The longer a drug has been in use, the more the likelihood of its uses and benefits being discovered that were not contemplated prior to or during the approval process. Countries other than the USA typically have their own drug approval processes, but their labels commonly include language similar to that of the FDA label. One focus of such treatment is identification and mitigation of harmful eating behaviors. It has been estimated that a BMI cutoff of 30 kg/m2 identifies only 50% of those who have increased cardiovascular risk due to adiposity.10 BMI significantly underestimates adiposity compared with DXA,11 or other direct adiposity measures.12 BMI as a measurement of adiposity compares unfavorably with the various direct measures of body fat. Hence, there are no federal laws regulating off-label medication use, although some individual states’ medical boards may have restrictive regulations. Resolution of the issue whether or not leptin analogs will be a solution to the problem of weight regain will require further research. There are no current data on off-label use of liraglutide with either dose form but it is likely some specialists have tried combining it with phentermine. There are many types of prescription weight loss medicines that work differently to help with weight loss. If you're trying to lose weight, our experts offer advice on when it's the right time to start a medication. The positive effects of yerba maté (Ilex paraguariensis) in obesity. If you want to lose weight, you don’t necessarily need to take prescription medication. Researchers looked into this after noticing that coffee seemed to decrease the risk of Type 2 diabetes. To date, there have not been any safety signals that have emerged to suggest that any of the currently available medications are not suitable for use in the long term. Several recent cardiovascular outcome trials have reported positive data on patients with T2DM at high cardiovascular risk. In the cohort that tolerated the combination, further weight loss of 5% (6.7 kg) was observed after a mean duration of 22 months. Several meta-analyses have estimated that 3.4–5.0 kg weight loss can be expected with topiramate monotherapy.20,21 Effective doses range between 25 and 100 mg daily. Liraglutide was recently approved in Australia for weight management as an adjunct to diet and physical activity. Does cinnamon increase GLP-1? A carbonic-anhydrase inhibitor, topiramate was found to stimulate lipolysis in preclinical studies (62). Administration of orlistat with psyllium mucilloid reduced the incidence of GI side effects to 29% with psyllium vs. 71% without psyllium (58). These symptoms are usually mild to moderate and decrease in frequency the longer the medication is continued. The gastrointestinal side effects of orlistat, including fatty/oily stool, fecal urgency, oily spotting, increased defecation, fecal incontinence, flatus with discharge, and oily evacuation (48), are the main reasons for discontinuation of therapy. Orlistat at a lower dose of 60 mg 3 times daily (trade name Alli) is approved for over-the-counter use in the United States (51). But not everyone is eligible for treatment with semaglutide. It can take more than a year for the drug to reach full effectiveness, although some patients hit their plateau earlier. The results of a clinical trial published in NEJM showed that—in addition to the 12.5% mean weight reduction above the placebo group (which included lifestyle interventions only)—more than a third of the participants (many of whom weighed more than 200 pounds) lost 20% of their weight. “With semaglutide, people are receiving more GLP-1, albeit in a synthetic form," she says. "They're essentially getting back more of that hormone, which helps them feel full.” Experts believe that’s also true for people with obesity, Dr. Jastreboff explains. Still, some internal or external factors may be driving you to try to lower your body weight. Novo Nordisk's Wegovy® pill, the first and only oral GLP-1 for weight loss in adults, now broadly available across America. FDA approves Novo Nordisk's Wegovy® pill, the first and only oral GLP-1 for weight loss in adults. Pfizer scraps daily weight loss pill after liver injury in one patient. Berberine is currently being studied for its effects on diabetes and risk factors for heart disease. During these check-ins, the provider will evaluate your progress in weight loss, monitor your medication tolerance, arrange follow-up lab tests or prescription refills, and adjust your care plan as necessary. Upon starting a weight loss medication, regular check-ins with your provider can be scheduled. Alongside lifestyle recommendations, your care plan may include a prescription for weight loss medication. But averages matter because they tell us what is likely for many people. Wanting support with your health doesn’t mean you’ve failed. It is not intended to substitute for the medical expertise and advice of your health care provider(s). Know the Science features a variety of materials, including interactive modules, quizzes, and videos, as well as links to informative content from Federal resources designed to help consumers make sense of health information. NCCIH and the National Institutes of Health (NIH) provide tools to help you understand the basics and terminology of scientific research so you can make well-informed decisions about your health. The pill versions are especially good for “needle phobic” people, Levy says. The lowest doses cost $149 a month for people paying out of pocket, a cheaper alternative to the injectable Wegovy. The once-daily Wegovy pill is already approved and became available in the U.S. in January 2026. She expects retatrutide to become available on the market in 2027, but some online companies have been selling what they claim is the medication, prompting warning letters from the FDA. “For somebody who has a lower BMI of 30, this might be overpowering,” Levy noted. A personalised approach must be used when selecting the appropriate weight loss drug for the patient. This is because people with some ethnic backgrounds have an increased risk of health conditions at lower BMIs. Tirzepatide for weight management is suitable for adults living with obesity and another weight-related health problem. However, evidence suggests that short-term treatment (3 to 6 months) with weight-loss medications does not produce long-term health benefits (Garvey et al., 2016); therefore, this review focuses on long-term weight-loss anti-obesity medications. 