There were also benefits of studying maintenance after a VLCD or LCD, as opposed to diets with a higher caloric intake. Meta-analysis as a method also allows for greater statistical power than individual trials, which is a common limitation in obesity lifestyle-intervention studies. We also synthesized data from different dietary strategies, which provides clarity in terms of which diets promote weight-loss maintenance. Table 1 lists several diabetes medications and their tendency to increase, decrease, or have no effect on body weight. As diabetes progresses, there is often a vicious circle of increasing β-cell dysfunction and insulin resistance requiring more intensive diabetes medication treatment, which then contributes to further weight gain and worsening of diabetes. This is particularly notable in obesity pharmacotherapy trials, in which weight losses are commonly 25% lower in patients with obesity and diabetes than in patients with obesity but without diabetes. In general, weight loss in patients with diabetes is challenging, and patients with diabetes consistently lose less weight with a given treatment than those who do not have diabetes. Moderate weight loss yields substantial benefits in patients with obesity and type 2 diabetes. Diabetes medications used for weight loss can lower blood sugar even in non-diabetics, but the effects are generally not extreme. Since weight loss itself improves insulin sensitivity, taking these medications while losing weight may have an even stronger effect on blood sugar control. In people with type 2 diabetes, these medications help lower blood sugar because their bodies either don’t produce enough insulin or don’t use it effectively. Understanding these effects is important for safety, especially for people considering these drugs for weight loss. Yes – in most cases, weight loss due to diabetes medication is safe and even beneficial. Some diabetes medications may also cause water retention or low blood sugar (hypoglycaemia). This helps the body remove excess glucose through urine, lowering blood sugar levels without relying on insulin. We can determine the best weight loss treatment for you based on your health history and goals – complete a simple assessment today to get started! Body Weight Considerations in the Management of Type 2 Diabetes Kosiborod MN, Abildstrøm SZ, Borlaug BA; STEP-HFpEF Trial committees and investigators (2023) Semaglutide in patients with heart failure with preserved ejection fraction and obesity. Henriksen K, Chakravarthy MV, Bager CL et al (2025) The Goldilocks for chronic weight management – Balancing quantity with quality of weight loss. Bliddal H, Bays H, Czernichow S et al; STEP 9 Study Group (2024) Once-weekly semaglutide in persons with obesity and knee osteoarthritis. These may allow personalised approaches to weight loss in future. Tirzepatide, a dual GLP-1 and GIP receptor agonist, is highly effective for weight loss and glycaemic control. Hyperthyroidism is more common in women and people older than 60.2 You are more likely to have hyperthyroidism if you With too much thyroid hormone, many of your body’s functions speed up. Thyroid hormones control the way the body uses energy, so they affect nearly every organ in your body, even the way your heart beats. Hyperthyroidism, also called overactive thyroid, is when the thyroid gland makes more thyroid hormones than your body needs. Ask your doctor about how to restart your treatment. People taking insulin for Type 2 diabetes gain an average of 4 lbs during the first year they’re using it. They all work by affecting insulin in the body. For people with diabetes who are also considered obese, they may lose up to 7 lbs with Symlin. Less glucose in the blood means less glucose is available to be turned into fat cells. However, the FDA warns against buying medications from any source other than a state-licensed pharmacy. Older AOMs also have indications based on BMI and may be contraindicated for use with certain other medications. Bupropion (Wellbutrin), an aminoketone, is considered weight-negative and is prescribed both to assist in weight loss and to treat depression. Desipramine, nortriptyline, and protriptyline have variable effects on weight. Weight-positive medications in the tricyclic antidepressant category include amitriptyline, doxepin, and imipramine. The Best Anti-Inflammatory Foods for People with Diabetes Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity. Always talk with your health care provider before you participate in a clinical study. NIDDK conducts and supports clinical trials in many diseases and conditions, including overweight and obesity. For lower BMI classes, discontinuation rates are higher in the semaglutide group but not the placebo group. Proportions of patients in the BMI categories at baseline and week 104 are shown in Fig. At baseline, mean WHtR was 0.66 for the study population. At week 104, 41.2% fell below the sex- and race-specific cutoff points for the semaglutide group, compared with only 18.0% for the placebo group (Fig. 3). Within the SELECT population with BMI −2 at baseline, 15.0% and 14.3% of the semaglutide and placebo groups, respectively, were below the sex- and race-specific WC cutoff points. They’ll help with a diabetes-friendly diet that