Muscle loss can affect strength and mobility, and it also can also leave people more vulnerable to falls, which are the second leading cause of unintentional injury deaths worldwide, according to the World Health Organization. They can often cause nausea, vomiting, and diarrhea, and their use has also been linked to inflammation of the pancreas—a condition that can be fatal. Unfortunately, like any drug, GLP-1 agonists carry safety warnings. The many users of GLP-1 agonists have been reporting some unexpected positive side effects. Liraglutide has been shown to help regulate appetite, while also slowing gut action, making people feel fuller for longer. Some people may be more prone to dehydration or yeast infections. Dapagliflozin improves blood sugar control by aiding the body in removing sugar (and the calories that come with it) from the bloodstream and through the kidneys via urine. Similar side effects have been reported with Contrave, as well as some digestive issues, such as nausea, vomiting and constipation. However, significant weight loss was observed among epileptic patients treated with topiramate, thereby leading to its evaluation in clinical studies for the treatment of obesity. Although many long-term trials demonstrated beneficial effects of lorcaserin in T2DM and its substantial CVD safety profiles, weight loss efficacy of lorcaserin is only modest. Since then, efforts to develop anti-obesity drugs have been made focusing on not only weight loss efficacy but also cardiovascular safety and lowered risk of cardiovascular disease (CVD). If you aim for double-digit weight loss, prescription options are generally more effective and require clinician supervision. 3) If using orlistat, adopt a lower-fat diet and take a multivitamin. Head-to-head randomized trials comparing oral supplements with modern prescription options are rare. The average effect for many OTC options is low single-digit percentage body-weight loss over six to twelve months. In short, common OTC supplements and orlistat tend to produce modest weight losses. NOT using over-the-counter diet aids Using over-the-counter diet aids I'm very worried about using supplements that may have unknown side effects. I'm not worried about using supplements that may have unknown side effects. However, the calorie reductions did not significantly affect body weight at either 6 weeks or 12 weeks. At the end of the trial, participants receiving 4 mg/day capsaicinoids reported a mean intake of 252 fewer calories per day than those receiving placebo and a mean of 140 fewer calories per day than those receiving 2 mg/day capsaicinoids. A 2017 clinical trial compared 2 mg/day and 4 mg/day capsaicinoid supplements for 12 weeks in 77 adults who were overweight . Capsaicin and other capsaicinoids have been proposed to have anti-obesity effects via their ability to increase energy expenditure and lipid oxidation, attenuate postprandial insulin response, increase satiety, and reduce appetite and energy intake 78-82. “Also, every one of these medicines will be subjected to large post-marketing trials, which will further assess safety and longer-term efficacy.” Alli isn’t an easy answer to weight loss. 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. 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. Although there are no published data on the frequency of use, phentermine is occasionally prescribed for patients with label contraindications. The label suggests the drug not be used in pediatric patients aged 27 and as old as 88 years.23 Nevertheless, it is an effective weight loss pill that works in a unique way when compared to the prescription weight loss pills. Belviq, while not the most effective pill for weight loss in terms of pounds shed, tends to be the best tolerated based on published data regarding adverse effects. Below, we list all the prescription weight loss pills that work and important information about them. Don't be afraid to ask your doctor about prescription weight loss pills as they much more evidence of benefit than any over the counter supplement. 