gain, mood swings, poor concentration, memory issues, sweating, heart palpitations – your internet search says these are all symptoms of thyroid disease…but what happens when thyroid blood tests are actually normal?

How to Get a Prescription for Mounjaro (a.k.a Tirzepatide)

Tirzepatide (Mounjaro) is a new medication recently approved for the treatment of diabetes. Even though the approved indication is only for diabetes, newly released research has shown that tirzepatide is the most effective weight loss medication ever.