can help you maintain or lose weight even while on insulin. Insulin-related weight gain, then, is a sign that the insulin is doing what it’s supposed to — helping your body utilize and store nutrients better. When other treatments aren’t effective (or when there’s some reason why you can’t use them), synthetic insulin can help directly lower your blood sugar levels. Dr. Hamaty explains the connection between diabetes, insulin and possible weight gain so you can better understand your condition and how to manage it. But one of the possible side effects of insulin is weight gain. Anthropometric measures are unreliable in identifying this type of obesity and make elucidating eutrophic versus obese states challenging. Stool samples were transferred to mice which exhibited improved metabolic parameters after metformin-treated stool transplant, as well as increase expression of bacterial genes related to SCFA metabolism . Has been shown to reduce hepatic glucose production in a rat model of T2D by restoring normal intestinal glucose sensing and sodium glucose cotransporter-1 (SGLT1) expression . Within each obesity class (−2, 30 to −2, 35 to −2, and ≥40 kg m−2), there were fewer SAEs in the group receiving semaglutide compared with placebo. The trajectory of WC change mirrored that of the change in body weight. Each patient’s percentage change in body weight is plotted as a single bar.Full size imageWC change from baseline to 104 weeks has been reported previously in the primary outcome paper21. Individual weight changes at 104 weeks for the in-trial populations for semaglutide and placebo are depicted in Fig. The average percentage weight-loss trajectories with semaglutide and placebo over 4 years of observation are shown in Fig. Is there still a place for orlistat in obesity management? Although quality of life is improved for many people, some suffer depression, substance misuse and other issues. However, loss of muscle and bone and increased risk of fractures have been demonstrated. Significant levels of physical activity and the corresponding preservation of muscle mass may at least partially prevent weight regain. “It means your body is utilizing sugar, fat and protein more effectively and that it’s able to store nutrients.”However, because topiramate is a known teratogen (that can cause cleft lip/palate), pregnancy should be ruled out before starting the medication, and women of childbearing age should be advised to use contraception and to have monthly pregnancy testing during use.Higher prices of drugs for weight loss and higher rates of obesity in the U.S. could mean a more significant impact of these drugs on overall health spending in the U.S. than in peer countries.Some diabetes medications may also cause water retention or low blood sugar (hypoglycaemia).In a trial of naltrexone-bupropion SR in patients with obesity and type 2 diabetes, those who were treated with the medication for 1 year lost 5.9% of initial body weight and had an A1C reduction of 0.6% compared to a 2.2% weight loss and 0.1% A1C reduction in the placebo group (20).Ultimately, the best diet for weight loss for any individual is one they’ll stick with. Any of the contraindications for GLP-1 receptor agonists when prescribing to treat diabetes will apply when prescribing to treat obesity. The STEP trials also looked at what happens when people continue with or discontinue semaglutide after 1 year. However, they did lose an average of almost 10% of their initial weight after one year on the medication, which was about 6% more than those who received a placebo. Scientists believe this occurs because the medications reduce appetite and they slow down gastric emptying, which can increase a sense of fullness and decrease hunger. Stay positive on your weight loss and diabetes journey Other drugs include Vicoza, Trulicity and Bydureon, and these may be options if people with diabetes are having a hard time filing their medication prescriptions, as Everyday Health reports (Everyday Health is owned by the same parent company as CNET, Ziff Davis.). Though comparing insulin to semaglutide is a bit of a "loaded question," he added, because while semaglutide may carry a lower risk of hypoglycemia, or low blood sugar, some patients really do need insulin. Ozempic was approved first for the treatment of type 2 diabetes, but in some cases it's also being used off-label as a weight loss drug. Ozempic and Wegovy are similar drugs that contain the same active ingredient, semaglutide, though Wegovy contains a higher amount of it and is FDA-approved specifically for weight loss. Like drugs for other health conditions, Ozempic and Wegovy are intended to be chronic medications -- ones that only work while you're taking them. Having a BMI above the normal range is the leading cause of type 2 diabetes, hypertension, cardiovascular disease, stroke, arthritis and cancer. Obesity is a chronic health problem that is often progressive and difficult to treat. The key to treating hypos with least calorie intake is to use the fastest and purest form of glucose – glucose tablets or a glucose drink One of the common symptoms of low blood sugar is a strong sense of hunger and it can be challenging not to overeat as a result of such hunger. The discovery could result in the next