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 usually go away after you get to the dose you've been prescribed and your body adjusts, but sometimes they can be serious. The SURPASS-2 clinical trial compared tirzeparide to semaglutide head to head. Benefits related to your heart health are still being studied. What are the Risks? An additional annual weight loss of 4.8% total body weight (mean 4.4 kg) has been observed, with side effects including nausea, headache and dizziness 11, 16. In this article, we discuss the clinical trials investigating pharmacotherapy for people with obesity. There is growing interest in drug therapies that can support weight loss and thereby reduce the prevalence of obesity and obesity-related complications. Nevertheless, these therapies are often limited by weight loss efficacy, side effects, surgical risks and frequently obesity relapse. It blocks the intestines from absorbing about 25% of the fat that you eat. A stronger dose of the same active ingredient in Alli is available by prescription and is sold under the brand name Xenical. Please note that a GLP-1 medication may not be appropriate in all patients. Before he became editor of Discover in 2012, Steve George spent more than 20 years as a writer and editor, specializing in health and medicine. Tirzepatide works similarly to semaglutide in that it also mimics a hormone in the body that regulates hunger, while additionally slowing down digestion and movement of food from stomach to small intestine. If patients haven’t lost 5 percent of body weight by week 12 of treatment, they should stop taking Belviq. Orlistat’s side effects are more likely to be experienced if you eat a diet that’s high in fat, which is why it’s advised that people avoid foods that contain more than 30 percent fat, like steak, avocado, and certain processed and fast foods. It boasts of having the power of multiple weight loss supplements, leading to healthy, yet quick fat reduction. However, amid all the chaos and shrouded secrecy and lies, there are still potent weight loss drugs and supplements that actually work. This Medicspot guide will help you understand how different medications support healthy, sustainable weight loss and when they may be prescribed. The downside is the subcutaneous route of administration which might be inconvenient for some patients, although weekly dosing makes it a bit more convenient than daily subcutaneous dosing of liraglutide. Semaglutide has been emerging as a promising pharmacotherapy for weight management when combined with lifestyle modifications. More studies need to be performed to further assess the long-term safety and benefits related to cardiovascular and metabolic health. The combination of naltrexone, an opioid receptor antagonist, and bupropion, a norepinephrine-dopamine reuptake inhibitor, is used for the management of obesity . However, due to the scarcity of information on long-term side effects, a longer prospective observational study would likely help address some of those concerns. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Although more research into all of the aforementioned medications is needed, current data provide sufficient evidence to support their use. Currently, no clear guidelines for the pharmacotherapy of obesity exist and such studies could help develop them. Insufficient data regarding long-term effectiveness and risks of side effects was available. Canagliflozin (Invokana) was approved for use in people with T2D by the EMA and the FDA in 2013.For example, supplementation with 1,500 mg/day calcium (from calcium carbonate) was investigated in 340 adults with overweight or obesity (BMI ≥25) with mean baseline calcium intakes of 878 mg/day (treatment group) and 887 mg/day (placebo group) .You can keep taking these medications as long as you are benefiting from treatment and not experiencing serious side effects.Medications, including OTC options, are seen as supplementary tools, not primary treatments.The five licensed AODs for long-term weight reduction identified in this study have been approved in North America, and four of them except NB ER are available in the European markets.The active component phentermine is mixed with a resin and delivered slowly into your circulation over a 24-hour period.Not every weight-loss treatment is right for every person or every kind of weight-loss issue.The guidelines for tirzepatide (Zepbound) and semaglutide (Wegovy) state that a patient should have a BMI of 30 or a BMI of 27 with weight-related health problems.We can verify who you are and that you meet the criteria needed for treatment. Over time, when taking Plenity consistently, many people report feeling full sooner during meals and in between, which can also reduce snacking. It can help people identify hunger and full cues, which some people cannot identify with,” says Amy Beney, RDN, CDCES, of My Nutrition Insights, who based in Lockport, New York. According to Plenity’s manufacturer, Gelesis100, this stomach expansion helps make it easier to eat less and lose weight. These two ingredients form a matrix that releases thousands of gel particles as it passes through your body. More in-depth understanding of obesity and its natural trajectory as well as solid data on the long-term effectiveness and safety of AODs from future studies would facilitate the generation of pharmacoeconomic evidence with enhanced quality. There are many ways to save on weight-loss pills. Also let them know what you’re willing to potentially spend on a weight-loss pill. The decision to start taking a weight-loss pill is a personal one. It’s hard to say which is the best weight-loss pill. Ozempic may be a more familiar name to some patients. It can be easy to overlook first-generation AOMs, but these may be appropriate for some patients, especially when cost is a factor. All of the medications discussed here are contraindicated for pregnancy. The medication’s cost and side effects will also affect the decision. