Prescription Weight Loss Pills & Medications: Can They Help You?

How Do Prescription Weight Loss Pills & Medications Work?

Weight loss medications work in several different ways. Some suppress appetite, making you feel less hungry or fuller faster. Others inhibit the body’s fat absorption from the food you consume. There are also medications that enhance the body’s fat-burning capacity, aiding in calorie expenditure and weight loss efforts. These modern medications differ significantly from past stimulant-based approaches, offering more targeted and diverse ways to manage weight.

Weight loss medications work via one or more of these mechanisms:

• Reducing appetite: Certain medications affect the brain’s signals, making you feel less hungry or satisfied with smaller portions. This can lead to a reduced calorie intake, supporting weight loss by creating a caloric deficit.
• Reducing fat absorption: Some medications interfere with the body’s ability to absorb dietary fats. By inhibiting enzymes responsible for fat breakdown, these drugs reduce the absorption of fats from the food you eat, lowering overall calorie intake.
• Increasing fat burning: Certain medications stimulate metabolic processes that enhance the body’s ability to burn stored fat. This increased fat utilization can contribute to weight loss by promoting a higher rate of calorie expenditure during physical activity and at rest.

Who Are Weight Loss Medications For?

Weight loss medications are typically recommended for adults diagnosed as overweight or obese, with a BMI of 30 or higher (or 27 or higher with obesity-related health issues). Healthcare providers assess overall health, medical history, and risks before prescribing. These medications are not approved for children or teenagers, and lifestyle changes remain the primary approach for pediatric weight management.

What Are the Criteria for Weight Loss Medication Prescriptions?

Healthcare professionals consider various factors when prescribing weight loss medications. Typically, individuals with a BMI between 25 and 30 are considered overweight, while obesity is defined as a BMI of 30 or higher. If lifestyle changes such as a healthy eating plan and regular physical activity prove insufficient for weight management, healthcare providers may prescribe medications as part of a comprehensive weight-control program. The decision to prescribe these medications is personalized, considering individual health risks and needs.¹

Who Should Not Take Prescription Weight Loss Medications

Certain individuals should avoid prescription weight loss medications. This includes pregnant or breastfeeding women due to potential risks, individuals with specific health conditions like heart disease or uncontrolled high blood pressure, those with a history of severe allergic reactions or adverse effects to these medications, and individuals with a history of eating disorders. It’s crucial for anyone who is interested in weight loss medications to consult with their healthcare provider to assess individual health status, share health history, and determine suitable weight management strategies.

Can You Take Weight Loss Medications While Pregnant or Breastfeeding?

Taking weight loss medications while pregnant or breastfeeding is generally not recommended. These medications may pose potential risks to the developing fetus or nursing infant, and their safety during pregnancy and lactation is often not well-established. Pregnant women should prioritize the health of the baby and avoid unnecessary exposures.

Similarly, breastfeeding women should consult with their healthcare provider before considering weight loss medications, as substances from these medications can pass into breast milk and affect the nursing infant.

Types of Prescription Weight Loss Medications

Prescription weight loss medications are each designed to address specific aspects of weight management. Appetite suppressants like phendimetrazine, phentermine (Adipex-P) and liraglutide (Saxenda) reduce hunger signals. Fat absorption inhibitors such as orlistat (Xenical) impede dietary fat absorption. And metabolic enhancers like lorcaserin (Belviq) or naltrexone-bupropion (Contrave) boost fat-burning capacity.

The choice depends on individual health profiles, and consulting healthcare professionals is crucial for personalized advice on the most suitable option for effective weight management.

• Appetite suppressants: Notable examples include phentermine (Adipex-P) and liraglutide (Saxenda), which curb hunger signals to the brain, aiding weight loss by reducing overall calorie intake.
• Fat absorption inhibitors: Represented by orlistat (Xenical), these medications hinder the body’s absorption of dietary fats, leading to weight loss through a decrease in calorie absorption.
• Metabolic enhancers: Examples like lorcaserin (Belviq) or naltrexone-bupropion (Contrave) stimulate metabolic processes, elevating the body’s fat-burning capacity and contributing to weight loss efforts.

Semaglutide (Wegovy, Ozempic, & Rybelsus)

Semaglutide, available as Wegovy, Ozempic, and Rybelsus, is FDA-approved for specific purposes. Wegovy injections were the first drug approved for chronic weight management in adults with obesity or overweight since 2014.² It’s indicated for those with a BMI of 27 kg/m2 or higher with weight-related conditions or a BMI of 30 kg/m2 or higher.