generation of drug therapies that bring more efficacious and tolerable treatments for the almost 400 million people globally who live with both type 2 diabetes and obesity. Millions of people around the world benefit from weight loss drugs based on the incretin hormone GLP-1. By activating GLP-1 peptides, these medications affect body weight in many ways, including inhibiting glucagon and stimulating insulin release, and resulting in an average loss of 5% to 15% of body weight sustainable for at least 12 months.1–3 Multiple glucagon-like peptide-1 (GLP-1) agonist medications, created for the treatment of type 2 diabetes mellitus, are now labeled for the treatment of obesity. In patients with diabetes randomized to either semaglutide or insulin, weight decreased 5.2 kg with semaglutide compared to weight gain with insulin. There are four Food and Drug Administration (FDA)-approved medications on the market for weight loss, namely phentermine-topiramate (Qsymia), orlistat (Xenical), naltrexone-bupropion (Contrave), and the glucagon-like peptide-1 receptor agonist (GLP-1 RA) liraglutide (Saxenda).1 3 Lorcaserin (Belviq) was previously given FDA approval but was recalled at the beginning of 2020 due to an increased risk of malignancies.6 Wegovy (semaglutide), the GLP-1 RA discussed in this article, received FDA approval in 2021.7 Glucagon-like peptide-1 (GLP-1) receptor agonists are a class of antidiabetic medications that have shown promise in encouraging glycemic control and promoting weight loss in patients with or without type 2 diabetes. GLP-1 drugs are synthetic mimics of that hormone, triggering the same pathways in ways that can help people with diabetes regulate their blood sugar, and, more recently, assist people in losing weight. Daily doses with four strengths start at 3.75 mg/23 mg to 15 mg/92 mg. Note that Suprenza contains tartrazine, an ingredient to which some people may have an allergic reaction. It is contraindicated in patients with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2. Side effects include nausea, diarrhea, constipation, vomiting, headache, decreased appetite, dyspepsia, fatigue, dizziness, abdominal pain, increased lipase, and renal insufficiency. In the previous SURPASS-2 trial, participants with type 2 diabetes were given either 5mg, 10mg, or 15mg of tirzepatide, or 1mg of semaglutide for 40 weeks. But it is important to remember that these medications should be used in addition to diet and exercise.” It could lead to even more weight loss than Ozempic or Wegovy, because it activates two gut hormones instead of just one. That’s how they make people feel fuller sooner and stay full longer, but it’s also where their side effects come in. Even a modest weight loss of 5 to 10 percent can make a big difference.” Clinical Trials for Prescription Medications to Treat Overweight and Obesity But more research is needed to know exactly how cinnamon affects people with diabetes and weight-related conditions. One of those benefits may be its effects on insulin sensitivity and blood sugar control. This is important because GLP-1 medications often cause loss of muscle mass along with body fat. One preliminary study of 42 people with metabolic syndrome showed that wild bitter gourd extract improved several health markers. Venous thromboembolism is a serious complication of morbid obesity due to lower extremity venous stasis, prothrombotic adipokines such as leptin and resistin, and chronic inflammation . Osteoarthritis is a common complication of obesity due to the high impact forces on joints . Observational studies have not consistently shown a reduction in fractures with the use of metformin . This may lead to weight loss. The FDA recently added orforglipron to the second group of medications in its new Commissioner’s National Priority Voucher (CNPV) program. In turn, this may translate to orforglipron being a more affordable weight-loss medication. Despite its excellent safety and tolerability profile, metformin remains equivocal as a primary treatment for obesity and as a weight loss agent. The current use of metformin as an agent exclusively for weight loss remains off-label but is frequently utilized in patients at high risk for metabolic complications and who do not tolerate other interventions. Subsequent smaller studies examined metformin with weight loss as the primary outcome and in patients without diabetes. Multiple mechanisms underlie the weight loss-inducing and health-promoting effects of metformin. This is because the population affected by the new indications overlaps almost completely with the population that already qualifies for treatment under the weight loss indication. Ozempic is expected to soon address peripheral artery disease in people with type 2 diabetes, and ongoing trials are exploring GLP-1’s potential in osteoarthritis, diabetic complications, Alzheimer’s, and even addiction treatment. At the same time, employers that don’t cover GLP-1s for weight-loss are exploring ways to leverage DTC options to help employees access desired medications. At week 104, 41.2% fell below the sex- and race-specific cutoff points for the semaglutide group, compared with only 18.0% for the placebo group (Fig. 3).The amount of weight loss can vary, depending on which medication and what dose is used.Though trials like Look AHEAD have analyzed the economic impact of anti-diabetic drug dose reductions consequent to weight loss , our observational study appears to be the first to identify the association between the magnitude of the weight loss and dose reductions or discontinuations of anti-diabetic medications.