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, the goal of obesity treatment is not exclusively centered on achieving weight loss, but rather on reducing the risk of obesity-related diseases and improving overall health. Patient access to drugs More than 20% lost at least 10% of their body weight. Once your body gets used to it, most people take 2 tablets every morning and 2 tablets every evening. In one large study, adults taking oral Wegovy lost about 14% of their starting body weight on average. These side effects are common when starting or increasing the dose, but they should improve as your body adjusts. "We can double the weight loss on GLP-1s in combination," Bolno said, referring to what the company is seeing in preclinical research. Bolno said the company is developing the injection, called WVE-007, as a monotherapy or a potential maintenance treatment that patients can switch to and take far less frequently after being on GLP-1s. But Pfizer CEO Albert Bourla said the company is also developing an in-house oral drug that blocks the GIP receptor, which can significantly reduce side effects when combined with GLP-1. Considering cardiometabolic risk factors, tirzepatide shows the best blood pressure- and glucose-lowering benefits, while semaglutide and liraglutide reduce the risk of MACEs. Random-effects meta-analyses were used to calculate weighted mean differences (WMDs), risk ratios (RRs), and 95% confidence intervals (CI). Overweight and obesity pose serious health challenges for individuals and societies. So yes, while the drugs are incredibly helpful for many people, they are not for everyone. This Medicspot guide will help you understand how different medications support healthy, sustainable weight loss and when they may be prescribed. While some people have been helped by weight loss drugs in the short run, the weight tends to return. The U.S. Food and Drug Administration (FDA) has approved a few prescription drugs for long-term weight loss use. For most overweight people, their body tries to prevent permanent weight loss. Some diabetes medications can help people with diabetes lose weight. Additionally, we conducted stratified analysis on individuals living with overweight or obesity to evaluate the differential effects of weight-loss medications on various individuals living with overweight or obesity and the responsiveness and sensitivity of different individuals to these medications, providing valuable clinical guidance. Although liraglutide was not the most effective for weight loss or cardiometabolic improvement, it significantly reduced the risk of MACEs in patients with weight-related complications, similar to semaglutide, indicating strong cardiovascular protective effects. Compared to individuals with psychiatric disorders-related or simple overweight/obesity, weight-loss medications showed greater benefits for weight loss and cardiometabolic improvement in those with weight-related complications, emphasising the importance of using weight-loss medications for weight control to improve cardiovascular metabolism in such populations. A weight-loss plan with diet, exercise and drug therapy is generally considered successful if you lose about 1 pound (0.5 kilogram) a week during the first month. But the weight loss will likely be modest. Orlistat (the active ingredient in Alli) promotes weight loss by decreasing the amount of dietary fat absorbed in your intestines. Patients need to be informed about the cost of these drugs, in addition to discussing efficacy and safety. They are useful during the weight loss phase, but are essential in the maintenance phase. “These results are an important step forward in potentially expanding effective therapeutic options for individuals with obesity,” says Ania Jastreboff, MD, PhD, a Yale Medicine adult and pediatric endocrinologist and director of the Yale Obesity Research Center (Y-Weight). There is no magic pill that will cure obesity, a condition that affects over 40% of adults in the United States. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Not everyone loses weight while taking the medicines. Your body may not absorb important vitamins, minerals, and other nutrients from food while you are using orlistat. Despite this side effect, most people tolerate this medicine. Topiramate is a gamma-aminobutyric acid agonist, glutamate antagonist, and carbonic anhydrase inhibitor; it is a drug used for epilepsy treatment and migraine prophylaxis (Pilitsi et al., 2019). Naltrexone (NAL) is an opioid receptor antagonist approved as a treatment for opioid dependency and alcohol dependence. Orlistat was approved for long-term weight management by the Food and Drug Administration (FDA) in 1999 and the Korea Ministry of Food and Drug Safety in 2000 (Jeon et al., 2023). Short-term treatment options include phentermine, diethylpropion, phendimetrazine, and mazindol (Jeon et al., 2023). 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). Similar to most chronic diseases, a combination of treatments may be required to achieve a patient’s treatment goals.256 For example, the use of pharmacological therapy following bariatric surgery, or the use of medication to achieve weight loss goals before bariatric surgery.25 These endoscopic procedures achieve greater weight loss than lifestyle modification, however, although infrequent, they do carry risks of adverse events.2832 The suitability of endoscopic procedures as a treatment option for an individual, should consider their circumstances, goals and treatment costs, given costs can approach that of bariatric surgery but has inferior long-term weight loss outcomes. Additionally, this area is rapidly evolving so it is recommended to check the TGA for the latest updates on medications approved for weight management. Equitable access to obesity medications is lacking, as none are currently subsidised under the Pharmaceutical Benefits Scheme (PBS) for weight management. Ideally the trial would have hundreds of people that researchers watched for side effects. So it's not possible to tell which ingredient caused the weight loss. The promise of fast and easy weight loss is hard to resist. Consult a doctor or other healthcare professional for diagnosis and treatment of medical conditions. Can men and women use the same medications? Additionally, drugs targeting hunger or satiety signaling have been actively studied and have shown increased adoption by physicians. Keep in mind that obesity is a disease, and no drug can permanently “cure” it. Even when a patient is engaging in exercise and other lifestyle adjustments, medications can help with hunger, cravings, and metabolic preservation. Some patients who are less comfortable with injections may ask about weight-loss pills. Some medicines are more likely to cause side effects than others. If you don't lose weight within 4 weeks after you start the medicine, it probably won't help you. Without those lifestyle changes, you will gain the weight back if you stop taking the medicine. Weight-loss medicines are used along with healthy eating and being more active. Mean change in body weight was -13.3% with semaglutide and -2.6% with placebo over 52 weeks. 