Ozempic is FDA-approved for treating type 2 diabetes. Rybelsus, an oral form of semaglutide, is approved for both type 2 diabetes treatment and reducing cardiovascular risk in adults with type 2 diabetes and established cardiovascular disease.

• How semaglutide (Wegovy) works: Wegovy works by mimicking the action of a hormone called GLP-1, which is naturally produced in the body. By activating GLP-1 receptors, Wegovy helps regulate appetite, making individuals feel fuller and slowing down the digestive process. This results in reduced food intake and, consequently, weight loss.
• Effectiveness of semaglutide (Wegovy): Research supports the effectiveness of Wegovy for weight management. Clinical trials, such as the STEP program, have demonstrated substantial weight loss in participants. For instance, the STEP 4 trial reported an average weight loss of 17.4% in participants receiving semaglutide, emphasizing its potential as a valuable tool in combating obesity.
• Side effects of semaglutide (Wegovy): Common side effects of Wegovy include nausea, diarrhea, vomiting, constipation, and abdominal pain. These effects are often temporary and may diminish over time. However, individual experiences may vary. It’s crucial to consult a healthcare professional if side effects persist or become severe.
• What else you should know about semaglutide (Wegovy): Interactions with other medications should be discussed with a healthcare provider before starting Wegovy. Additionally, individuals with a history of thyroid cancer or multiple endocrine neoplasia syndrome type 2 (MEN 2) should avoid this medication. Boxed warnings highlight potential risks of thyroid C-cell tumors. If severe abdominal pain persists, discontinuation may be advised. Pregnant and breastfeeding individuals should also avoid Wegovy due to potential risks to the fetus or nursing infant. Always follow healthcare provider advice for optimal safety and effectiveness.

*All medications, including weight loss treatments, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Tirzepatide (Mounjaro)

Tirzepatide is an FDA-approved injectable prescription medicine designed to help adults with obesity or excess weight lose weight and maintain it. Tirzepatide is available by prescription as the brand name Mounjaro. It is intended for use alongside a reduced-calorie diet and increased physical activity.

Tirzepatide may also be prescribed off-label for weight loss in individuals without diabetes, especially for those with a BMI over 30 or a BMI over 27 with at least one weight-related condition like high blood pressure or heart disease.³

• How tirzepatide works: Tirzepatide (Mounjaro) is a synthetic hormone that regulates blood sugar levels, reduces appetite, and slows down digestion.
• Effectiveness of tirzepatide: Clinical trials, like SURPASS-4, have shown significant weight loss (14.9%) with tirzepatide, indicating its potential in combating obesity.
• Side effects of tirzepatide: Common side effects of tirzepatide include temporary nausea, diarrhea, vomiting, constipation, and abdominal pain. Individual experiences vary, and persistent or severe side effects should be discussed with a healthcare professional.
• What else you should know about tirzepatide: Individuals with a history of pancreatitis or allergic reactions to tirzepatide (Mounjaro) should avoid it. Discontinue if severe abdominal pain persists. Pregnant and breastfeeding individuals should also avoid tirzepatide due to potential risks to the fetus or nursing infant.

*All medications, including weight loss treatments, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Liraglutide (Saxenda)

Liraglutide (Saxenda), an injectable prescription medicine, is FDA-approved for weight management in adults with obesity or excess weight and associated medical problems. It is also approved for children aged 12 to 17 with obesity to aid in weight loss. When used with a reduced-calorie diet and increased physical activity, Saxenda helps with weight loss.

While primarily intended for those with weight-related health issues, it may also be considered by healthcare providers for weight management in individuals without these problems. Saxenda is approved for long-term use, offering a treatment option for sustained weight loss.⁴

• How liraglutide works: Liraglutide (Saxenda) mimics a natural hormone to regulate appetite, slow digestion, and create a sense of fullness, aiding in weight loss.
• Effectiveness of liraglutide: Clinical trials like SCALE Obesity and Prediabetes show liraglutide’s significant role in promoting weight loss, making it an effective tool in managing obesity.
• Side effects of liraglutide: Common side effects of liraglutide include nausea, diarrhea, vomiting, constipation, and abdominal pain. These side effects are usually temporary. Consult a healthcare professional if these persist or worsen. Other reported side effects include indigestion, injection site reactions, fatigue, allergic reactions, belching, hair loss, and heartburn.
• What else you should know about liraglutide: Discuss medication interactions with a healthcare provider before starting liraglutide (Saxenda(). Not suitable for those with a history of thyroid cancer or multiple endocrine neoplasia syndrome type 2 (MEN 2).