“The effectiveness and safety of these compounded versions of GLP-1 medications haven’t formally been tested,” he stresses.Many adults have found success with this class of drugs, enjoying both improved blood sugar levels and a lighter scale reading.Liraglutide is the only diabetes medication to be explicitly approved for weight management.It is contraindicated in patients with own or family history of thyroid carcinoma and in patients with multiple endocrine neoplastic syndrome. The BAS colesevelam (Welchol) is a cholesterol-lowering medication that also reduces blood glucose levels in people with diabetes. These drugs help the body lower blood glucose levels by blocking the breakdown of starches, such as bread, potatoes, and pasta in the intestine. All sulfonylurea drugs have similar effects on blood glucose levels, but they differ in side effects, how often they are taken, and interactions with other drugs. By increasing the amount of glucose excreted in the urine, people can see improved blood glucose, some weight loss, and small decreases in blood pressure. Obesity and DM in unison also generate immense health care costs , . Further, on average, obese individuals with DM have a higher prevalence of end-organ damage and are at higher risk for cause-specific mortality compared to obese individuals without DM , . Data from the Behavioral Risk Factor Surveillance System showed that overweight (BMI 25–29.9), obese (BMI 30–39.9), and morbidly obese (BMI≥40) US adults had 1.59, 3.44 and 7.37 times higher odds, respectively, of diagnosed DM, compared to those with normal BMI (BMI 18.5–25) . Weight loss should be approached with a long-term perspective, prioritizing health over quick fixes. There is limited research on how extended use may affect metabolism, hormonal balance, or overall health. There are no Tier 3 weight management services in Northern Ireland so Wegovy can’t be prescribed through the Northern Ireland health service. Although Wegovy is given via injection, it is a different medication to insulin. This means it can help you stay full for longer, which can lead to weight loss. Curcumin improves glucose tolerance via stimulation of glucagon-like peptide-1 secretion.It is not uncommon that patients treated with insulin can gain 7–20 pounds the first year after initiating insulin therapy .It’s best to discuss with your healthcare team what changes would be best for you.The degree of weight loss achieved with surgery is usually much greater and lasts longer than with medications.As the majority of people with type 2 diabetes are overweight or obese, weight management is an essential component of diabetes management to improve their overall health and quality of life.Finally, asymptomatic hypoglycemia is common, although symptomatic or severe hypoglycemia has been found to occur only in patients with diabetes taking concomitant medications such as sulfonylureas that increase the risk of hypoglycemia.This conversation allows for a tailored approach to treatment that prioritizes your safety and health objectives.Additionally, people who had previously used gastrointestinal medications-which may indicate they are more vulnerable to the common adverse gastrointestinal side-effects reported by GLP1-RA users, such as nausea, vomiting, diarrhoea-were 9% more likely to discontinue semaglutide within the first year.Metformin is often the first medication prescribed for Type 2 diabetes, and it’s not just effective for managing blood sugar levels; it can also aid in weight loss! More on Weight Loss & Obesity Before you exercise, make sure your glucose level is not too low (below 100 mg/dl) or you could risk low blood sugar (hypoglycemia). Diet is a key part of any weight loss plan, but for those with diabetes it’s even more important. Insulin is the hormone that regulates blood sugar (glucose) levels in the body and helps your cells convert blood sugar into energy. These options provide different ways to help you achieve your weight-loss goals. GLP-1 receptor agonists, such as semaglutide (Wegovy) and liraglutide (Saxenda), are available as injectables. Talk with your patient about their personal preferences as well as any barriers to taking the medication, such as access and cost. This class of medicines may also have a positive effect on other obesity-related conditions, such as heart disease, kidney disease, and sleep apnea. But most people who have it done end up reversing their diabetes. It works best for people who've had the disease for 5 years or less and don't use insulin. Researchers estimate that upwards of three-quarters of people see their diabetes reversed after bariatric surgery. The effect of various antidiabetes medication classes on glycemic control and weight will be reviewed here. Intensive lifestyle modification with diet and exercise to achieve weight loss of at least 5–10% has been shown to improve glycemic control with improvements in insulin sensitivity and beta cell function . Obesity, particularly intra-abdominal obesity, induces insulin resistance in muscle and liver that leads to glucose intolerance . Obesity has been increasing in prevalence worldwide and the majority of patients with type 2 diabetes are either overweight or obese. The dose must be increased gradually over 16 to 20 weeks to arrive at the 2.4 mg dosage. Wegovy is a brand name for semaglutide, a GLP-1 receptor agonist. It can be easy to overlook first-generation AOMs, but these may be appropriate for some patients, especially when cost is a factor. The little blue pill might help with physical arousal, but there are better treatments for low libido in women It has a comparable GIP receptor–binding affinity to native GIP and five times lower GLP-1 receptor affinity than that of native GLP-1.64 The SURPASS trials were designed to assess the efficacy and safety of tirzepatide as a treatment to improve glycemic control in people with T2D. In the Semaglutide Treatment Effect in People with Obesity (STEP) 2 trial, the estimated change in mean body weight from baseline to week 68 was –9.6% (standard error, 0.4). One is a low risk of hypoglycemia; if hypoglycemia occurs frequently, a drug with high efficacy cannot be used in sufficient dosages to achieve normoglycemia. Therefore, in order to ensure remission, maintaining weight loss is required, and continuous attention and the efforts of several specialists must be combined. In the Look AHEAD trial, obese patients with T2D were randomly assigned to ILI or diabetes support and education (DSE). However, in a follow-up study, weight regain was demonstrated.39 At 2 years, only 11% of participants had a weight loss of ≥15 kg, and 36% of them in the intervention group had diabetes remission. Diabetes remission at 1 year (HbA1c ≤6.5% after 2 months off all anti-diabetic medications) was achieved in 46% of the intervention group and 4% of the control group.36 In particular, 36 patients losing ≥15 kg maintained diabetes remission up to 86%. According to a meta-analysis study that reviewed 16 randomized controlled trials, RYGB led to a lower fasting blood glucose and HbA1c than SG.29 Similarly, in the case of diabetes remission, there was variability in the remission rate by surgical procedure.30 Despite this variability, metabolic surgery has a higher remission rate than medical therapy. The factors predicting remission of T2D are weight loss, baseline pancreatic function, and diabetes duration.7,8 Although the factors may vary depending on the treatment strategy, significant weight loss is the most common predictive factor in all treatment options. Your treatment for unexplained weight loss depends on what’s causing it.Innovent announces Mazdutide, first dual GCG/GLP-1 receptor agonist, received approval from China's NMPA for chronic weight management.Each class of medicine has one or more medications.First, SELECT was not a primary prevention trial, and the data should not be extrapolated to all individuals with overweight and obesity to prevent major adverse CV events.Patients who received liraglutide had better glycaemic control as well as an additional 4.2 kg weight loss compared to placebo after 26 weeksErtugliflozin (Steglatro) is the most recent SGLT-2 inhibitor to come to the market, with approval for use in people with T2D received from the EMA in 2018 and the FDA in 2017.When it comes to Medicaid, only a dozen or so state programs cover GLP-1s for weight loss.And they’re just one part of your treatment plan if you have Type 2 diabetes or obesity. There are other medications that can cause problems if you take them with statins. Not everyone who takes a statin will have side effects, but some things can increase your risk of side effects with statins. The weight gain could be because people may feel more comfortable eating higher-cholesterol foods, believing that the statins will protect them. Statins could cause some weight gain, but it may not be from the drug itself. It’s based on the amount and size of fat cells in your body. For best results, providers recommend you use the medication alongside a reduced-calorie diet and a regular exercise routine. Be prepared to give yourself once-weekly injections of the medication at home. “Semaglutide is an injectable type 2 diabetes drug that can help with weight loss—on average, around 15 percent of patient’s body weight,” Nicole Zucconi, D.O., a primary care physician at Inspira Medical Group Primary Care Millville. Given that most type 2 diabetes is obesity-related, it makes sense to favour treatment strategies that promote weight loss. As discussed previously, although SGLT2i reduce body weight when used for the treatment of type 2 diabetes, weight loss is less than expected, largely because of a compensatory increase in food intake. In general, drugs that increase energy expenditure have proven unsuccessful for inducing weight loss or have unacceptable adverse effects (such historical drugs include the β3-adrenoceptor agonists, thyroid hormones and mitochondrial uncouplers, such as dinitrophenol). But semaglutide isn’t simply a tool that suppresses appetite, Dr. Butsch clarifies. Using a medication “off-label” means it’s prescribed for a use other than its stated purpose. The only difference from Wegovy is the dose. Ozempic is the