At the time, a small phase two clinical trial involving 300 people with Type 2 diabetes saw some participants experiencing, on average, almost 13 percent loss of their starting body weight over six months. Just last month, the Food and Drug Administration (FDA) approved Eli Lilly’s injectable Zepbound on November 8 specifically for chronic weight management in people with obesity or who are overweight. The study also showed that weight loss provides other health benefits, such as better physical mobility and improved blood glucose, blood pressure, and cholesterol levels. Studies suggest that some virtual programs may work if they include the key features described above.3,7 But researchers are still studying whether virtual weight-loss programs are effective, especially in the long term. In August, Novo Nordisk executives noted that around 1 million U.S. patients are taking compounded GLP-1s. Novo Nordisk in June said some mass, so-called 503B compounding pharmacies have scaled back production, but accused others — including those tied to Hims & Hers — of continuing to sell the drugs under the "false guise" of personalization. Those decisions legally barred compounding pharmacies from making and selling copycats of those drugs by deadlines that passed earlier this year, except in rare cases where it's medically necessary. Older weight loss drugs are in demand. Lilly's Zepbound (tirzepatide) superior to Wegovy (semaglutide) in head-to-head trial showing an average weight loss of 20.2% vs. 13.7%. The most effective weight-loss pill for many people is Wegovy (semaglutide) tablets. Many of the top upcoming weight-loss drugs are injectable medications. It tends to lead to the largest amount of weight loss in the highest percentage of people. Many experts suggest aiming to lose 0.5 to 2 pounds (0.2 to 0.9 kilograms) a week. But a slow and steady program is simpler to keep up. Think about your lifestyle and weight-loss goals. This is important if you have health or physical challenges, or pain with daily tasks. There were four reported cases of adjudication-confirmed pancreatitis, which were evenly distributed across treatment groups, including the placebo group. In November 2023, tirzepatide became the first GLP-1/GIP dual RA approved by the FDA for chronic weight management. In the semaglutide group, the primary cardiovascular endpoint incidence was 20% lower than in the placebo group, which was a statistically significant effect (Lincoff et al., 2023). The Semaglutide Effects on Cardiovascular Outcomes in People with Overweight or Obesity (SELECT) trial (Lincoff et al., 2023) was a randomized, placebo-controlled trial. The significant weight reduction and improved metabolic parameters observed with semaglutide administration would be expected to result in the reduction of adverse cardiovascular outcomes. Correspondingly, the blood pressure lowering effect onweight loss also appears to be linear, with higher achieved weight lossresulting in greater decline in blood pressure. Nonetheless, in individuals withobesity, inhibition of the renin-angiotensin aldosterone system may reverse someof the pathophysiologic mechanisms driving end organ damage in this population.Small studies in humans have demonstrated that renin-angiotensin aldosteronesystem blockade may reduce insulin resistance , endothelial dysfunction , and aldosterone production in individuals with obesity. Individuals withobesity seem to have exaggerated hemodynamic responses to medications inhibitingthe sympathetic nervous system and renin-angiotensin aldosterone system 26–29, potentially increasing the risk of organ ischemia . In the SCALE Diabetes study, HbA1c levels were 0.93% lower in the liraglutide 3.0 vs. placebo treated group, and similar significant benefits on triglyceride (lower) and HDL cholesterol (higher) as in the SCALE Obesity study were reported (73). By the end of the study, participants in the liraglutide 3.0 group lost an additional 6.2% compared to 0.2% with placebo (74). Energy expenditure in subjects treated with liraglutide 3.0 mg/d decreased, even when corrected for weight loss (72), which may reflect metabolic adaptation to weight loss. Similar weight loss efficacy was reported in COR-II (25) and COR-Diabetes (68) trials. Regarding gender distribution, 33 studies (72%) included both male and female participants, 11 (24%) included only female participants, and 2 (4%) included only male participants. The basic information and characteristics of the reviewed studies are summarized in Table 1. Ultimately, 46 studies were included in the final review and meta‐analysis (Figure 1).1, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60 A total of 1584 studies were screened, of which 184 were excluded due to duplication. Although an energy deficit is the most important way to lose weight, weight regain after successful weight loss is very common and may seem inevitable. Under the “calories-in, calories-out” model, dietary management has focused on the concept of “eat less, move more,” and patients have been advised to consider and calculate their calorie balance whenever they eat. The key component of diets for weight loss and weight-loss maintenance is an energy deficit. Therefore, dietary interventions remain the cornerstone of weight-management strategies, and pharmacologic and surgical interventions also aim to improve dietary management. What Are My Weight Loss Surgery Options? It is in contrast to Western medical doctors who conform to the uniform therapeutic guidelines and prescribe similar medications to patients with the same clinical diagnosis. As to weight reduction concepts in TCM, the imbalance of the physiological state in energy (yang) deficiency, materials (yin) deficiency, or phlegm-stasis constitution may cause a high tendency of obesity (Hou et al., 2021). Given the lower level of aerobic fitness, a higher proportion of lean body mass loss, and a progressively decreasing metabolic rate, sarcopenic obesity may become a part of clinical conundrum in older individuals with obesity in the WM group (Coker and Wolfe 2018). Research also indicated that each pound of weight loss would result in a 4-fold reduction in the load exerted on the knee per step during daily activities (Messier et al., 2005). Patients who achieved more than 5% of weight loss would produce significant improvements in knee functionality, speed, walking distance, and pain (Messier et al., 2004). Improvements in fasting glucose and insulin levels were seen in the SEQUEL study, and a 54% and 