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Caution should be taken if used in patients predisposed to renal stones, acute angle glaucoma, or metabolic acidosis (154). Topiramate can cause paresthesias and cognitive side effects, such as word-finding difficulty and memory loss. In EMPA-KIDNEY, adults with eGFR or eGFR with UACR ≥200 were randomized to empagliflozin 10 mg or placebo (147). There can be less than optimal oversight of this process and some people have been hospitalized. We call that metabolic adaptation,” Wolver said, adding that when someone starts to lose weight, hunger increases, and metabolism slows over time. We talk about their sleeping habits and managing their mental health,” she said. We use lifestyle modification which includes teaching them how to eat a nourishing diet, along with exercising and behavior modification. The drugs also regulate appetite by sending signals to the brain to tell the body it is full, which inhibits overeating. The FDA approved tirzepatide for treating type 2 diabetes in May 2022 and is now reviewing whether to approve it to treat obesity. To lose weight, especially harmful belly fat, combine diet and exercise It's approved for people with type 2 diabetes to help lower blood sugar. I’m thrilled to share a detailed guide on the top over-the-counter OTC weight loss medications that work. Prescription medications to treat overweight and obesity. Lilly's Zepbound (tirzepatide) superior to Wegovy (semaglutide) in head-to-head trial showing an average weight loss of 20.2% vs. 13.7%. 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. Check with your doctor if you’re taking warfarin (a blood thinner), diabetes or thyroid medications, or other weight loss drugs. The U.S. Food and Drug Administration (FDA) has approved a few prescription drugs for long-term weight loss use. Based on the latest clinical trials and real-world data, tirzepatide (Zepbound) currently stands out as the most effective FDA-approved prescription medication for weight loss. Motus reports about 10.4% average weight loss in human trials over six months and a high ratio of fat-to-lean loss, which is unusual for a non-prescription option. While major pharmaceutical companies have spent billions developing the new GLP-1 agonists, the National Institutes of Health doled out just $250 million in 2022 to scientists across the country to investigate childhood obesity, an amount equivalent to a single, Phase 3 drug trial. Overall these compounds have proven startlingly effective, shown to help patients shed 10 percent to 22 percent of body weight in their first year of use. Along with helping to control blood sugar and boosting weight loss, GLP-1 agonists and SGLT-2 inhibitors seem to have other health benefits. But people who take them still have better weight loss results than those who do not take the medicine. There are two main groups of type 2 diabetes medicines that lower blood sugar and also may lead to weight loss. Obesity is recognized as a major pandemic of the 21st century, contributing to increased morbidity, mortality, and the burden of healthcare costs (1). Our comments section is a place where readers can engage in healthy, productive, lively, and respectful discussions. And if you don’t have the tools to know what healthy foods are, you’re probably not going to do it.” “And if your doctor can’t do this, ask for an obesity medicine specialist.” If you’re curious about these medications, speak up. We’ll be able to confirm your identity and BMI, so we can deliver your treatment to your chosen address. Let us know if you have any issues with blood pressure when you take your initial consultation and we will determine if you’re suitable for a treatment like Mounjaro or Wegovy. Reduce sugars and fats and focus on lean proteins, whole grains and fruit & vegetables. Who Might Benefit from Trying Weight Loss Medications? Each type of medicine has different side effects. Like any medication, appetite suppressants sometimes cause side effects. They might encourage you to try other things, including making changes to your diet, exercise, and sleep habits. That's considered "off-label" use of the drug, meaning you can't have the same confidence that it's safe and effective for you. But