same medication as Wegovy, which the U.S. This Is What Happens To The Body When You Are Sleep Deprived For A Long Time This action leads to increased glucose excretion through urine, helping to lower blood sugar levels. Managing diabetes involves a comprehensive approach that often includes lifestyle modifications and medication. Eating healthy foods and being physically active most days of the week can help you not gain weight. This happens in people who don't have diabetes, too. But if you take in more calories than you need to keep a healthy weight, your cells will get more sugar than they need. Always remove the needle right after you inject your dose. Do not use semaglutide if it is colored, cloudy, thickened, or contains solid particles, or if the expiration date on the pen has passed. Always look at the semaglutide solution before you inject it. Among overweight or obese patients with type 2 diabetes, intentional weight loss of 7–14% was typically required for full discontinuation of at least one anti-diabetic medication. 22/50 patients (44%) discontinued anti-diabetes medications (14 sulfonylureas 36%, 7 insulin 23%, 4 sitagliptin 19%). Case records of 50 overweight or obese patients with DM who successfully decreased dosage or discontinued diabetes medications after losing weight via attendance at two University-based, outpatient weight management centers were analyzed. Intentional weight loss, primarily by improving insulin resistance, is known to decrease the need for anti-diabetic medications. GLP-1 agonists mimic the way a hormone called glucagon-like peptide 1 works in the body. Another form of semaglutide is available in a pill that's taken by mouth once a day. GLP-1 agonists for type 2 diabetes are generally taken by a shot, also called an injection. The second is sodium glucose cotransporter 2 (SGLT-2) inhibitors. Sesame’s Editorial Team is committed to delivering useful, relevant and reliable health information to our readers. The U.S. Food and Drug Administration approved the first GLP-1 drug for type 2 diabetes in 2005 and another, the first for weight loss, in 2014. Both are types of GLP-1 drugs, a class of medications that has soared in popularity in recent years and includes the brand name drugs Ozempic, Wegovy, Mounjaro and Zepbound. New clinical trials show that orforglipron and another oral drug help people with obesity lose weight. Metformin is a common diabetes drug that doctors sometimes prescribe off-label for weight loss. Overall, around 6 per cent of people taking tirzepatide and 8 per cent of those taking semaglutide stopped taking the drug before the end of the study due to side effects. Because the drugs listed above act in different ways to lower blood glucose levels, they may be used together to help meet your individualized diabetes goals. Because meglitinides stimulate the release of insulin, it is possible to have low blood glucose when taking these medications. If you’ve been diagnosed with type 2 diabetes, metformin may be the first medication your doctor recommends. The anti-obesity drug studies used last observation carried forward, which includes the last measured value, and, similar to the completers analysis, could lead to an overestimation of the treatment effect. The anti-obesity drug trials (5–7) and the diet and exercise study (26) were the only studies that provided data from intention-to-treat analyses. An agonist is a drug that works by acting like a substance that your body naturally has. These drugs do have a lot of similarities but also important differences. It can lower your chances of diabetes, heart disease, some cancers, sleep apnea, and many other health conditions. Rarely weight loss drugs can have side effects, like nausea and diarrhea, that may lead to dehydration and electrolyte imbalances. The risks and benefits of Anti-diabetic medications leading to weight loss needs to be considered before starting any medication. The choice of anti-diabetic medication is based on multiple factors like patients age, duration of diabetes, co-morbidities and body weight. It is used together with diet and exercise to help control your blood sugar. Tirzepatide injection is used to treat type 2 diabetes. GLP-1 agonist formulations that include insulin were not included in the analysis. What drugs are approved for weight loss? Sometimes combining medicines may increase the effectiveness of each individual medicine to lower blood sugar. People with liver problems or a history of heart failure shouldn't take this kind of diabetes medicine. Ask your health care provider about your choices and the pros and cons of each. Each class of medicine works in a different way to lower blood sugar. Susan Z. Yanovski, MD, discusses the critical need for effective ways to treat and manage weight for people with diabetes. If you're worried about your medication, struggling with side effects, or want to know if it's right for you, speak with your healthcare team. It’s also important that you take individual advice from your healthcare team before starting treatment and report any side effects to your healthcare professionals, if you experience any. Wegovy (semaglutide 2.4 mg), the first and only once-weekly GLP-1 therapy for weight management, approved in the US. Novo Nordisk files for US