76% reduction in progression to T2D in the two treatment groups was noted in subjects without diabetes at baseline (63). Improvements in systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides, and high-density lipoprotein (HDL) cholesterol were seen in subjects treated with phentermine plus topiramate compared with placebo in both EQUIP and CONQUER (26,27). Multiple Phase 1, 2, and 3 studies including more than 5000 subjects have evaluated the efficacy and safety of phentermine/topiramate combination therapy. In addition to promoting weight loss and maintaining lost weight, orlistat has been shown to improve insulin sensitivity and lower serum glucose levels. It promotes weight loss by inhibiting gastrointestinal lipases, thereby decreasing the absorption of fat from the gastrointestinal tract. Together, you can go over your health issues and the medicines you take that might affect your weight. Here are some suggestions for choosing a weight-loss program. Some magazines, books and websites promise that you can lose all the weight you want for good. You've likely seen lots of advice about weight loss. Don't fall for gimmicks when it comes to weight loss. He has a background in investigative and science journalism and has worked on documentary films about war and trauma, health, sanitation, and the changing climate around the world. Orlando de Guzman is a writer and editor with expertise in health and environmental news. She's currently a contributor for Everyday Health and Yahoo Life, and her work has also appeared in Forbes Vetted, Healthline, Greatist, mindbodygreen, and Bicycling magazine, among other outlets. To truly lose fat and keep it off, you need to eat at a modest calorie deficit, following an eating plan that you can feasibly stick to for life. Therefore, oral treatments that are easy to use and have a similar weight reduction efficacy to currently approved medications are required. Despite the high efficacy of GLP-1-based anti-obesity medications, the need for regular injections is still a significant barrier for many patients. Mean weight loss from baseline with tirzepatide administration (10 mg or 15 mg) in SURMOUNT 1 to SURMOUNT 3 was 12.8% to 20.9%; this weight loss was significantly higher than in the placebo group (–3.1% to –2.5%) (Jastreboff et al., 2022; Garvey et al., 2023; Wadden et al., 2023). These placebo-controlled trials aimed to evaluate the efficacy and safety of tirzepatide, as an adjunct to lifestyle intervention, in chronic weight management in adults with a BMI ≥27 kg/m2 with or without T2DM. It is being studied for use in patients with acquired hypothalamic obesity. It is intended for use with a reduced-calorie diet and is also indicated to reduce the risk of weight regain. If more than 5% weight loss is not achieved after 12 weeks of the maximum dose, the weight loss pill should be gradually discontinued. Obesogenic environments and biological and psychological factors all contribute to obesity.10 However, obesogenic environments, including social determinants, cultures, and food supply systems, are challenging to modify. Our review indicated that there is no single best strategy for weight management. Some macronutrient composition-based diets, such as the ketogenic diet or high-protein diet, could be considered in some cases, although the potential risks and long-term effectiveness remain unknown. Phentermine-topiramate is a combination of a weight-loss drug called phentermine and an anticonvulsant called topiramate. Some patients who are less comfortable with injections may ask about weight-loss pills. Based on the latest clinical trials and real-world data, tirzepatide (Zepbound) currently stands out as the most effective FDA-approved prescription medication for weight loss. Researchers continue to study hormones that play a role in appetite for other ways to target obesity with medication. In Phase 2, orforglipron showed weight loss up to 14.7%at 36 weeks. Novo Nordisk is developing an oral version of semaglutide (50 mg)specifically for obesity. Chinese adults (aged ≥18 years old) were diagnosed to be overweight (Body Mass Index (BMI) ≥24 kg/m2) or obese (BMI ≥28 kg/m2), according to the diagnosis criteria recommended in the "Guidelines for the Prevention and Control of Overweight and Obesity in Chinese Adults (2021)" released by the National Health Commission's Bureau of Disease Control and Prevention. Randomized controlled trials (RCTs) that used TCM to treat obesity published in English or Chinese were eligible for review. Two reviewers independently screened titles and abstracts to identify studies that met the inclusion criteria described below. Second, most review studies have adopted the methodology of pairwise meta‐analysis, which only allows head‐to‐head direct comparison between the effectiveness of two particular interventions of interest. However, there are some significant limitations in the previous review studies. Connect with UF Health Ephedrine is a potential slimming drug that mediates thermogenic effects, primarily by the enhancement of sympathetic neuronal release of norepinephrine (NE) and epinephrine in both humans and laboratory animals (Bukowiecki, Jahjah, and Follea 1982; Dulloo, Seydoux, and Girardier 1992; Dulloo 1993). Ma-Xing-Gan-Shi-Tang (MXGST) is an oriental herbal formula that has traditionally been used in patients with phlegmatic asthma and productive cough. This difference in therapeutic approach may partly explain the higher efficacy and lower incidence of adverse effects in the CHM group than in the WM group in the real-world (Sui et al., 2012). Second, WM users consisted of a greater proportion of seniors who may face challenges complicated by the progressive loss of skeletal muscle and accumulation of excess adipose tissue, which has been commonly referred to as sarcopenic obesity (Coker and Wolfe 2018). When it comes to adverse events in taking medications, the herbal formulae used in the CHM group showed better tolerability than in the WM group (). After that, you transition into the second phase, where you continue to lose 1 to 2 pounds (0.5 to 1 kilograms) a week until you reach your goal weight. If you've been inactive or you have a medical condition, talk to your doctor or health care provider before starting a new physical activity program. Instead, you'll eat tasty foods that will satisfy you and help you lose weight. The Mayo Clinic Healthy Weight Pyramid is a tool to help you lose weight or maintain your weight. This program can be tailored to your own