when you have obesity, the regulation of your body set point is dysfunctional.The risks, side effects and cost related to taking the drug likely override any potential benefit.But for many people, reaching that target weight can be difficult without extra help.Together, these mechanisms result inaltered plasma concentrations of certain medications (particularly lipophilicmedications) in obese compared to normal-weight individuals 24, 25.Compared to placebo, these drugs cause a significant weight reduction, including meaningful improvements in cardiometabolic profiles, while demonstrating good tolerability and safety in patients with obesity.Fats that aren’t absorbed leave your body through bowel movements. What are the side effects of weight loss medicine? These side effects are generally mild and temporary.As the morbidity and mortality of obesity have significantly increased, most current guidelines recommend pharmacotherapy as the second line of treatment for this disorder following lifestyle modifications.Much of the research on probiotics and its influence on the gut microbiota and obesity has been in mice, and the results have been promising.Generally considered safe and well-tolerated, some side effects of metformin may include stomach upset, as well as mild nausea or diarrhea.Before he became editor of Discover in 2012, Steve George spent more than 20 years as a writer and editor, specializing in health and medicine.It has been used medicinally in China for thousands of years and is marketed in the USA as an energy booster and weight control agent through its agonism of adrenergic receptors . SURMOUNT-3 investigated the effect of tirzepatide (10 mg or 15 mg) vs placebo after ≥5% weight loss with ILI in adults with BMI ≥ 30 or ≥ 27 and at least one weight-related comorbidity. Psychiatric side effects did not emerge as a treatment-related adverse event, and a real-world cohort study of over 200,000 patients found no evidence for increased risk of suicidal ideation (102). In the STEP 1 trial, these gastrointestinal side effects occurred more often in those receiving semaglutide vs. placebo (74.2% vs. 47.9%). Most supplements produce single-digit, often low, weight reductions. Because these prescription medicines are injection-based, they usually require clinician supervision, ongoing prescriptions and monitoring. See an example trial listing for oral semaglutide at PubMed and related coverage at Technology Networks for context. Green tea extracts and caffeine-containing blends can increase short-term energy expenditure and fat burning in human studies. Garcinia Cambogia Plus supplement supports getting a flatter tummy as it promises to melt several inches of fat in your waist for tighter abs and a flatter belly. Garcinia Cambogia is a remarkable diet pill that targets three (3) pain points of a lot of women which most diet pills overlook. It’s a widely known fat burner, mood lifter, and appetite suppressant. Taking this supplement as instructed can see you lose up to 10kg of body mass in a matter of weeks. Trimtone makes use of potent, carefully selected ingredients to produce fat-burning results. Common ingredients in these supplements include botanicals (herbs and other plant components), dietary fiber, caffeine, and minerals. Caffeine has a large body of evidence regarding it's use as a stimulant. While the release of Alli over the counter was hotly anticipated, the sales for the drug have been less than manufacturer expectations. As mentioned in the introduction, there is a chance your prescription insurance may cover Qsymia. Qsymia does have some potential side effects however such as dizziness, insomnia, tingling in hands and impaired cognition so it is important to take those into consideration. These medications’ full benefits can take even longer to set in. A lower-dose version of orlistat, Alli, is available over the counter. It can also reduce the risk of regaining weight after losing weight. Over-the-counter refers to medicines, herbs, or supplements you can buy without a prescription. This includes prescription, herbal, and over-the-counter remedies. Some of these supplements can have serious side effects. You may also see ads for herbal remedies and supplements that claim to help you lose weight. For many, the addition of weight loss medications can make a significant difference. GLP-1 treatments like Semaglutide and Tirzepatide are redefining what’s possible for patients once stuck in a cycle of diets and disappointment. Oxytocin has hypophagic effects, by acting centrally, and leads to a reduction in the intake of appetizing food.202 It is being investigated for weight management in a phase 2 trial.203 Exenatide, a GLP1-RA, was explored in the treatment of patients with obesity, without