*All medications, including weight loss treatments, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Naltrexone/bupropion (Contrave)

Contrave combines naltrexone and bupropion for weight management in adults with weight-related medical issues, prescribed with a reduced-calorie diet and increased physical activity. Some physicians may also choose to combine it with phentermine, based on their professional judgment. Approved for long-term use, Contrave’s safety and effectiveness with other weight loss products or in children under 18 is not established.⁵

• How naltrexone/bupropion works: Contrave combines naltrexone and bupropion to influence the brain’s appetite and reward system, reducing cravings and increasing calorie burning.
• Effectiveness of naltrexone/bupropion: Research, including the COR-II and COR-BMOD trials, demonstrates naltrexone/bupropion’s (Contrave)effectiveness in promoting significant weight loss, emphasizing its role in managing obesity.
• Side effects of naltrexone/bupropion: Common side effects of naltrexone/bupropion include nausea, headache, constipation, dizziness, and insomnia are usually temporary. However, serious side effects such as rash, itching, fever, chest pain, and trouble breathing require immediate attention and may necessitate discontinuation.
• What else you should know about naltrexone/bupropion: Naltrexone/bupropion (Contrave) may interact with certain medications. Safety during pregnancy or breastfeeding is unclear. Individuals with a history of seizures, opioid use, or eating disorders should avoid naltrexone/bupropion. Boxed warnings highlight potential risks of suicidal thoughts and behaviors, requiring mental health monitoring. Immediate discontinuation is advised for severe skin reactions or signs of liver damage

*All medications, including weight loss treatments, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Phentermine/topiramate (Qsymia)

Qsymia is an FDA-approved prescription medicine with phentermine and topiramate extended-release. It may help achieve weight loss in adults and children aged 12 and older with obesity or overweight individuals having weight-related medical problems. The long-term impact on heart problems, stroke risk, or death remains uncertain.

Qsymia is a federally controlled substance due to its phentermine content and common side effects include dizziness, insomnia, constipation, and dry mouth in adults, while children aged 12 and older may experience depression, joint pain, fever, flu, and ankle sprain.⁶

• How phentermine/topiramate works: Phentermine/topiramate (Qsymia) suppresses appetite with phentermine, and with topiramate, it impacts the brain’s signals to create a feeling of fullness and alters taste perception, ultimately aiding in weight loss.
• Effectiveness of phentermine/topiramate: Clinical studies, including the EQUIP and CONQUER trials, have demonstrated phentermine/topiramate’s effectiveness in promoting weight loss. Participants experienced significant reductions in body weight, reinforcing its role as an effective tool in managing obesity.
• Side effects of phentermine/topiramate: Common side effects of phentermine/topiramate include paraesthesia, dizziness, dysgeusia, insomnia, and constipation. These effects are generally temporary and may diminish over time. However, more serious side effects can occur, necessitating immediate medical attention, such as those related to mood changes, vision problems, or an increase in heart rate.
• What else you should know about phentermine/topiramate: Phentermine/topiramate (Qsymia) may interact with certain medications, and its use is cautioned in individuals with glaucoma, hyperthyroidism, or a history of seizures. Boxed warnings highlight potential risks of mood and cognition changes, metabolic acidosis, and increased heart rate. If mood changes, persistent vision problems, or signs of metabolic acidosis occur, prompt medical evaluation is recommended.

*All medications, including weight loss treatments, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Orlistat (Xenical)

Orlistat, available as Xenical, is an FDA-approved prescription medicine used in conjunction with a low-calorie diet to increase weight loss in individuals with obesity. It can promote weight loss and weight maintenance for individuals diagnosed with obesity. While its approval for long-term use is not explicitly stated, Orlistat is commonly prescribed for extended durations. Orlistat is also available as an over-the-counter medication known as Alli.