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. To reduce the risk of MACE in adults with established CVD and either obesity or overweight. Medicines for long-term obesity management Because the gut is a challenging environment for absorption, oral semaglutide doses are much higher — 25 milligrams (mg) daily — than standard 2.4-mg weekly injections. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. If you are a Mayo Clinic patient, we will only use your protected health information as outlined in our Notice of Privacy Practices. So your prescriber may recommend taking it for longer, depending on your personal risks and benefits. And there were concerns that it could increase risk for heart disease. It’s available in both generic and brand name versions for people ages 17 and older. Phentermine (Adipex-P) is a prescription weight-loss pill that comes as a tablet and capsule. If you are struggling with your weight, a healthy eating plan and regular physical activity may help you lose weight and keep it off over the long term. People who have a BMI between 25 and 30 are considered to be overweight. Susan Jara is a health communications strategist and writer with more than 15 years of experience transforming complex medical information into clear, accurate, and engaging content for diverse audiences of patients and caregivers. Enlist friends and family to help hold you accountable or consider participating in a reputable weight loss program. 7 weight loss tips to shed pounds and keep them off for good Even without losing weight, you can be healthier by being physically active and eating healthy foods. Regardless of your weight, exercise has many other health benefits. It's nearly impossible to maintain weight loss without it. 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). Liraglutide 1.8 mg is now FDA-approved for secondary CV prevention in adults with T2D (78). Try to avoid foods containing high levels of salt because they can raise your blood pressure, which can be dangerous for people who are already living with obesity. It can take several months of making lifestyle changes and possibly using medicine before you start to see changes in your weight and any related health conditions. Your GP can advise you about losing weight safely by eating a healthy, balanced diet and doing regular physical activity. Pivotal Peptides says it offers research grade tirzepatide, while MangoRx sells a compounded version, both online. Lilly said these lawsuits were not in any way contingent on tirzepatide coming off of that list and could have been filed regardless of whether supply issues had been resolved. Food and Drug Administration took the drug off its list of medicines in short supply earlier this month. In the US, around 40% of the population is obese1, a four-fold rise since – many are now wondering if the end of the obesity epidemic could be in sight. As we move from a world of quantifiable risk to hard-to-measure uncertainty, we take a look at how insurers are responding, and what the impact is likely to be for investors and the wider economy. Today, health insurance is just one of a number of sectors facing disruption and uncertainty. Your body makes more insulin when you take these medications.In a recent 48-week phase 2 study, over 80% of people who received survodutide experienced significant improvements in their liver biopsy reports.Hundreds of medications are needed for the treatment of a chronic disease like obesity, says Dr. Ania Jastreboff, director of the Yale Obesity Research Center.Common side effects include headache, hypoglycemia, decreased weight, and abdominal pain.In the STEP 2 trial, conducted in adults with obesity and T2D, HbA1c levels at 68 weeks were reduced by -1.6% in the semaglutide 2.4 vs. -1.5% in the semaglutide 1.0 vs. -0.4% in the placebo group, and 78.5%, 72.3%, and 26.5% achieved an HbA1c89).It's also important to remember that no one drug works for all people.A GIPR antagonist conjugated to GLP-1 analogues promotes weight loss with improved metabolic parameters in preclinical and phase 1 settings.However, phentermine inhibits red cell uptake of serotonin so combining it with bupropion may increase circulating serotonin, which has been shown to cause heart valve fibrosis. Phentermine (trade name Adipex) was among the first FDA-approved short-term medications for weight loss and remains available today. Today, nine FDA-approved AOMs remain on the market, with six approved for long-term weight loss, of which one is indicated for specific monogenic obesity mutations, and one “device” that functions as a medication (Table 2). Today, six anti-obesity medications (AOMs) are approved by the Federal Drug Administration (FDA) for the long-term treatment of obesity. Novo Nordisk’s CagriSema falls short of 25% weight loss target in patients with obesity or overweight. Research study to investigate how well semaglutide tablets taken once daily work in people who are overweight or living with obesity (OASIS 1) (OASIS 1). Phentermine-topiramate Since it was a double-blind trial, in which some participants were given a placebo, at first she didn’t know if she was taking the drug, but she says over a period of about a year, “the weight melted off of me.” Near the end of the trial, she had lost 85 pounds, so she believes she was taking the drug. They answered commonly asked questions about anti-obesity medications. Anti-obesity medications have been around for decades, and there are several