DM. Phentermine is a stimulant that decreases appetite; topiramate is an anti-seizure and migraine drug that also decreases appetite and causes feelings of fullness. Lorcaserin – This drug acts on serotonin receptors in the brain to promote feelings of fullness, thus encouraging users to eat less. People who take the drug should watch for signs of liver malfunction such as yellow skin or eyes, itching, loss of appetite, brown urine or yellowish stool. Speak to a navigator who can guide you to reliable health information or connect you with a health professional. Saxenda Injections for Weight Loss: How It Works, Eligibility, Side Effects, and More Improvements in body composition were observed by dual-energy X-ray absorptiometry in STEP 1, while reductions in visceral fat areas were observed in a subpopulation of participants assessed by computed tomography in STEP 6. Secondary endpoint results from the STEP trials indicated improvement in cardiometabolic risk factors, including waist circumference, blood pressure, lipids, and C-reactive protein with semaglutide administered at a dose of 2.4 mg, as well as benefits on physical function and quality of life. The Satiety and Clinical Adiposity-Liraglutide (SCALE) Obesity and Prediabetes study was a key trial in determining liraglutide efficacy. Instead, products are now sold with ephedra extract, which lacks the potent ingredient for weight-loss efficacy. Wilding, John P.H., D.M., Once-Weekly Semaglutide in Adults with Overweight or Obesity. We don’t recommend stocking up on weight loss treatments, as you may need to adjust doses if you experience side effects or taper down doses as you reach your goal weight. Generally, making healthy lifestyle choices (like reducing portion sizes and doing more exercise) will help weight loss regardless of any other treatments you might be using. In fact, some clinical trials have shown that using weight loss like Mounjaro can result in overall lower blood pressure. It is important to stick to a calorie-controlled diet when using weight loss treatments for the best possible results. However, some people develop a tolerance to phentermine, meaning that it doesn’t work as well over time. Phentermine is a stimulant medication that has been used for weight loss for decades. There are ways to save on OTC and prescription orlistat. 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. With a growing selection of weight loss medications available, patients may ask what the strongest or most effective weight loss prescription medication is, and which one is best for them. Currently, these medications are administered by injection, but oral weight loss drugs in the same category may soon follow. Motus is an oral supplement backed by human clinical trials reporting about 10.4% average weight loss over six months and a majority of the reduction coming from fat mass. Drugs commonly used off-label for weight management are discussed in the following section. 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. While, in general, OLDU is neither illegal nor unethical, some jurisdictions may limit the use of specific medications for specific situations. 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. Instant Knockout contains a blend of natural ingredients that are designed to work together to help users lose weight. Capsiplex Trim has several advantages that make it a popular choice for those looking to lose weight. Capsiplex Trim offers several benefits for those looking to lose weight and achieve a leaner physique. Capsimax contains capsaicinoids, which are known to increase thermogenesis, a process that boosts the body’s metabolic rate and burns more calories. Modest weight loss has consistently been observed when individuals are treated for diabetes (Wilding and Hardy, 2011), but there is evidence that higher doses of the GLP-1R agonist liraglutide than are necessary for glucose lowering can produce greater weight loss of up to 10 kg in trials of up to 2 years duration (Astrup et al., 2009; Astrup et al., 2011)."We're only at the tip of the iceberg in our knowledge of weight regulation."Table adapted from Markovic (2022) and Draft Clinical Practice Guidelines for the Management of Overweight and Obesity for Adults, Adolescents and Children in Australia 2024 (based on Walmsley et al (2023) with information on Tirzepatide from Lingvay et al (2024) and Jastreboff et al (2022).Like all dietary supplements, weight-loss supplements can have side effects and might interact with prescription and over-the-counter medications.Prescription GLP-1 and dual agonist medications usually produce much greater average weight loss than OTC products.In these models, a manageable number of the key health states and the state transitions were structured to capture