individual needs, health history and preferred eating style. Together, these mechanisms result inaltered plasma concentrations of certain medications (particularly lipophilicmedications) in obese compared to normal-weight individuals 24, 25. Taking into account the pathophysiologic drivers of elevated bloodpressure due to adipose tissue, individuals with obesity experience severalchallenges in the management of their hypertension (Table 1). Almost three-quarters of individuals with hypertension in the US areoverweight or obese ; correspondingly,higher rates of hypertension are observed in individuals with obesity compared tonormal-weight individuals . Much of the increased morbidity andmortality in individuals with obesity is due to adverse metabolic effects of adiposetissue. While these drugs are powerful, they work best when paired with lifestyle modifications. These drugs are based on incretins—gut hormones that regulate our biological response to food. If an individual experiences early symptoms of diabetes, such as persistent thirst, blurred vision, or chronic fatigue, selecting the right therapy becomes a vital step toward long-term longevity. Today’s generation of drugs has shifted the paradigm by addressing metabolism holistically. When evaluating a patient with obesity for the first time, the clinician should perform a thorough review of all current prescription and over-the-counter medications to investigate for potential weight-gaining medications. Metreleptin is administered as a once daily subcutaneous injection with dosages ranging from 0.06 mg/kg/d to 10 mg/d, depending on body weight and sex. It has been used off-label for the treatment of obesity and other endocrine complications in people with congenital leptin deficiency and hypothalamic amenorrhea (159). The fourth SGLT2 inhibitor, ertugliflozin, also resulted in about 2kg weight loss over placebo in adults with T2D treated for 26 weeks (136). In the landmark EMPA-REG CVOT, average placebo-subtracted weight loss of about 2 kg was maintained out to 220 weeks with empagliflozin 25 mg (135). Roche is seen as somewhat of a latecomer to the weight loss market amid the runaway success of rivals Novo Nordisk and Eli Lilly. GLP-1s, or glucagon-like peptide 1 agonists, are a group of drugs used to treat diabetes and obesity. "We do believe we have two next generation GLP-1/GIPs that have a best in disease potential," he said of the obesity drugs. As society and the scientific community furthers our understanding of obesity, obesity management will evolve to match the standard of care of other chronic conditions, recognizing polypharmacotherapy as a vital component of comprehensive care. Rossner et al. found that subjects receiving orlistat lost significantly more weight in the first year of treatment, and fewer regained weight during the second year of treatment, than those taking placebo (52). Phentermine’s and diethylpropion’s main side effects are related to their sympathomimetic properties, including elevation in blood pressure and pulse, insomnia, constipation, and dry mouth (47). Both phentermine groups lost approximately 13% of their initial weight, while the placebo group lost only 5%. †Range of weight loss observed in single-arm trial (not placebo-controlled) depended on genetic mutation. Women tend to have more success than men when it comes to losing weight and maintaining it. We put a strong emphasis on programs that had empirical evidence backing their success, especially when this evidence was collected by independent researchers. Generic dietary prescriptions, like “low carb” or “low fat,” weren’t good enough, since they weren’t specific enough to be useful. People who have a hard time sticking to a diet on their own. New prescription weight loss drugs like Ozempic, Wegovy and Zepbound are currently in the spotlight for their fast, dramatic results. Weight loss aims to improve obesity-related complications and patients’ health and quality of life. A phase 1 study showed AMG 133 had an acceptable safety and tolerability profile and resulted in dose-dependent weight loss (Veniant et al., 2024). It is approved for use in adults with obesity (BMI ≥30 kg/m2) or overweight (BMI ≥27 kg/m2) and at least one weight-related condition alongside a reduced calorie diet and increased physical activity. It was approved for chronic weight management in adults in December 2014 and in patients aged 12 and older in December 2020 by the FDA. In addition, topiramate has weight loss effects caused by an incompletely understood mechanism; however, dose-dependent adverse neuropsychiatric events such as depression limit its use as a single agent for weight loss (Allison et al., 2012). It was approved in 1959 for short-term obesity treatment at a dose of 15.0 to 37.5 mg/day (Gadde et al., 2011). One clinical trial reported 1.3% weight loss in the placebo group and 6.1% weight loss after NAL/BUP administration at a dose of 32 mg for 56 weeks. Most were originally developed to treat type 2 diabetes, but in June 2021, Wegovy became the first drug to be approved for weight management since 2014. Novo Nordisk, the company behind two of the popular medications, has seen profits soar, and pharmacies have struggled to keep the drugs in stock. He said the "clearest path forward" for U.S.-based obesity biotechs is likely inking partnerships with larger firms to develop and commercialize their drugs. Some analysts argue that their experimental drugs, most of which are still in mid-stage development, have not differentiated themselves enough from existing treatments. But patients experienced a high rate of side effects and discontinuations in the trial. The South Beach Diet is a fast, high protein, low carb, and low sugar diet that ensures your body gets enough “good” fats to keep your heart healthy while still burning body fat. The diet program is focused on eating simple, healthy, delicious meals in moderation. BodyNutrition.org’s 2022 overall weight loss program winner by a long shot. The complexity of conditions in patients with more comorbidities may lead to less body weight loss in participants with metabolic syndrome than in those without such comorbidities (Zhou et al., 2012).In this study, pramlintide-treated patients experienced a 3-fold increase in successfully achieving a total body weight loss of ≥ 5%, when compared to those who received placebo.The South Beach Diet makes it as easy as possible to lose weight.With about 70 new obesity treatments in development, six are now awaiting regulatory review.Obesity