currently in use. According to a study published in The New England Journal of Medicine, use of tirzepatide in the trial resulted in more than a 20% weight reduction in those with obesity—an average of 52 pounds per person. Overall, little proof exists that any dietary supplement can help with healthy, long-term weight loss. There is no guarantee of a specific weight loss medication being prescribed. Dr Adam Abbs is SCOPE certified (the international gold standard for obesity management) and has a keen focus on personalised medicine and weight loss. Both men and women respond to GLP-1 and dual-agonist medications, though results can vary based on body composition and dose. Wegovy pill Previous weight loss drugs have hit problems, from amphetamines and ‘fen-phen’ to Sanofi’s Acomplia, which was abandoned in 2008 after concerns over increased suicide risk. GLP-1 weight loss drugs have big implications for public health, pharmaceutical and medical technology companies, as well as knock-on impacts on the consumer sector. Now the firm is taking a similarly proactive approach to GLP-1s, offering the drugs at a discount in combination with coaching from a dietitian to improve adherence and help to maintain a healthy weight after the course of medication is complete. Novo Nordisk's weight loss injection Wegovy is also the only GLP-1 approved for slashing the risk of heart attack, stroke and death in obese or overweight adults with cardiovascular disease. A large swath of insured Americans could be eligible for a highly popular class of weight loss and diabetes medications called GLP-1s, such as Novo Nordisk's Wegovy and Ozempic. Gelesis100 (Plenity) is the first anti-obesity agent that is FDA-approved for adults with overweight (BMI kg/m2) irrespective of comorbidities. Similarly, in participants receiving PAP therapy at baseline, those on tirzepatide had a reduction in AHI by -29.3 event/hr vs. -5.5 events/hr in placebo and placebo subtracted weight loss of 17.3%. In participants not receiving PAP therapy, those on tirzepatide had a reduction in AHI by -25.3 events/hr vs, -5.3 events/hr in placebo and a placebo subtracted weight loss of -16.1%. The weight-loss results in patients prescribed GLP-1 receptor agonists to treat diabetes inspired research to see whether higher dosages would produce even more weight loss. In addition, semaglutide and another medication in this class, liraglutide, reduce risk of major adverse cardiovascular events with diabetes. According to the Government Accountability Office, only about 660,000 of more than 70 million Americans with obesity used prescription weight-loss medications from 2012 through 2016. About 80% of adults with type 2 diabetes also have overweight or obesity. For example, drugs may not be needed in ketogenic diets because ketones suppress hunger. Although GLP-1 agonists lower glucose in patients with diabetes, they do not cause hypoglycaemia in individuals who do not have diabetes. It does not inhibit hunger, so it does not have a role in maintaining weight loss. Forced overfeeding studies from America have shown that, despite a group of individuals being overfed by the same amount, there is a range of weight gain. Although they will gain weight, they may not develop obesity. These medications mimic natural hormones that help regulate appetite and blood sugar. Weight-loss medications influence appetite, digestion, or nutrient absorption. These medications typically work by either regulating appetite, slowing digestion, or blocking fat absorption. There is also an in-depth guide which explains weight loss injections in more detail. Check out our Living Light Living Well classes for weight loss support Your health care professional may alsoAnti-obesity medications work in the brain to help bring that set point down, enabling individuals not only to lose weight but also to maintain the weight loss.In a pooled, post-hoc analysis of overweight and obese insulin-treated patients with T2D, pramlintide-treated patients (receiving 120 ug twice daily) had a body weight reduction of -1.8 kg (P130).A few studies were on the combined therapies (i.e. PHEN/TPM ER and NB ER) compared to different comparators, which could hardly lead to a generalized summary of the cost-effectiveness.Because weight loss was still ongoing at 52 weeks, researchers believe people may lose even more weight with longer treatment.In addition, it's likely the weight will be regained when the medicines are stopped.So it's not possible to tell which ingredient caused the weight loss.Patients with symptoms of attention deficit are quite common among the overweight and obese.Ozempic may be a more familiar name to some patients. Experts are concerned that, in some cases, the side effects of prescription medications that treat overweight and obesity may outweigh the benefits. When combined with lifestyle and behavior changes, including healthy eating and increased physical activity, prescription medications help some people lose weight and maintain weight loss. As with many medications, some weight loss drugs have been on the market longer, have generic alternatives, and tend to be more affordable. In other words, you may eventually be able to take these medications alongside your morning protein latte. Velayati says these newer drugs are “even more exciting,” because their natural stability allows them to survive stomach acid without a special chemical enhancer (like SNAC). If you’re thinking about trying the new weight loss pill instead of the weekly injection, you may need to rethink your morning routine. Velayati says your body absorbs only about 0.4 to 1 percent of semaglutide taken by mouth. The peptide nature of this hormone is why developing effective oral versions of GLP-1 medications has been so challenging, says Dr. Velayati. In the SURMOUNT-1 trial, adults with obesity or overweight (without diabetes) taking tirzepatide achieved up to 22.5% average body weight reduction at 72 weeks. Even as the range of weight loss medications has expanded, some drugs have been withdrawn based on their lack of efficacy as well as safety concerns. In a Phase 2 study, the medication showed up to 20% average weight loss at 52 weeks for people with obesity or overweight. Pharmacologic Treatment of Overweight and Obesity in Adults The author has found this safe in carefully selected patients provided their recovery is genuine, recovery has