the disease progression.It’s approved by the Food and Drug Administration for long-term use, and it’s been shown to help people lose about 10 percent of their body weight in one- and two-year clinical trials.You’ll be pleased to know that millions of people around the world use PhenQ and the results are all glaring.Weight loss of 10-20% of your body weight is common. However, the larger issue is that many people see the new drugs as a quick-fix solution. "But there isn't enough evidence to know whether these drugs might be beneficial or dangerous for people who fall outside of the FDA criteria," says Dr. Caballero. Still, that has not stopped some doctors from prescribing these medications "off-label" for weight loss, which means they are used for a different purpose than explicitly intended. It is important to remember that these medications are only approved for people who meet certain criteria. For participants with obesity and moderate/severe obstructive sleep apnea, liraglutide 3.0 mg treatment resulted in significantly greater reductions than placebo in apnea-hypopnea index, body weight, SBP, and HbA1c levels (76). The controlled-release, single-tablet combination phentermine plus topiramate (trade name Qsymia) was approved by the FDA in 2012 as a long-term treatment for obesity for adults with BMI ≥ 30 kg/m2 or BMI ≥27 kg/m2 with at least one weight-related comorbidity. In subjects with obesity and T2D, hypercholesterolemia, or hypertension, orlistat treatment also led to greater weight loss and reductions in HbA1c, LDL, and total cholesterol (57). In a 2-year trial, Davidson et al. reported less weight regain rates and lower levels of serum glucose and insulin in patients maintained on a 120 mg three times per day dose of orlistat, as compared to those on placebo (54). Participants taking the herbal supplement had a significant increase in mean body weight (1.13 kg) compared with those taking a placebo (0.09 kg) at the end of the study. At the end of the study, participants taking the combination bitter orange product had a significantly greater reduction in percent body fat and fat mass and a greater increase in basal metabolic rate than those in the placebo and control groups. In one of these studies, 66 women who were overweight followed a low-calorie diet (designed to produce a 0.5 kg/week weight loss) for 3 months that was supplemented with 5–6 g/day beta-glucan (from oat bran), 8–9 g/day beta-glucan, or no beta-glucan (control) . Several studies have investigated the effects of beta-glucans on blood lipids, blood pressure, and insulin resistance, with weight loss as a secondary outcome. No adverse effects have been found in rats at doses up to 2,500 mg/kg body weight per day , but its safety has not been rigorously studied in humans. Talk with your health care provider about which type of medication is best for you. These include food intake, how much you exercise and your health status. It should be taken as directed by your health care provider. Our goal is to help you make informed decisions about your health and weight loss journey. By the end of this article, you will have a better understanding of OTC weight loss medications. People often have many questions about OTC weight loss medications. However, many OTC weight loss products, especially dietary supplements, do not have to meet the same standards. With the exception of phentermine, phendimetrazine, diethylpropion, and benzphetamine, weight-loss pills are FDA-approved for long-term use, as they help address a dysfunction of the weight regulation system. There are also appetite-suppressing medications approved by the FDA for other purposes that may be prescribed off-label for weight loss. That said, prescription weight-loss pills are meant to be combined with a lifestyle program, like WeightWatchers, which focuses on eating a healthier diet, getting more exercise, and other behavior-change techniques. Before prescribing any weight loss medicine, your doctor will talk you through the benefits and limitations of starting treatment, including any side effects you might get. The Health Encyclopedia contains general health information. Tell your doctor about any other prescription and OTC medicines, vitamins, herbs, and supplements you are taking. If you are thinking about trying an OTC weight-loss product, talk to your doctor first. The risks of over-the-counter (OTC) weight-loss products depend on which one you take. Food and Drug Administration (FDA) is orlistat (Alli). Phentermine works by affecting the central nervous system, leading to appetite suppression and, consequently, weight loss. These drugs are also used to reduce risk of heart attack and stroke. In 2014, it was approved to treat obesity under the brand name Saxenda. Liraglutide was