medicine specialists at University of Utah Health understand the complex causes of weight gain.The most common side effects in phase 3 RCTs of semaglutide 2.4mg were nausea, diarrhea, vomiting and constipation.They are not regulated by the FDA and do not have proper studies to confirm their safety and effectiveness.In the U.S., phentermine is available as a 15 mg or 30 mg capsule, or an 18.75 mg or 37.5 mg tablet. Naltrexone (NAL) is an opioid receptor antagonist approved as a treatment for opioid dependency and alcohol dependence. Bupropion (BUP) is a dopamine and norepinephrine reuptake inhibitor known for its role in the management of depression and smoking cessation. Common adverse events are gastrointestinal symptoms such as stool incontinence, oily stool, and fatty stool, with frequency rates ranging from 15% to 30% in most studies (Padwal et al., 2004). In addition, the incidence of T2DM was 45% lower in the orlistat group than in the placebo group over 4 years (Torgerson et al., 2004). They are also at higher risk of developing weight-related conditions such as arthritis, low back pain, and obstructive sleep apnea than normal-weight individuals. The Chang Gung Research Database (CGRD) was used as the data source of this study. The botanical and mineral drugs contained in Ma-Xing-Gan-Shi-Tang (every 3 g of the water extract are derived from 20 g of the raw materials). The ratio of each botanical and mineral drugs is according to the authority of TCM in Taiwan and is presented in Table 1 (Ministry of Health and Welfare). MXGST used in our clinical practice is the dry powder derived from the water extract of a mixture of four botanical and mineral drugs, which contains Ephedra sinica Stapf, Prunus armeniaca L. Some analysts say orforglipron will also be easier to manufacture at scale than Novo Nordisk's, which is crucial as demand for obesity and diabetes injections outpaces supply. Both drugs work by mimicking the GLP-1 gut hormone to suppress appetite and regulate blood sugar. But others raise questions about how much of a role pills will play in the space given that some appear to be less effective than injections and bring greater side effects. Novo Nordisk is also testing semaglutide in Alzheimer's, with initial late-stage trial results expected this year. Your effort to overcome obesity is more likely to be successful if you follow strategies at home along with your formal treatment plan. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. Always consult your healthcare professional before you begin a weight-loss medicine. Some of these medicines are approved specifically for weight loss. Before selecting a medicine for you, your healthcare professional considers your health history as well as possible side effects. The program focuses on eating delicious healthy foods and increasing physical activity. The Mayo Clinic Diet is the official weight-loss program developed by Mayo Clinic experts. The Mayo Clinic Diet is based on the latest behavior-change science, which will help you find your inner motivation to lose weight, set achievable goals and learn to handle setbacks. You will learn how to put the South Beach Diet principles into practice in your everyday life, and continue your weight loss journey on your own.Thecombination of sodium restriction and DASH diet is more effective than eithersodium restriction alone with regard to blood pressure lowering .Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.The study also showed that weight loss provides other health benefits, such as better physical mobility and improved blood glucose, blood pressure, and cholesterol levels.Phase 2 studies using ecnoglutide for T2DM showed a 2.26 kg body weight reduction after ecnoglutide 1.2 mg administration (Zhu et al., 2024).In November 2023, tirzepatide became the first GLP-1/GIP dual RA approved by the FDA for chronic weight management.Regarding body weight, 11 loops were found in the network of studies without restrictions of intervention duration (Appendix E).Despite its promising efficacy in weight management, the precise mechanisms by which acupotomy affects simple obesity have not been be fully elucidated.While it’s true that GLP-1 medications, like Ozempic and Wegovy, can make you lose weight, it’s not wise to run to your nearest pharmacy. Tirzepatide is a dual GIP and GLP-1 receptor agonist that suppresses appetite, improves satiety, and supports metabolic health. With more options available, doctors will be increasingly able to personalize treatments. Amgen is developing MariTide, a monoclonal antibody designed to increase GLP-1 receptor activity while reducing GIP receptor activity. It could provide a welcome alternative for people who do not want injections. In May 2025, they reported 39 new GLP-1 medications in development. Bupropion is contraindicated in patients with seizures, current or prior diagnosis of bulimia or anorexia nervosa, and concurrent use with MAOs (115). The impact of Gelesis100 on the absorption of other medications was investigated only with metformin. The manufacturer recommends caution in patients with active gastrointestinal reflux diseases. It should be avoided in patients with esophageal anatomic anomalies, suspected strictures, or post-operative complications that affect gastrointestinal transit and motility. Gelesis100 is contraindicated in pregnancy or individuals with allergies to cellulose, citric acid, sodium stearyl fumarate, gelatin, or titanium oxide (45). In addition, tirzepatide resulted in significantly lower blood pressure and blood sugar levels and improved lipid profiles compared to placebo (Qin et al., 2024).A phase three study from Eli Lilly, which is studying orforglipron's ability to maintain weight loss, will bring more clarity on that issue.One of the most striking discoveries is the effect these drugs have on the brain.For pairwise meta‐analysis, the exclusion of studies that did not direct measures of mean body weight or BMI differences did not significantly alter the pooled effect estimates for comparison between TCM treatments with Western medicine or non‐pharmcological interventions (Appendix F1, 2, 3 & 4).Several companies are trying to drive innovation with new drugs that promote weight loss differently, are taken less frequently or preserve muscle mass, among other changes.If that study shows that GLP-1s reduce the risk of cognitive decline, "it would give a big boost" to Novo Nordisk and Eli Lilly because it could encourage patients to stay on them longer, said Leerink Partners