endured for at least several years and phentermine does not induce phentermine cravings or desire for their former drugs of abuse. Evidently, some patients with stimulant use disorder who use cocaine, methamphetamine or other strong stimulants add phentermine to a drug cocktail in an attempt to heighten the stimulant effects, but no data have been published on the frequency of this practice. Effective dosages for weight loss or maintenance for these patients vary widely but most require or tolerate higher phentermine doses than patients without attention deficit. The medication improved her adherence to caloric restriction, and she achieved weight loss of 5 kg. Modest weight loss of 5–10% could result in significant clinical benefit and improvement of Sally’s many obesity-related complications; unfortunately, the weight loss achieved with lifestyle modifications was not durable. Rather, medications reinforce lifestyle management and play a useful role in long-term management of obesity. Similarly, if the medication produces satisfactory weight loss and is well tolerated, it should not be discontinued empirically. This reflects the fact that obesity is a chronic disease that requires sustained treatment, with pharmacotherapy playing an important role in promoting long-term weight maintenance and limiting weight regain. The most common side effects involve the digestive system, such as nausea or delayed gastric motility. In 2026, we expect high-dose oral semaglutide to match the efficacy of injections, making therapy even more accessible for frequent travelers. This helps patients rebuild their biochemistry naturally while on therapy. Without adequate protein, the body may lose muscle mass faster than fat. 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. “Not everybody responds to GLP-1,” she tells TODAY.com.The results indicated that medication categorisation is closely related to weight loss outcomes (weight, BMI, and waist circumference), blood pressure (systolic and diastolic), glucose levels (fasting blood glucose, insulin, and HbA1c), and high-sensitivity C-reactive protein, while having little effect on lipid levels."A lot of people are going to like that," Levy says.Whenever possible, the clinician should consider alternatives to medications known to cause weight gain (163), or should consider measures that would ameliorate the weight-gaining effect of the prescribed drug.When people stop treatment, "rapid weight regain" can happen, a 2026 review of studies found.Many antidepressants are weight-positive (cause weight gain), some are weight-neutral, and at least one is weight-negative (causes weight loss).However, US obesity medicine specialists, based on the known mechanism of action of phentermine, and the pathophysiology of the illness, would consider congestive heart failure, uncontrolled hypertension, untreated clinically significant arrhythmias, and severe advanced coronary artery disease to be absolute contraindications. Soluble fiber absorbs water and forms a gel-like substance in your body. As a bonus, these foods are very nutritious and can lower your risk for heart disease and cancer. A healthy diet is the best and least expensive way to increase GLP-1 levels naturally. The relationship between the gut microbiome and weight is complex. A recently published meta analysis concluded that retatrutide led to the most weight loss among GLP-1-based treatments, but it also caused the most side effects. As with many other weight-loss medications, monulubant is linked to mild to moderate GI-related side effects. The decision came after early studies involving people who are considered obese showed significant and lasting weight loss. Increasing physical activity to up to 60 minutes a day and continuing to watch what you eat may help you keep the weight off. If you go back to your previous calorie intake once you've lost weight, it's very likely you'll put the weight back on. Getting psychological support from a trained healthcare professional may also help you change the way you think about food and eating. To avoid regaining weight after being obese, you may need to do 60 to 90 minutes of activity each day. If you take Alli with a high-fat meal, you'll likely experience more-severe digestive side effects. When you take the drug with a meal, about 25% of the fat you eat isn't broken down. The FDA published a safety review of orlistat in 2010 because of rare reports of serious liver injury in people using it. Xenical is approved for use in adults with a BMI of 30 or more (obese). Food and Drug Administration for use in adults 18 and older who have a body mass index (BMI) of 25 or more. Methamphetamine is a category II controlled substance and although today this drug is apparently rarely used for treating obesity, such usage is not off-label. Today, methamphetamine remains FDA-approved for treating attention deficit and obesity and is still available as Desoxyn®. Later, in 1962, the US congress amended the Food Drug and Cosmetic Act requiring the FDA to approve new drugs based on their safety but only if the new drug demonstrated proven effectiveness for the stipulated indication. Both approvals were made at a time when when US law required the FDA to only consider whether new drugs were safe without consideration of their effectiveness. Hence, information contained in labels of older drugs may be outdated due to unavailability of more recent research and clinical experience at the time the warnings were added to the label. These include food intake, how much you exercise and your health status. It should be taken as directed by your health care provider. Olistat is also approved by the FDA in a lower-dose, over-the-counter option known as Alli. It's made by the same company as Ozempic, which also has the same active ingredient semaglutide. It's a weekly injection used for long-term weight management. 