originally approved by the FDA to treat type 2 diabetes. It is an effective weight loss agent with studies observing 6.6–8.6 kg weight loss over 12 months . Orlistat is indicated for patients with a BMI ≥ 30 kg/m2 or ≥ 28 kg/m2 in association with other risk factors (e.g., hypertension, diabetes, hyperlipidaemia) . Orlistat is a selective inhibitor of pancreatic lipase, which thereby moderates the intestinal digestion and absorption of fat, approved for use by both the FDA and EMA. Tirzepatide for weight management is suitable for adults living with obesity and another weight-related health problem.Weight loss of 5% is sufficient to bring about improvements in some weight-related complications see Health benefits of weight loss.In fact, some clinical trials have shown that using weight loss like Mounjaro can result in overall lower blood pressure.Health experts agree that making lifestyle changes—including following a healthy dietary pattern, reducing caloric intake, and engaging in physical activity—is the basis for achieving long-term weight loss 4-7.The side effects include sudden loose stools and oily spotting on your underwear.“Ephedrine can slightly decrease your appetite, but no studies have shown it to be effective in weight loss.For people with cardiovascular risk or certain psychiatric conditions these products can be unsafe.But we agreed on a plan where I will check in with her often so she can monitor my progress and any side effects I may have.Match your choice to your medical history and lifestyle, use a trial period to test effectiveness, and consult a clinician when in doubt. It blocks the body from taking in some of the fat from foods you eat. It is half as strong as prescription orlistat (Xenical). The only over-the-counter weight-loss product approved by the U.S. Stimulant-based OTC fat burners can cause small, short-term increases in metabolic rate or brief weight changes, but long-term evidence is weak and variable. Still, it is unsettling to learn that a widely used, FDA-approved medication demonstrates serious safety concerns. That said, people taking lorcaserin are advised to stop taking it and contact the doctor who prescribed it for guidance on next steps. They can have serious, often dangerous side effects. In clinical studies, the Wegovy pill helped people lose a significant amount of weight when combined with a nutritious diet and routine exercise. But your healthcare professional could also prescribe a different pill, such as metformin or topiramate, for off-label use in weight loss. Prescription-only pills that are FDA approved for weight loss are summarized below. Weight-loss pills are a convenient needle-free option for people who need help losing unwanted body weight. You’ve likely heard all about the importance of a nutritious diet and routine exercise when it comes to achieving your target body weight. It found people taking tirzepatide for type 2 diabetes lost as much as 12 pounds more than people taking a 1-milligram dose of semaglutide for 40 weeks. Exenetide is the oldest of the GLP-1 agonists approved to treat type 2 diabetes. While insurance generally covers GLP-1 agonists for diabetes control, it's less common when they're prescribed for weight management. But that's not a side effect of Ozempic -- any quick weight loss can cause those changes. Side effects of orlistat Newer medications, which may be safer than earlier drugs, have expanded the options for treating obesity.At one year, some medicines may support around 5% weight loss and others may support around 15%, however the response to the medicine varies between people.Several new weight-loss drugs are making waves in clinical trials.NICE and MHRA approved medicationsDoctors wrote more than 18 million prescriptions for phentermine and fenfluramine in 1996.While insurance generally covers GLP-1 agonists for diabetes control, it's less common when they're prescribed for weight management.Another important reason to be cautious with OTC weight loss medications is the lack of strict regulation for some products.With its easy access and weight-loss promises, is Alli your answer for losing weight? As long as orlistat has successfully helped in reducing weight by 5% or more after three months, there's no restriction on how long it can be used for. It is only recommended in people over a certain body mass index (BMI). Remember, orlistat prevents only some of the fat that you eat from being absorbed (just under a third). Please see the leaflet that comes with your medicine for a full list of possible side-effects and cautions. You may have fatty smelly stools, urgency to get to the toilet, oily spotting on your underwear, and excess wind. Low-dose orlistat (60 mg) is also available to buy over the counter in pharmacies, based