FDA regulatory approval of once-weekly semaglutide 2.4 mg for weight management. While it can work well for many people, semaglutide isn’t right for everyone. The drug has a long half-life, which means it can be administered monthly or less frequently, giving the drug “the potential to improve adherence and long-term weight control”, according to Jay Bradner, executive vice president of research and development at Amgen. Gastrointestinal adverse events were “predominantly limited to initial dosing”, while dose escalation resulted in lower discontinuation rates owing to these adverse events than among patients who remained on the starting dose. While incretin agonists, such as GLP-1s, activate hormone receptors in the gut, other drugs — known as antagonists — take the approach of shutting down certain functions. Retatrutide is still unavailable outside of clinical trials, but that has not stopped a surge in illegal activity around the drug, with people claiming to buy and sell it on social media. Weight loss is an important part of managing diabetes, but it’s not always easy to achieve. If you're a diabetic patient struggling to lose weight, you may be wondering why this is happening. The category ‘Other’ for CV inclusion criteria includes patients where it is unknown if the patient fulfilled only one or several criteria and patients who were randomized in error and did not fulfill any criteria. Data are represented as number and percentage of patients. The dots show estimated treatment differences and the error bars show 95% confidence intervals. However, it must be noted that none of these drugs or drug combinations are currently approved for use and there is limited data to support their use specifically in diabetes. There is substantial interest in the development of new treatments to support weight management, particularly in type 2 diabetes, and emerging data from some experimental treatments and novel combinations of existing treatment shows significant recent progress. There is some evidence to support metformin use to mitigate weight gain in type 1 diabetes, although the weight change with metformin has been found to be modest . Liraglutide You will be given the Medication Guide when you begin treatment with semaglutide injection and each time you refill your prescription. Your doctor may order certain tests to check your body's response to semaglutide injection. It is not known if this medication increases the risk of tumors in humans. Make sure you stay hydrated while taking this medication.Research has shown that many people regain weight after discontinuing GLP-1 medications.In addition, the mechanisms by which bariatric operations improve diabetes may include both weight-dependent and weight-independent mechanisms, and the latter may involve changes in gut hormones, bile acids, or gut microflora.Weight loss caused by metformin varies from 0.6-13%.Wu et al. elucidated that mTOR suppression is mediated by metformin through action on transport through the nuclear pore complex (NPC) 83, 84.They dubbed the hybrid molecule lac-phe and went on to show that it's not only more abundant after exercise but it also causes people (as well as mice and even racehorses) to feel less hungry immediately after a hard workout. Most people gain and lose a little weight from day to day, but these changes tend to stay within a five-pound range. And it’s not just a little weight — it’s a loss of 10 pounds or 5% of your body weight in six to 12 months. For example, privately insured patients in the U.S. can get Wegovy coupons of $225 per 28-day supply for up to 1 year if their plan covers Wegovy, or $500 per 28-day supply if their private health plan does not cover it. In adults with type 2 diabetes and chronic kidney disease, there is an increased risk of the disease worsening, or of experiencing cardiovascular death. People with type 2 diabetes and known heart disease are at a greater risk of major cardiovascular events such as stroke, heart attack, or death. Additionally, this combination medication also affects reward-driven eating and decreases cravings for high-calorie, pleasurable foods (17,18).Full of additives like high-fructose corn syrup, ultra-processed “big food” is a direct cause of obesity.There is a paucity of data on other drugs for weight loss or control in persons with type 2 diabetes.Together, we can take control of diabetes and live healthier lives.It is really important that you speak to your healthcare team for support to manage your insulin if you’re considering a low-carb diet.We only included dosages approved for glycemic control (i.e. we did not include higher dose GLP-1 agonist with approved indications for weight loss).The average dose ended up being 2,230 milligrams per day.Managing Type 2 diabetes is a challenge, and your treatment plan has to work for you.The accumulation of metformin in the GI tract is thought to impact not just epithelial brush border metabolism but also that of the complex bacterial community of the gut. The scale was calibrated yearly as a minimum unless the manufacturer certified that calibration of the weight scales was valid for the lifetime of the scale. Body weight was measured without shoes and only wearing light clothing; it was measured on a digital scale and recorded in