2) The addition of pharmacotherapy to usual medical treatment improves the weight loss outcome significantly. The best the diabetes prevention trial could come up with was a 5% weight loss at 8 years.57 Other trials have had equally dismal results. Thus, naming the disease as obesity has detracted from care for patients in early stages when treatment could be expected to be more successful. However, leptin levels fall during weight loss and remain low afterward,50 and leptin administration after weight loss in obese patients reverses some of the neuroendrocrine adaptations involved in weight regain.51 These data suggest that daily leptin injections could possibly be useful in preventing weight regain after a significant weight loss. Obese patients typically have high circulating leptin levels, and clinical trials have shown that leptin administration does not induce weight loss. To see if you're eligible for an assessment for tirzepatide, check with your local integrated care board (ICB). If you have at least 4 of these conditions but your BMI is less than 40, you may be eligible for tirzepatide due to your ethnicity. You may also be able to get tirzepatide from your GP, although it's currently only available if you meet the criteria listed below. Semaglutide is not recommended if you're pregnant, trying to get pregnant or breastfeeding or have certain health conditions. It is not recommended if you're pregnant, trying to get pregnant or breastfeeding or have certain health conditions, such as liver or kidney problems. Surveys indicate that the average phentermine dose employed in the USA is about 60 mg/day, and that some physicians have used up to 112 mg/day. A study in baboons25 found that intravenous amphetamine and phentermine produced equivalent plasma levels of norepinephrine. Current treatment recommendations for attention deficit call for a starting dose of amphetamine of 0.3 mg/kg/day, then titrating up, if needed, to a maximum of 1.0 mg/kg/day. Whatever the theoretical explanation, doses higher than 37.5 mg/day have been found effective and safe in a number of observational studies.6,14,15,19–23 The phenomenon referred to may be related both to intra-species variability of drug metabolism and dose–time induction of more rapid drug metabolism. Who is weight loss medication suitable for? NICE and MHRA approved medications That’s why more people are using medication to help with weight management. Most importantly, always discuss over-the-counter drugs or supplements with your health care provider. A weight loss medication can help you get closer to your goal weight. But it isn't a good choice for people with heart disease, high blood pressure, an overactive thyroid gland or glaucoma. Phentermine is one of the most prescribed weight-loss medicines. For example, it can be be used with healthy eating, physical activity and behavior change. Correspondingly, for the modelling-based evaluation with more than a one-year time horizon, discount rates that followed the guideline or consensus in a specific country or setting were applied to future effects and costs in most of the studies (51–55, 58, 59, 61–65, 67–71). The two data-based studies focus on the outcomes within the one-year treatment period, no discounting was performed as unnecessary (59, 60). In addition, the event-driven simulation was used in three studies to capture the complex disease course of obesity (56–58). These findings provide valuable guidance for personalised weight management and may help improve health and reduce the risk of all-cause or cardiovascular mortality in individuals living with overweight or obesity. Further, we evaluated the effects of weight loss medications on psychological well-being and covered multiple safety indicators across various systems. In terms of psychological effects, all weight-loss medications increased the IWQOL-Lite total score, with tirzepatide showing the greatest improvement. Moderate certainty evidence suggested that tirzepatide was the most effective medication for weight loss, followed by semaglutide. Importantly, we included 11 studies on the newly FDA-approved weight-loss medication tirzepatide. Outcomes related to liraglutide showed slightly lower quality due to high-bias risk in some studies. Overall, 151 (98.1%) studies showed a low or medium risk of bias (Figure S1 in Supplementary Appendix 7). A sensitivity analysis excluding studies with a high or medium risk of bias was also conducted. “They’re smaller in molecular weight than peptide medications that mimic or interfere with endogenous bioregulatory peptides.” Phentermine-topiramate is a combination of a weight-loss drug called phentermine and an anticonvulsant called topiramate. Most prescription weight-loss drugs work by making you feel less hungry or fuller. For example, you shouldn't take prescription weight-loss drugs if you're trying to get pregnant, are pregnant or are breastfeeding. Importantly, the high certainty evidence for key outcomes—such as the reduction of MACEs with semaglutide and liraglutide—provides valuable guidance for clinical use. High-certainty evidence demonstrated that topiramate and phentermine/topiramate negatively impacted psychological outcomes. These results collectively highlight the significant advantage of tirzepatide in improving cardiovascular metabolism. The individual-based state-transition Monte Carlo simulation was also employed by modelling different patient characteristics with multiple runs in the model cycle representing the state changes in a few of the studies (54, 65, 69). Various decision- analytic approaches were observed in the modelling-based studies. There was one study conducted in the Australian setting that used disability-adjusted life year (DALY) as a measure of health loss (62). They may switch you to a different weight-loss drug. How long you take a weight-loss drug depends on whether the drug helps you lose weight. But practicing healthy lifestyle habits may help limit weight gain. The meta-regression results showed that medication categorisation impacts body weight, while the type of mental disorder and the presence of obesity-related comorbidities did not significantly affect the outcomes. The policy implications are significant, as it informs healthcare providers and policymakers about the most effective pharmacotherapies for individuals with overweight or obesity. In this meta-analysis, we not only compared the weight-loss effects of medications across multiple indicators but also evaluated nearly all cardiometabolic outcomes. Therefore, further high-quality studies are needed to investigate the effects of semaglutide on lipid metabolism and tirzepatide on MACEs events. Similarly, the low incidence of MACEs in tirzepatide studies diminishes the reliability of its conclusions, as high to moderate certainty evidence confirms its significant benefits in weight loss and cardiometabolic improvement. For