How can prescription drugs help people dealing with excess weight?
Why should I consider using these medications?
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 medicines work best when you use them with planned meals, exercise, and other healthy behavior changes.
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?
Several weight loss medications are currently approved as safe by the FDA for long-term use (2 years). Many of these are undergoing even longer-term studies, including in patients with heart disease. Additional medications are approved for short-term use (less than 12 weeks). Using weight loss medications requires regular medical monitoring. There is no evidence that these medications are addictive.
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 medicines you already take. Your physician 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 3 months you need to stop taking them and discuss next steps with your physician.
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. Others may need to keep using them to maintain their weight loss. Talk to your physician about what is best for you.
What obesity medications are FDA approved?
Medications approved for long-term use
Naltrexone-bupropion (Contrave) 2 pills twice a day
Targets the brain to decrease hunger and food cravings
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
May cause dry mouth, insomnia, change in taste, tingling sensation, dizziness
Orlistat (Xenical/Alli OTC) 1 pill 3 times a day with meals
Decreases absorption of the fat you eat
May cause diarrhea, oily stools, gas
Liraglutide (Saxenda) 1 shot a day
Targets centers in the brain to decrease hunger and increase fullness
May cause nausea, constipation, diarrhea, vomiting, low blood sugar
Semaglutide (Wegovy/Ozempic) and Tirzepatide (Mounjaro/Zepbound) 1 shot a week
Targets centers in the brain to decrease hunger and increase fullness, regulates hormones
May cause nausea, constipation, diarrhea, vomiting, hair loss, pancreatitis and in mice has been shown to increase rate of medullary thyroid carcinoma- it has not been seen in humans but if a patient has a history of medullary thyroid carcinoma or family history of it-it will not be prescribed
Medications approved for short-term use
Phentermine Adipex, 1/2 to 1 pill a day
Lomaira, 1 to 3 pills a day
Targets centers in the brain to decrease hunger
May cause dry mouth, constipation,
Domenica M. Rubino, Washington Center for Weight Management and Research, Arlington, Virginia, USA; Tareneh Soleymani, Summit Medical Group, Department of Nutrition Sciences, University of Alabama at Birmingham, USA; Scott Kahan, Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, Maryland, USA. The Obesity Patient Page is a public service of The Obesity Society (TOS) and its Clinical Committee. These recommendations are appropriate in most instances, but they are not a substitute for medical diagnosis. Consult your healthcare provider for specific information concerning your personal medical condition. This page may be photocopied non commercially by healthcare practitioners to share with patients. Healthcare practitioner is de ned as being legally permitted to provide healthcare services and advice as de ned by governing state laws and regulations.