analyst David Risinger. Weight-loss medications work in various ways to help you lose weight and maintain weight loss long term. Healthcare providers should consult with patients before choosing the optimal diet strategy because successful weight loss and its maintenance depend on the patient’s choices, preferences, and long-term adherence to the diet plan. Dietary guidelines recommend vegetarian-patterned diets.78 A systemic review suggested that vegetarian diets reduce mean body weight, but the studies are few and of variable quality.79 Since fish and seafood are excluded, this diet is low in omega-3 fats. Frequently Asked Questions About Weight Loss Medications # NAL monotherapy also has minimal weight loss effects; however, when combined with other weight-loss drugs, it prevents the classic weight loss plateau observed with monotherapies (such as BUP) by blocking β-endorphin-mediated proopiomelanocortin autoinhibition (Greenway et al., 2009). Currently available long-term anti-obesity medications for adults include orlistat, naltrexone/bupropion (NAL/BUP) extended release (ER), liraglutide, phentermine/topiramate ER, semaglutide, and tirzepatide (Table 1). Therefore, guidelines recommend that obese individuals lose 5% to 10% of their initial body weight within 6 months of starting a weight-loss intervention (Kim et al., 2023). “Long-term study results are not available regarding this technology and the effect on weight loss.” Are there ways to enhance the results of these medications through natural or integrative methods? Thirteen subjects (0.4%) in the liraglutide 3.0 group compared to one (0.1%) with placebo developed pancreatitis, but nearly half of these had evidence for gallstones as well (79). In a secondary analysis of these trials, treatment with liraglutide 3.0 resulted in dose-independent, reversible increases in amylase/lipase activity (7% for amylase and 31% for lipase) (79). After a median of 3.8 years, individuals on liraglutide 1.8 mg demonstrated a 13% risk reduction in 3-point MACE compared to placebo. Adults with T2D and baseline average BMI 32.5 kg/m2 were randomized to liraglutide 1.8 mg vs. placebo. Setmelanotide is a melanocortin-4 receptor agonist indicated for chronic weight management in adult and pediatric patients six years and older, with obesity due to certain rare genetic disorders. Like semaglutide, it works by reducing appetite and is meant to be used in combination with diet and exercise to lose weight. Determining whether someone is a candidate for weight loss medications begins with BMI. With a growing selection of weight loss medications available, patients may ask what the strongest or most effective weight loss prescription medication is, and which one is best for them. Currently, these medications are administered by injection, but oral weight loss drugs in the same category may soon follow. Criteria for Weight Loss Medication Prescriptions # However, the clinical effectiveness of CHM on weight control has not been well studied, while potential risks and adverse effects are still unknown.Topiramate (trade name Topamax) is an antiepileptic agent that has been found to reduce body weight in patients with a variety of disorders including epilepsy, bipolar disorder, and binge eating disorder (153).The amount and type of activity will depend on your personal health and ability.Adults with migraines and obesity are good candidates for this weight-loss medication.They are also at higher risk of developing weight-related conditions such as arthritis, low back pain, and obstructive sleep apnea than normal-weight individuals.GoodRx can help you navigate your options, which may include GoodRx discounts, manufacturer copay savings cards, and patient assistance programs.BodyNutrition.org’s 2022 overall weight loss program winner by a long shot.The following medications can potentially cause variable weight gain in some individuals. The SELECT trial builds upon an established body of evidence (e.g., SUSTAIN-6) demonstrating the CV safety and benefits of semaglutide and is groundbreaking as the first CVOT to demonstrate secondary cardiovascular prevention with an anti-obesity medication in a population without T2D. The phase 3 RCT, STEP 8, randomized adults with obesity without T2D to liraglutide 3.0 mg/d or semaglutide 2.4 mg/wk or respective placebos (94). At 68 weeks, mean weight change was -13.2% with semaglutide 2.4 mg, -9.6% with semaglutide 1.7 mg, and -2.1% with placebo (91). “RDNs’ nutrition plans involve a comprehensive assessment of a person’s health, including medical history, anthropometrics, blood and lab test results, physical signs and symptoms, diet history, and food and health care accessibility, to meet individuals where they are at.” Programs should include guidance from licensed, registered dietitians — not just generic nutritionists, says Dr. Christopher McGowan, gastroenterologist and obesity medicine specialist in North Carolina. Research shows that the most effective programs come with counselors who can help you build new diet and exercise habits. A reasonable weight loss goal is typically 1-2 pounds per week, according to the National Institutes of Health. “Effective programs provide nutrition skills, and help you set weight, activity and energy intake, and make it reasonably easy to track your behavior against your goals, including tracking everything you eat,” Forman says. Compounded medications are not FDA-approved.Gelesis100 was not significantly more effective in individuals with prediabetes or drug-naïve T2D with respect to mean percent change in body weight, which had been a notable observation in the pilot study First Loss of Weight (FLOW) (112).More seriously, being overweight and obese increases the risk of death from all causes, cardiovascular disease, cancer, or other diseases for both men and women in all age groups (Calle et al., 1999).The most common side effects were nausea, diarrhea, constipation and vomiting.For body weight outcomes, a high heterogeneity (83%) was present in the comparison of CHM plus LI versus WM plus same LI. SURMOUNT-1 enrolled 2539 participants with BMI ≥ 30 or ≥ 27 with at least one weight-related comorbidity who were randomized to 5, 10, or 15 mg of tirzepatide or placebo for 72 weeks (108). Across all RCTs, participants experienced an average increase in heart rate of 1-4 beats per minute (bpm); 26% of individuals on semaglutide vs. 16% of those on placebo had increased heart rates by 20 bpm or more (84). However, most of these were mild-moderate in