instance, the two CEA studies of NB ER conducted in the health care setting of Canada and the UK respectively reported NB ER to be a cost-effective weight loss option relative to standard weight management for long-term use (56) and even in a lifetime horizon (58). Studies revealed that the general cost-effectiveness picture of the four anti-obesity drugs approved earlier for long-term use (i.e. orlistat, PHN/TPM ER, NB ER, LIRA 3.0mg) was not desirable. Both free texts and subject headings were adopted for searching the key concepts about obesity, anti-obesity drugs approved by the FDA for long-term use, as well as pharmacoeconomic evaluation. Semaglutide (Wegovy, Ozempic) The weight loss it produces is “profound” and might be a good fit for people with a very high BMI, Levy added. That compares to about 21% average weight loss for Zepbound, Eli Lilly’s GLP-1 drug. No amylin analogs are approved for weight loss right now by the U.S. Lilly will read out data on seven other Phase 3 trials on the drug this year. By reducing that protein, Wave believes the drug can increase fat loss, particularly harmful visceral fat, while preserving lean muscle mass. Pfizer inherited several experimental injections and pills with combination potential from its roughly $10 billion acquisition of the obesity biotech Metsera last year. "I feel like the winners are now starting to emerge for the monotherapy" treatments, he said. That could look like combining a GLP-1 with one of the existing treatments for fatty liver disease. The degree of weight loss achieved with surgery is usually much greater and lasts longer than with medications. Ozempic can help people lose weight, which can reduce the risk for many other serious health conditions, such as heart problems. Learn about weight loss medications, like Wegovy, and whether they're right for you Find out if weight loss medications can actually help you lose weight Physicians following either approach agree that obesity is a chronic disease and that treatment must be long term. On the other hand, private obesity medicine practitioners led by the 67-year-old American Society of Bariatric Physicians (ASBP), recently renamed the Obesity Medicine Association, have taken a pragmatic approach to treatment. Zafgen announced they had halted research on their obesity-drug candidate beloranib in July 2016 after two deaths during trials. And, if they do, will these be healthier lives, or will more years also mean more health interventions? The question is not merely whether GLP-1s should be available through health insurance, but of what the impact will be from their widespread uptake. As they do, insurers are scrambling to analyse the long-term implications for the wider healthcare sector. Just four years ago, relatively few people had heard of the appetite-regulating hormone ‘glucagon-like peptide-1’. Prescription weight loss drugs; Diabetes - weight loss drugs; Obesity - weight loss drugs; Overweight - weight loss drugsLilly will read out data on seven other Phase 3 trials on the drug this year.The best way to achieve this is to swap unhealthy and high-energy food choices – such as fast food, processed food and sugary drinks (including alcohol) – for healthier choices.There are many ways to save on weight-loss pills.Specifically, weight loss of 5% to 10%, along with improvements in lifestyle, has clinically significant benefits in achieving these goals.And if weight-loss pills don’t work, there is an increasing number of injectable medications available, although cost is a factor.Further, we analysed the response and sensitivity of individuals with overweight or obesity to various medications (Tables S6–S8 in Supplemental Appendix 7).Orlistat can cause side effects such as passing gas and having loose stools. People who are considered overweight or obese have a higher risk for developing MASH. In June 2025, Innovent Biologics announced that China’s regulatory agency approved mazdutide for chronic weight management in adults considered overweight or obese. It’s being studied for weight loss and Type 2 diabetes in adults. NB ER is another combination therapy for long-term weight management that makes use of the synergistic effect of two distinct agents. However, the clear mechanism of action of the combination therapy of PHN/TPM ER still awaits confirmation in animal and human studies (45, 74). Different from the previous reviews on similar topics, the primary focus of this study rests on the methodological design of the pharmacoeconomic evaluations in the synthesis and analysis of the included studies. In addition, in many studies, authors solely listed specific variables or scenarios for analysis without giving detailed justification for selecting a specific parameter for the sensitivity analysis in advance. More than half of these studies performed both deterministic and probabilistic sensitivity analyses (51–55, 58–61, 64, 69). Naltrexone is an opioid receptor antagonist that diminishes the mu-opioid receptor auto-inhibitory feedback loop on anorexigenic hypothalamic neurons activated by bupropion, thereby allowing for sustained weight loss (67).Paraesthesia, dry mouth, constipation, altered taste sensation, insomnia, dizziness, cognitive effects“For somebody who has a lower BMI of 30, this might be overpowering,” Levy noted.Always talk with your health care provider before you participate in a clinical study.Orlistat (Xenical®) has been available on the market for more than 20 years and is the only one among the five long-term AODs approved by different major drug regulatory authorities including the U.S.The majority of those who reported having side effects noted that they are mild and not serious.Find an obesity medicine specialist near you who can assist in finding the best weight loss medications for you. The most common side effects were nausea and fatigue. This amylin drug from Eli Lilly is injected once a week. This drug from Novo Nordisk also mimics both GLP-1 and amylin, and is being tested as a daily pill and a weekly injection. Most people lose about 1–2 pounds per week while taking weight loss medicines, and sometimes even more.Alli is a 60-milligram, over-the-counter version of orlistat (Xenical), a 120-milligram prescription drug.It is not intended to substitute for the medical expertise and advice of your health care provider(s).Enlist friends and family to help hold you accountable or consider participating in a reputable weight loss program.When deciding what diabetic med is used for weight loss, you need more than just a prescription—you need ongoing support.Some people who take these medicines report less “food noise” in their brains.Figure 3 shows the overall prevalence of these side effects among our survey sample, with distinctions made as to whether the side effect was mild or severe. 