Orlistat is not known to be safe and effective in children under 12 years old. Common side effects include oily rectal discharge, passing gas with oily discharge, urgent need for a bowel movement, oily or fatty stools, and an increased number of bowel movements, potentially affecting bowel movement control.⁷

• How orlistat works: Orlistat works by inhibiting the absorption of dietary fats, preventing their breakdown and subsequent absorption in the digestive system. This leads to a reduction in calorie intake and promotes weight loss.
• Effectiveness of orlistat: Research studies, such as the XENDOS trial, demonstrate that Orlistat is effective in aiding weight loss when used in conjunction with a low-calorie diet. Participants using Orlistat experienced greater weight loss compared to those using a placebo.
• Side effects of orlistat: Common side effects of orlistat include oily rectal discharge, passing gas with oily discharge, an urgent need for a bowel movement, oily or fatty stools, and an increased number of bowel movements. These effects are typically temporary and occur due to the medication’s mechanism of action on fat absorption.
• What else you should know about orlistat: Orlistat may interact with certain medications, and its use is cautioned in individuals with chronic malabsorption syndrome or cholestasis. There are no specific boxed warnings, but individuals experiencing severe abdominal pain, persistent nausea, or jaundice should stop taking Orlistat and seek medical attention.

*All medications, including weight loss treatments, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Can You Take Weight Loss Medications While Pregnant or Breastfeeding?

Taking weight loss medications during pregnancy or breastfeeding is generally not recommended. The safety of these medications for the developing fetus or nursing infant is not well-established, and potential risks may outweigh potential benefits. Pregnant individuals should prioritize a healthy lifestyle, focusing on a balanced diet and regular physical activity, under the guidance of their healthcare provider.

For breastfeeding individuals, many weight loss medications can pass into breast milk, and their impact on the nursing infant is not fully understood. Breastfeeding mothers should consult their healthcare provider before considering any weight loss medications to ensure the well-being of both themselves and their infants.

How Effective Are Weight Loss Treatments?

The effectiveness of weight loss treatments varies based on factors like genetics, lifestyle, and overall health. Prescription medications, including orlistat, phentermine/topiramate, and liraglutide, can aid weight loss when combined with a healthy diet and exercise. However, success is individual, influenced by factors such as adherence to prescribed regimens and overall lifestyle. Weight loss treatments are generally recommended for individuals with specific BMI criteria, and consulting with a healthcare professional is crucial to determine suitability and set realistic expectations.

Short-term Vs. Long-term Efficacy

The efficacy of weight loss medications can differ between short-term and long-term use. In the short term, these medications often show more immediate results, aiding in initial weight loss. However, long-term effectiveness may vary as factors like tolerance, adherence, and metabolic adaptations come into play.

Some individuals may experience diminishing effects over time or struggle with weight regain after discontinuation. Long-term success often hinges on a comprehensive approach that includes lifestyle modifications, such as maintaining a healthy diet and regular physical activity. It is essential for individuals using weight loss medications to work closely with healthcare professionals to establish realistic expectations and develop sustainable strategies for both short-term and long-term success.

Comparative Effectiveness

Comparing the efficacy of different types of weight loss treatments involves considering various factors, including the medication’s mechanism, average weight loss, and the time frame of effectiveness. These are rough estimates based on clinical studies. You should talk with your healthcare professional about weight loss expectations for you with any medication you are considering.

How Much Weight Can You Lose on Weight Loss Medications?

The amount of weight one can lose on weight loss medications varies widely and is influenced by several factors. Prescription medications, when used as part of a comprehensive weight management plan that includes a healthy diet and regular exercise, can contribute to significant weight loss. On average, individuals using medications like phentermine may achieve a weight loss of about 5-10% of their initial body weight within a few months.

It’s important to note that individual responses differ, and success depends on factors such as adherence to prescribed regimens, lifestyle choices, and overall health. Weight loss medications are generally recommended for individuals with a BMI over 30 or those with a BMI over 27 with weight-related health conditions.

Which Medication Is the Best for Losing Weight?

The effectiveness of weight loss medications varies, with Wegovy and Ozempic, both GLP-1 receptor agonists, showing significant weight loss of 15-17%. Phentermine and Orlistat are FDA-approved options known for appetite suppression and fat absorption inhibition, respectively.

The best weight loss medications for each person depend on individual factors, considering potential side effects and long-term outcomes. A comprehensive approach, including lifestyle modifications, is crucial. Consulting healthcare professionals ensures personalized guidance based on individual health circumstances and weight loss goals.

How Much Do Weight Loss Medications Cost?

The cost of weight loss medications can widely vary, impacting treatment decisions. For instance, generic phentermine (Adipex-P) is an affordable option, as low as $10 without insurance, aiding weight loss by decreasing appetite. However, Qsymia, a combination of phentermine and topiramate, has no generic alternative and tends to be pricier, starting at $169 without insurance. Wegovy (semaglutide), effective for weight loss, lacks a generic alternative and may not be covered by most insurance plans, with prices starting at $1,302.⁸

Healthcare providers and pharmacists may have cost saving options available, such as coupons for Trulicity, Rybelsus, and others.