severity; serious adverse events occurred in 9.8% of those receiving semaglutide vs. 6.4% of those on placebo. The most common side effects in phase 3 RCTs of semaglutide 2.4mg were nausea, diarrhea, vomiting and constipation. Some people find them helpful, along with healthy eating and exercise. Still, we know it's important to lose those extra pounds, both for our physical and mental health. Healthy eating and exercise are the most recommended ways to lose weight. University of Utah Health experts help patients fix underlying issues contributing to obesity. Losing even a small amount of weight can have huge positive impact on your overall health. Participants on tirzepatide experienced significantly greater improvements in SBP, DBP, fasting insulin, fasting glucose, A1c, LDL cholesterol, HDL cholesterol, and triglycerides compared to placebo. From week 36 to week 88, participants lost an addition 5.5% with tirzepatide and gained 14.0% with placebo. A post hoc analysis showed that the proportion of participants who increased anti-diabetic therapy intensity decreased in the tirzepatide arms and increased in the placebo arm. Your GP can advise you about losing weight safely by eating a healthy, balanced diet and doing regular physical activity. Prescription medications to treat overweight & obesity. Weight loss medications in the treatment of obesity and hypertension. Consider whether the cost, side effects, and the small weight loss you can expect are worth it to you. About 6 pounds (3 kilograms) or up to 6% of body weight can be lost when using this medicine. If only one pathway is targeted, as in monotherapy, this can lead to the occurrence of compensatory mechanisms, which reduces drug efficacy; the use of phentermine/topiramate as a combined therapy can overcome these compensatory mechanisms.Our retrospective study assessed the weight-loss efficacy of MXGST in the CHM group and liraglutide in the WM group as well as anti-obesity therapy-related adverse effects in this cohort according to the 6 months of treatment of compliance with these prescriptions.Setmelanotide is a melanocortin-4 receptor agonist indicated for chronic weight management in adult and pediatric patients six years and older, with obesity due to certain rare genetic disorders.In an August note, Goldman Sachs analysts forecast daily oral pills will capture 24% share — or around $22 billion — of the 2030 global weight loss drug market, which they expect to be worth $95 billion.People can also get one-on-one dietitian support from board-certified registered dietitians.The most significant change in lipid profile was in the triglycerides that were reduced by 13.0 mg/dl in the liraglutide 3.0 mg group vs. 5.5 mg/dl in the placebo group.Generic weight loss advice (eat less, exercise more) isn’t very helpful to begin with, but that’s doubly true for people with health conditions like high blood pressure or metabolic syndrome.Her research shows people who participate in the TOPS program for at least one year can lose up to 5-7% of their initial weight and maintain the weight loss for up to seven years.Yes, weight loss drugs can interact with other medications, supplements and herbal products. They are not recommended for children, women who are pregnant or breastfeeding and those with certain health conditions like liver or kidney problems. Talk to your doctor about how to safely taper off the medication and strategies to prevent weight gain. Obesity is a chronic disease like hypertension and when the medications are stopped, the condition returns. Some also report side effects like irritability, anxiety and/or sleep problems. Except for energy deficit, there seems to be no significant difference between macronutrient composition-based diets. Most side effects are mild and most often improve if you continue to take the medication. For example, some medications may help you feel less hungry or full sooner. Obesity is a chronic disease that affects more than 4 in 10 adults in the United States, and nearly 1 in 10 Americans have severe obesity.1 People who have a BMI between 25 and 30 are considered to be overweight. He promotes wellness through lifestyle changes, emphasizing exercise, healthy eating, and supportive relationships in addition to traditional metric goals. Among those who took the medication for the entire 15-month study period, the average weight loss was closer to 17%. In one large study, adults taking oral Wegovy lost about 14% of their starting body weight on average. Weight-loss pills are a convenient needle-free option for people who need help losing unwanted body weight. You’ve likely heard all about the importance of a nutritious diet and routine exercise when it comes to achieving your target body weight. For BodyNutrition’s #1 weight loss program recommendation, click here. How Many Meals Should I Be Eating Each Day to Lose Weight? Side effects due to Gelesis100 are commonly gastrointestinal, including abdominal distension, infrequent bowel movements, or dyspepsia. Overall, there were no significant differences between Gelesis100 or placebo in cardiovascular risk factors of LDL-C, HDL-C, triglycerides, systolic BP, diastolic BP, or HOMA-IR. The efficacy of Gelesis100 was evaluated in the Gelesis Loss of Weight (GLOW) randomized double-blind placebo-control trial (112). Because it achieves its primary intended purpose through a mechanical mode of action, it is considered a device rather than a drug and has no systemic effects. However, for comparisons between TCM and Western medicine, the choice of effect model did influence the results, with fixed effect model appearing to have superior effects on reducing body weight and BMI. Regarding body weight, 11 loops were found in the network of studies without restrictions of intervention duration (Appendix E). Acupotomy (98.1%) was found to have the highest effectiveness in reducing body weight, followed by combined TCM treatments (79.6%), catgut embedding (66.4%), electroacupuncture (65.6%), warming needle acupuncture (61.7%), acupuncture (54.5%), TCM treatments combined with non‐pharmacological interventions (48.5%), CHM (36.7%), and auricular acupuncture (32.2%). With regard to body weight and BMI, 31 studies (67%) reported on both body weight and BMI in the results, 5 (11%) on body weight changes only, and 10 (22%) on BMI reduction only. Six studies (13%) compared TCM therapies with Western medicine (e.g., Sibutramine, Metformin, etc.), 15 (33%) compared with non‐pharmacological interventions (e.g., diet, exercise), 5 (11%) compared between single TCM therapies, 11 (24%) compared between combined TCM therapies and single TCM treatments, and 11 (24%) compared TCM therapies with placebo/no treatment. (Many more take them for other indications.) According to the Kaiser Family Foundation, public awareness has ramped up, with 32% of adults now saying they have heard “a lot” about these drugs. Next came a dual receptor agonist, Mounjaro, which is indicated for type 2 diabetes, and Zepbound, which is indicated for obesity. Qsymia (phentermine / topiramate ER), Contrave (naltrexone / bupropion) and phentermine (Adipex-P) are also common choices. Weight-loss apps can be another tool in your arsenal to help you log meals, track exercise, or receive support from weight-loss coaches. GoodRx can help you navigate your options, which may include GoodRx discounts, manufacturer copay savings cards, and patient assistance programs. Doctors Encourage a De-emphasis on the Use of BMI to Assess Weight and Health A phase 2 trial demonstrated body weight changes from baseline to week 24 of −6.7% with mazdutide 3 mg, −10.4% with mazdutide 4.5 mg, −11.3% with mazdutide 6 mg, and 1.0% with placebo. At week 12, participants receiving mazdutide at 6 and 9 mg had body weight losses of 6.1% and 11.7%, respectively (Ji et al., 2021, 2022). Furthermore, body weight reduction with CagriSema administration was 15.6%, compared with 5.1% and 8.1% with semaglutide and cagrilintide alone, respectively (Frias et al., 2023). Therefore, chronic administration of amylin reduces total energy intake, which results in body weight loss. The complexity of conditions in patients with more comorbidities may lead to less body weight loss in participants with metabolic syndrome than in those without such comorbidities (Zhou et al., 2012). What is meaningful about our study is that patients don’t have to reach the level of BMI 2 in all instances, and they can be healthier at any weight as long as they have a moderate weight loss. The majority of subjects had lost more than 5%–10% of body weight in the CHM group and the maximum weight loss didn’t exceed 20% of body weight after 180 days of treatment. If you’re eligible, your first appointment is a virtual group visit with our registered dietitian (RD). We’ll review these forms to see if you’re eligible for our program. More insulin in your body means you will have lower blood sugar. They also lower blood sugar in people with diabetes. Most of the injectable medications are GLP1 and GIP receptor agonists, which mimic hormones that manage hunger, insulin, and digestion. If you answered yes to these questions, a prescription weight-loss drug may be a choice for you. Study the pros and cons of medicines to treat obesity. A. Pawlowski is a TODAY health reporter focusing on health news and features. Metsera, a company that was recently bought by Pfizer, is also investigating monthly GLP-1 and amylin analog drugs. "A lot of people are going to like that," Levy says. This means your body is actually working against you to lose weight. Some insurance plans cover weight loss medications, while others don’t. These drugs can also make you feel less hungry and cause weight loss. We conclude that Shi-gao may be a useful herbal medicine for changing the distribution of body fluid and increasing urine excretion with the highest potential to eliminate edema. Shi-gao, which is mainly composed of CaSO4, has been used as a treatment for reducing fevers and alleviating thirst in various TCM (Yuan et al., 2002; Ikarashi et al., 2013). It seems that supplementation with Gan-cao may efficiently improve the lipid profile in overweight and obese subjects. The Mayo Clinic Diet makes healthy eating easy by teaching you how to estimate portion sizes and plan meals. The triangular shape shows you where to focus when selecting healthy foods. It emphasizes that the best way to keep weight off for good is to change your lifestyle and adopt new habits that you enjoy and can stick with. This improves overall health and lowers the risk of developing complications related to obesity. Our caring team of Mayo Clinic experts can help you with your obesity-related health concerns. To diagnose obesity, your healthcare professional may perform a physical exam and recommend some tests. “Whether it's medication or surgery, we just want our patients to have the best options so they can improve their overall health." You must have a BMI of 27 or higher to schedule an appointment with one of our medical weight loss specialists. You may lose about 25% of your muscle mass as you lose weight. You will likely start losing weight within the first few weeks of treatment. These medications work best when you also eat healthy foods and get regular physical activity. The maximum dose of phentermine/topiramate ER is 15 mg of phentermine and 92 mg of topiramate; these doses are lower than those marketed or studied as monotherapies in obesity (Allison et al., 2012). Although many anti-obesity medications have been developed, several have been withdrawn because of adverse events (Wen et al., 2022). Specifically, weight loss of 5% to 10%, along with improvements in lifestyle, has clinically significant benefits in achieving these goals. This article summarizes existing and emerging anti-obesity medications, with a particular focus on those evaluated in clinical trials. The improvement in HFpEF symptoms may be mediated by weight-independent mechanisms and measurable via reductions in N-terminal pro–B-type natriuretic peptide (NT-proBNP)(101). Semaglutide 2.4 mg was demonstrated in the STEP HFpEF trial to significantly improve the Kansas City Cardiomyopathy Questionnaire clinical summary score by 16.6 points vs 8.7 points with placebo in adults with HFpEF and obesity (BMI ≥ 30) (100). This endpoint was observed in 1.8% of participants on semaglutide 2.4 mg vs 2.2% of participants on placebo, resulting in a relative risk reduction of 22%. Besides, obesity is one of important risk factors of knee osteoarthritis (Raud et al., 2020). The diagnosis codes used in the study is presented in Supplementary Table S4 in the Supplementary Appendix SA1. No adverse effects with respect to hypertensive encephalopathy were observed in both groups by the end of the trial (Table 6). There were also no reported cases of cerebrovascular disease or brain disease occurring in both group treatments. Nedelcovych said the convenience of a once-daily pill may not be enough to convince patients to switch, since some of them "really don't mind" taking an