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. In November 2023, tirzepatide became the first GLP-1/GIP dual RA approved by the FDA for chronic weight management. In addition, glycemic status shifted from prediabetes to normoglycemia in people receiving semaglutide. 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. Adults with migraines and obesity are good candidates for this weight-loss medication. It was originally used as a short-term medication to jump-start weight loss, but now newer medical guidelines have added it to long-term therapy. Phentermine is the oldest and most widely used weight loss medication. Some patients may lose 5–10% of body weight, especially with the higher dose of liraglutide. Our team consists of physicians and licensed nurse practitioners who possess the qualifications to prescribe medications, order lab tests, and evaluate your symptoms and health objectives. We're here to assist you through this process, ensuring you have access to the medications you need for managing your health effectively. Our team understands the complexities of insurance procedures, and we're committed to ensuring that you have access to the medications prescribed by your healthcare provider. After a mean follow-up duration of 39.8± 9.4 months, the primary endpoint occurred in 6.5% of participants in the semaglutide group vs 8.0% in the placebo group, resulting in a relative risk reduction of 20%. 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). It promotes weight loss through multiple mechanisms including slowing gastric emptying, thereby reducing hunger and energy intake, in addition to direct anorexigenic effects on the brain leading to increased satiety (85). Drugs like Ozempic, Wegovy, and Mounjaro help people with diabetes get their blood sugar under control and help overweight and obese people reach a healthier weight. How do you discuss medications to manage weight with your patients with diabetes? There are also new incretin medications being developed that target more than one receptor, both to treat diabetes and obesity, including one called tirzepatide. That’s why the most prescribed obesity medication is phentermine, which is a generic medication that’s only approved for short-term use and has not been tested in long-term studies. With larger amounts of weight loss, for example from bariatric surgery, remission of type 2 diabetes can occur with a return to healthy blood glucose levels in some patients. Another substituted phenethylamine approved as an antidepressant is a norepinephrine–dopamine reuptake inhibitor, which commonly induces modest weight loss. Both drugs are frequently used off-label in the US in manners similar to phentermine. These patients typically are less scattered, can focus better and are more productive when taking phentermine and, realizing this, “like” taking the drug. For example, it can help prevent and manage more than 20 conditions, such as reducing the risk of type 2 diabetes by 40%. As well as helping you maintain a healthy weight, physical activity also has wider health benefits. Reducing the amount of calories in your diet will help you lose weight, but maintaining a healthy weight requires physical activity to burn energy. Oral semaglutide at a dose of 25 mg in adults with overweight or obesity. 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%. Except for four funded by the government (61, 62, 64, 65), all the other studies involved the relevant pharmaceutical companies (e.g. Roche, Novo Nordisk, Vivus, etc.) in various forms.There is no guarantee of a specific weight loss medication being prescribed.Like any medical condition, there are different ways to manage obesity.Velayati says these newer drugs are “even more exciting,” because their natural stability allows them to survive stomach acid without a special chemical enhancer (like SNAC).“There are no blood tests that could let someone know they’re going to respond to a given therapy or medication, such as a GLP-1 analogue like semaglutide.”It’s being studied for weight loss and Type 2 diabetes in adults.Feed medication混饲给药Osumili et al.35 also reported significantly greater reductions in body weight with tirzepatide compared to semaglutide.If you're having problems with side effects, talk to your doctor. Most people taking anti-obesity medications pay for them out of pocket, and they can be very expensive. Results from a follow-up study of semaglutide versus placebo showed that this weight loss can be sustained for at least two years. Following this research, liraglutide was approved in 2014 and semaglutide in 2021 to treat obesity, both at higher dosage than that used to treat diabetes. The impact of weight-loss medications on lipid and glucose levels varied, likely due to differences in baseline characteristics and the effects of concurrent medications such as antipsychotics, antidepressants, antihypertensives, antidiabetics, and lipid-lowering medications. Other common adverse effects of weight-loss medications included fatigue and dry mouth. Regarding adverse events, no weight-loss medications increased the risk of serious adverse events (defined as any event that resulted in death, was life-threatening, required prolonged hospitalisation, or caused persistent disability or incapacity33) (Table 4). The paradigm should also acknowledge that guidelines should not replace treatment decisions made according to an individual physician’s judgment and the clinical needs of an individual patient. Thus, the treatment paradigm should explicitly acknowledge that the disease is far more dangerous than any of the medicines in current use. The endemic will likely continue to expand unless more attention is given to treating early stage patients and to prevention. The conventional paradigm is appropriate for patients diagnosed as obese, morbidly obese, and super obese with a BMI exceeding accepted cutoffs. Pharmacotherapy may also arrest progressive weight gain caused by a variety of other reasons.