Whether scrolling through your social media feed or catching up on the latest news, it’s hard to miss the buzz around weight loss medications.
While it may seem these medications have come out of nowhere, many have been on the market for many years. Some started as medications for treating type 2 diabetes and were later approved by the Food and Drug Administration (FDA) for use in weight management.
Who is a good candidate for weight loss medications?
FDA guidelines say that weight loss medicines may be considered for people who have tried lifestyle changes and meet one or more of the following conditions:
- Have a body mass index (BMI) equal or greater than 30
- Have a BMI equal or greater than 27 with one or more obesity-related conditions (like high blood pressure or diabetes)
- Have not lost at least 5% of their total body weight in three to six months with lifestyle changes alone
Weight loss medications are not for everyone, and there are several considerations to make before starting them:
- You should not take weight loss medications if you are trying to get pregnant, are pregnant, or are breastfeeding.
- If you have a history of disordered eating, discuss the medications with your provider and therapist before starting them.
- Consider the expense, potential downsides, and side effects before beginning weight loss medications.
Why are these medications good for weight loss?
You and your provider may discuss medication options to help you lose weight and help improve your overall wellbeing, including your blood pressure, cholesterol and diabetes levels and reducing cardiovascular, kidney and metabolic risks.
Over a year, individuals using these drugs typically lose 3-12% more weight than those who don’t. While this might sound small, losing 5-10% of your body weight can significantly improve your health by lowering blood pressure, blood sugar, and triglycerides (fats). This long-term improvement in health is a promising outcome of weight loss medications.
Medications for weight management
With so many types, brands and approvals, staying informed can get overwhelming. Let’s look at the most common weight loss medications recommended for long-term use.
It is important to consult with your healthcare provider and read patient information materials to fully understand any medication you’re considering for weight loss.
Semaglutide (Wegovy), originally developed to treat type 2 diabetes, has been approved for weight management. This class of medications is particularly beneficial for those with at least one other chronic condition, such as high blood pressure, high cholesterol or type 2 diabetes, as they can also help manage these conditions. Semaglutides help block hormones that target areas of the brain that control your appetite and how much you eat to help:
- Lower blood sugar
- Reduces the risk of heart conditions
- Reduce appetite, aiding weight loss
Dosage: Taken via injection once a week
Common side effects: Nausea and vomiting, pain in the belly, diarrhea, tiredness, headache, if injected, pain at the injection site
Bupropion-naltrexone (Contrave) is a combination of one medication to treat depression and help people stop smoking (Bupropion) and a drug used to help treat alcohol and opioid addiction. The drug helps to reduce appetite and control a person’s cravings.
Dosage: Taken by mouth, twice a day
Precaution and common side effects:
- As with all antidepressant drugs, this combination carries a suicide risk warning.
- It could raise blood pressure.
- Nausea, headache and constipation
Liraglutide (Saxenda) is used to manage diabetes and can promote weight loss in certain patients. It helps control blood sugar by telling your pancreas to make insulin when needed. Insulin moves sugar from your blood into your body’s cells for energy. Liraglutide also makes food move more slowly through your stomach, making you less hungry and helping you lose weight.
Dosage: Taken via injection daily injection
Common side effects:
- Headache
- Constipation
- Heartburn
- Runny nose, sneezing, or cough
- Tiredness
- Difficulty or pain or burning when urinating
- Injection site rash or redness
Phentermine-topiramate (Qysmia) combines phentermine, a weight loss drug and the anticonvulsant (prescription medications that treat or prevent seizures) drug topiramate. It decreases appetite and causes feelings of fullness to last longer after eating.
Dosage: Taken by mouth once daily
Precaution and common side effects:
- Topiramate is known to increase the risk of congenital disabilities
- “Pins-and-needles” sensation, dry mouth, and constipation
Tirzepatide (Zepbound) copies two natural gut hormones (GLP-1 and GIP) that your body releases after eating. The medication helps release insulin, reduces hunger by making food move more slowly through your stomach, and tells your brain you’re full.
Dosage: Taken via injection once a week
Common side effects:
- Stomach pain
- Difficulty in breathing or swallowing
- Fast heartbeat
- Gaseous stomach pain
- Heartburn
Orlistat is a medication that helps decrease the amount of fat absorbed when you eat. Orlistat blocks fat absorption in the intestines, helping with both initial weight loss and maintaining weight afterward. The unabsorbed fat passes through the body in the stool. People on this medication must follow a low-fat diet and exercise regularly.
Brand names: Available as prescription Xenical and as Alli, a reduced strength over-the-counter version
Dosage: Taken by mouth, dosage varies
Common side effects:
- Changes in bowel movement habits
- Oily leaking stools
- Incontinence
Wait, why aren’t some medications I have heard of listed?
You may have heard about medications that help you lose weight that are not on this list. These medicines are FDA-approved only to help control blood sugar in people with type 2 diabetes. One of the benefits is that they can also aid with weight loss.
- Ozempic, a once-weekly injection, and Rybelsus, a once-daily tablet taken by mouth, are semaglutide medications known to lower blood sugar levels in adults with type 2 diabetes.
- Mounjaro is a tirzepatide made by the same makers of Zepbound.
Medication for weight loss is only one part of the equation.
It’s crucial to understand that medications for weight loss are just one part of the solution. While they can be beneficial, combining them with a balanced diet, regular physical activity, and consistent exercise under the guidance of your healthcare provider will enhance their effectiveness. Remember, you’re not alone in this journey — every small step you take is a step towards a healthier you, and these lifestyle changes put you in control of your health.
Reviewed by the Ovia Health Clinical Team
Sources
- “The Difference Between Ozempic, Wegovy & Rybelsus | HealthFocus SA | University Health.” University Health, www.universityhealth.com/blog/weight-loss-medication#:~:text=Semaglutide%20can%20be%20taken%20as,strengths%20than%20the%20injectable%20semaglutide.
- “FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014.” U.S. Food and Drug Administration, 4 June 2021, www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014#:~:text=The%20FDA%20granted%20the%20approval,type%202%20diabetes%20in%202017.
- “Orlistat Capsules: Uses & Side Effects.” Cleveland Clinic, 20 Sept. 2023, my.clevelandclinic.org/health/drugs/19489-orlistat-capsules.
- “Pros and Cons of Weight-loss Drugs.” Mayo Clinic, 29 Oct. 2022, www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/weight-loss-drugs/art-20044832.