injection once a week. They expect Novo Nordisk's oral semaglutide to have a 21% share — or around $4 billion — of that segment. The Goldman analysts said they expect Eli Lilly's pill to have a 60% share — or roughly $13.6 billion — of the market for daily oral treatments in 2030. Before having weight loss surgery, tell your healthcare team (including the anaesthetist) if you're taking liraglutide, semaglutide or terzepatide. Tirzepatide for weight management is suitable for adults living with obesity and another weight-related health problem. You may be prescribed tirzepatide by a healthcare professional at a specialist weight management service if they feel it is the right treatment for you. A specialist weight management service can prescribe semaglutide for obesity for a maximum of 2 years. Losing weight also can improve some other health problems related to overweight and obesity, such as joint pain and sleep apnea. Weight management medications don’t replace physical activity and healthy eating habits. Medications don’t replace physical activity or healthy eating habits as a way to lose weight. Your health care professional may prescribe a medication to treat your overweight or obesity if you are an adult with Short- and long-term effects of antiobesity drugs on blood pressure You may need to exercise for longer each day to prevent obesity or to avoid regaining weight if you've been obese. Your GP, weight loss adviser or staff at your local sports centre can help you create a plan suited to your own personal needs and circumstances, with achievable and motivating goals. As well as helping you maintain a healthy weight, physical activity also has wider health benefits. One study published in the Journal of the American Medical Association found that it outperformed the Atkins Diet and Weight Watchers over the course of a year, but other research on its efficacy is lacking (2). The Atkins Diet was one of the original low-carb diets to gain popularity. It’s a pretty restrictive diet, which has benefits and drawbacks. This makes it easy to follow, but if you have health issues like metabolic syndrome, you might need a different plan that cuts back on sugars and refined carbs. The third phase is all about transitioning from diet to life. Diethylpropion (trade name Tenuate), another sympathomimetic and derivative of bupropion, is also an approved short-term drug for treating obesity. The voluntary recall of lorcaserin in 2020 occurred among significant confusion, as long-term data from the CAMELLIA-TIMI 61 trial did not demonstrate an imbalance in adverse events between treatment groups (39,40). Approval of the first AOM, desoxyephedrine, in 1947 led to the development of a number of amphetamine derivatives for weight loss that have all since been removed from the market due to this amendment (34). Talking to your healthcare professional openly and honestly about your weight concerns is one of the best things you can do for your health. Many dietary supplements that promise to help you shed weight quickly are available. Current GLP-1 agonists approved for weight loss include Wegovy, Zepbound and Saxenda. Contrave is a weight loss medication that is taken by mouth along with a low-fat meal. Zepbound is another weight loss medication approved by the FDA in 2023. These drugs are recommended for people who are obese. This is true for many medications that control other health conditions. In the 4-year XENDOS study conducted in Sweden, the cumulative incidence of T2D was 9.0% in the placebo plus diet and lifestyle group and 6.2% in the subjects receiving orlistat (24), corresponding to a risk reduction in development of T2D of 37.3%. In a 2-year trial, Davidson et al. reported less weight regain rates and lower levels of serum glucose and insulin in patients maintained on a 120 mg three times per day dose of orlistat, as compared to those on placebo (54). Subjects in the orlistat group lost significantly more weight in the first year (10.2 vs. 6.1%) and regained half as much weight during the second year of treatment, as compared to the placebo group (53). It’s less common than other weight-loss pills, though. Orlistat (Xenical) is another prescription weight-loss pill. They’re also controlled substances meant for short-term use. Rossner et al. found that subjects receiving orlistat lost significantly more weight in the first year of treatment, and fewer regained weight during the second year of treatment, than those taking placebo (52).One study suggests that men are more likely to work out (vs. diet), and since dieting is more effecting than exercise alone, this might explain why (18).The South Beach Diet is a fast, high protein, low carb, and low sugar diet that ensures your body gets enough “good” fats to keep your heart healthy while still burning body fat.Sometimes, health care professionals may not address issues such as the benefits of choosing healthy food and drinks, physical activity, and weight during a general office visit.In Phase 2, orforglipron showed weight loss up to 14.7%at 36 weeks.However, energy intake and energy expenditure are dynamic processes influenced by body weight and influence each other.11 Thus, interventions aimed at creating an energy deficit through the diet are countered by physiological adaptations that resist weight loss.A review regarding the Paleo diet and its impact on cardiovascular risk factors suggested that it has favorable effects on lipid profile, blood pressure, and circulating C-reactive protein concentrations, but the evidence is not yet conclusive.66 The Paleo diet emphasizes vegetables and unprocessed foods, but it is also high in saturated fats, which might increase the risk of cardiovascular disease.Several drugmakers, including Novo Nordisk and Eli Lilly, are betting on amylin analogs as part of the next wave of obesity treatments People who want to sustain their weight loss long-term. Fortunately, the WW app is super intuitive and easy to use, making it a great choice if you want to use an app to guide your weight loss program. Men often struggle with weight loss diets because preparing all your own food takes a lot of work (not to mention cooking skill). The Zone Diet takes a low-carb approach to weight loss and combines this approach with a frequent-eating strategy to keep the body feeling full and prevent food cravings. One drawback, according to a meta-analysis of weight loss programs, is an increased rate of constipation among Atkins Diet adherents (not surprising given its low fiber content) (1).