How Long Do You Have to Take Weight Loss Medications?

The recommended timeframe for taking weight loss treatment can vary for individual patients. Short-term options like phentermine are typically used for around 12 weeks, while GLP-1 receptor agonists like Wegovy or Ozempic may be prescribed for longer periods. Deciding when to continue, switch, or stop depends on individual progress and health goals. Regular communication with healthcare professionals is crucial for personalized guidance and adjusting the treatment plan based on individual responses and long-term objectives.

What Happens After You Stop Taking Weight Loss Medications?

After stopping weight loss treatments, the potential for changes in weight and overall well-being depends on factors such as lifestyle habits, dietary choices, and the specific medication used. For short-term medications like phentermine, gradual weight regain may occur if healthy lifestyle changes are not maintained.

Individuals who have stopped taking weight loss treatments should prioritize maintaining a healthy lifestyle, incorporating a balanced diet and regular physical activity. Sustainable habits play a crucial role in weight management post-medication and can help prevent potential rebound effects. Regular follow-ups with healthcare professionals provide ongoing support, monitor progress, and offer guidance on sustaining a healthy weight without reliance on medication.

How to Get Weight Loss Medications

Weight loss treatments are prescription medications that can be obtained through healthcare professionals such as primary care physicians, endocrinologists, or specialized weight management clinics. To initiate the process, individuals interested in weight loss medications and other treatments should schedule an appointment with a healthcare provider.

The prescriber may conduct a thorough evaluation to determine the most suitable weight loss medication based on individual health needs. Factors such as BMI, the presence of weight-related health conditions, and previous weight loss attempts may influence the prescriber’s decision.

Stigma With Weight Loss Medications

Willpower, diet restrictions, and frequent exercise are often held up as socially acceptable methods for weight loss. The stigma around weight loss medications can stem from misconceptions about the causes of obesity, potentially creating a barrier for those considering medications.

Healthcare professionals play a crucial role in destigmatizing weight loss medications by providing education, understanding, and support to individuals seeking these options. Encouraging a non-judgmental and empathetic environment can empower individuals to discuss their weight management journey openly, reducing the stigma associated with seeking pharmacological support for a healthier lifestyle.

Weight Loss Treatments in Combination With Lifestyle Changes

Combining weight loss treatments with lifestyle changes, including a balanced diet and regular exercise, offers a comprehensive strategy for achieving a healthy weight. These medications can provide an initial boost, aiding appetite control or fat metabolism, and support the adoption of sustainable habits. However, it’s crucial to view them as complements rather than standalone solutions.

Potential drawbacks include side effects and overreliance on medication without addressing underlying factors. The most effective and sustainable approach involves a balanced integration of weight loss treatments with lifestyle interventions, ensuring personalized guidance from healthcare professionals for optimal results.

Questions to Ask Your Healthcare Provider About Weight Loss Treatments

Individuals considering weight loss treatments may want to ask their healthcare provider important questions to gather information and make informed decisions. Some questions to consider include:

• How safe are weight loss treatments for my specific health conditions?
• What is the expected timeline for achieving weight loss?
• Are there potential interactions or risks if I am already on other medications?
• Can treatments support long-term weight loss maintenance?
• What are the common side effects of weight loss medications, and how can they be managed?
• Is weight loss treatment suitable for individuals with a history of heart problems or other medical issues?
• How often should I expect follow-up appointments while on weight loss treatment?
• Will weight loss treatments require any specific lifestyle changes, such as adjustments to diet or exercise?
• What criteria will determine the success of a medication for my weight loss goals?
• Are there any contraindications or scenarios where a weight loss treatment may not be recommended?
• How do weight loss medications compare in terms of efficacy and safety?
• What support or resources are available to assist with the cost of weight loss treatments?
• How do different treatments compare, such as Trulicity vs. Ozempic?

How to Know if Prescription Weight Loss Medications Are Right for You

Determining if prescription weight loss medications are suitable involves a thorough assessment of overall health, existing medical conditions, and medications. Consulting with a healthcare provider is essential to evaluate factors like BMI, weight-related health risks, and past weight loss attempts.

Individuals should also reflect on their commitment to lifestyle changes, as these medications work best when combined with a healthy diet and regular exercise. Open communication with healthcare professionals allows for a personalized assessment, ensuring that prescription weight loss medications align with individual health needs and realistic weight management goals.