kilograms or pounds (one decimal with a precision of 0.1 kg or lb), with preference for using the same scale throughout the trial. Investigators were provided with guidelines for, and encouraged to follow, evidence-based recommendations for medical treatment and lifestyle counseling to optimize management of underlying CVD as part of the standard of care. They work in different ways to help lower blood glucose. There are several different types of medications available. Studies have shown DPP-4 inhibitors have little effect on body weight. Less glucose in the blood means there’s less glucose available to change into fat. Best canned fish for people with diabetes Before looking at what can be done to prevent weight gain, it’s important to understand in what ways medication can lead to weight gain. Packer M, Zile MR, Kramer CM et al; SUMMIT Trial study group (2025) Tirzepatide for heart failure with preserved ejection fraction and obesity. Lincoff AM, Brown-Frandsen K, Colhoun HM et al; SELECT Trial investigators (2023) Semaglutide and cardiovascular outcomes in obesity without diabetes. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. Low blood sugar also can occur if you delay or miss a meal or snack, exercise more than usual, drink alcohol, or cannot eat because of nausea or vomiting. This medicine does not cause hypoglycemia (low blood sugar). This medicine may increase the risk of having thyroid tumors. In May 2025, they reported 39 new GLP-1 medications in development. The average weight loss in real-world studies is 9%. A medical device rather than a medication, Plenity was FDA-cleared in 2019 for people with a BMI of 25 to 40. 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. His research focuses on the evaluation, etiology, and treatment of overweight and obesity in adults and children. During treatment, be sure to monitor how well your patient is tolerating the medication and watch for unwanted side effects. According to Dr. S. Yanovski, GLP-1 receptor agonists and dual GIP and GLP-1 receptor agonists may be more effective for losing weight than other weight-loss medications. As a result, Medicaid coverage of GLP-1 drugs for obesity treatment is optional for states, while coverage for other indications (diabetes, cardiovascular disease, and sleep apnea) is required. These medications already have transformed care for millions living with type 2 diabetes and obesity, delivering meaningful health improvements, and their use is expanding. The GLP-1 weight loss drug market is experiencing a notable shift with the rise of Direct-to-Consumer channels, which are offering these medications at significant discounts compared to traditional retail prices. People who are considered overweight or obese have a higher risk for developing MASH.Keep this medication in the container it came in and out of reach of children.However, almost four in ten adults and a quarter of children with Medicaid have obesity, meaning expanding Medicaid coverage of these drugs could provide access to effective obesity treatments for millions.Managing diabetes and weight loss requires a holistic approach that considers the effects of medications, lifestyle changes, and individual health goals.There are no Tier 3 weight management services in Northern Ireland so Wegovy can’t be prescribed through the Northern Ireland health service.This medication and those that will follow soon are able to be scaled and thus have the ability to address obesity in patients with T2DM to disrupt diabetes.Perhaps the most relevant contributor, and one that is readily within the control of health care providers to address, is the use of diabetes medications that are known to contribute to weight gain—especially insulin and sulfonylureas.This is especially the case if you can’t take or tolerate metformin.Of the diabetes medication combinations prescribed, 46.0% were weight-neutral/loss, 41.3% mixed and 12.7% weight-gaining. Even modest weight loss can significantly improve glucose homeostasis and lessen cardiometabolic risk factors in patients with type 2 diabetes, but lifestyle-based weight loss strategies are not long-term effective. Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. This medicine is also used to lower the risk of heart attack, stroke, or death in patients with type 2 diabetes, obesity, and heart or blood vessel disease. After completion of the 4-month study, 260 subjects continued to participate in the single-blind extension for 8 months. Pramlintide is an injectable synthetic analog of amylin which is a naturally occurring neuroendocrine hormone co-secreted with insulin by pancreatic beta cells in response to food intake. Patients given metformin-glyburide achieved a greater reduction in HbA1c of 1.7% compared with 0.4% with metformin alone. When it comes to weight loss compared to injectable GLP-1 medications, the pill “activates that GLP-1 receptor in your body,” Skovronsky said. Orforglipron is not yet approved by the FDA, but adults with obesity and Type 2 diabetes who took the highest dose of the pill for 72 weeks in a late-stage trial lost an average of 23 pounds, or 10.5% of their body weight, Eli Lilly announced. Earlier in August, the company said people who had obesity without diabetes lost 12% of their body weight with the pill.