on pharmacists' clinical judgement. Orlistat isn't suitable for everyone who wants to lose weight. In order to lose weight you still have to eat less and exercise regularly. Prescription injectables like semaglutide (injectable) and tirzepatide (injectable) often show larger average weight loss, but injectables require medical oversight and are not always accessible. Those investments aim to provide clinicians and users clearer information about who might benefit most from an oral supplement versus a prescription treatment. Tonum has invested in human clinical trials and transparent reporting as part of the brand’s mission to bridge nature and science. Tonum combines research-backed supplements with coaching and telehealth to increase the odds that a product’s trial results map to real-world success. Amanda Raffoul, a specialist at the Harvard T.H. Chan School of Public Health and Boston Children’s Hospital who works to prevent eating disorders, told The 19th that critically, this research is the first summary of the existing research on adolescents use of non-prescription weight loss aids. Diet pills and supplements were the most commonly used non-prescription weight loss aid, followed by laxatives and then diuretics. The report, an analysis of English-language research, noted that teenage girls in North America were the most likely group to have used these so-called weight loss aids, and pointed out that these tendencies — and the mindset driving them — raise the risks for eating disorders and overall harm to physical and mental health. This story, first published by The 19th, examines new research on the prevalence of non-prescription weight loss pills among teen girls. Lower-dose versions of these same active ingredients, known respectively as Victoza and Ozempic, have been used for years to help people with diabetes control their blood sugar levels. Like Ozempic, Mounjaro (tirzepatide) is another popular medication that has been used off label to help with weight loss. Off-brand versions of these drugs have been seen at compounding pharmacies across the U.S. These medicines work in the kidneys where they help take extra sugar out of the blood that then goes out of the body in urine. More common side effects often improve after taking the medicine for a while. As with any medicine, there is a risk of side effects when taking a GLP-1 agonist. Lower blood sugar helps control type 2 diabetes. Between 1980 and 2015, a mounting prevalence of obesity was recorded at the global level (5). According to the latest statistics of the World Health Organization, more than 1.9 billion adults (aged or older than 18 years) were overweight and around 650 million were obese. In the modelling studies, a manageable number of the key health states and the state transitions were structured to capture the disease progression. Pharmacological therapy is recommended as a second-line alternative to reverse obesity. Here, a look at how they work, what the science says about efficacy and safety, and information about potential side effects. In fact, some of these products can have scary health consequences, such as liver damage or heart trouble. Read on to learn more about how weight-loss pills work. Change in weight was -12.8%, -14.7%, and -3.2% with tirzepatide 10 mg, 15 mg, and placebo, respectively. In SURMOUNT-2, adults with BMI ≥ 27 and A1c 7-10% on stable anti-diabetic therapy, either diet and exercise alone or oral antihyperglycemic medication for at least 3 months were randomized to tirzepatide 10 mg, 15 mg, or placebo for 72 weeks (109). The mean weight change was -15.0%, -19.5%, -20.9%, and -3.1% with tirzepatide 5 mg, 10 mg, 15 mg, and placebo, respectively. The FDA approved the first GLP-1 agonist, exenatide, to treat type 2 diabetes in 2005. They're more likely to be covered if you need the drugs for an added purpose, like reducing your heart disease risk. Following a healthy diet and staying physically active can help. They should be used as part of a comprehensive weight loss plan, which includes lifestyle changes. However, it is important to remember that even prescription medications are not a magic solution. However, a massive obstacle in developing treatment guidelines remains the lack of prolonged studies monitoring the long-term safety and efficacy of obesity medications. "I have a lot of weight to lose, and I want to try an over-the-counter diet aid. I'm not technically obese, but my weight is definitely not healthy. I've tried to make healthy eating and exercise work, but I think I need more help." Orlistat has been proved to help people lose weight.1 It works by preventing fat absorption, so that the fat you eat moves through your intestines undigested. Your doctor is not likely to recommend that you use an over-the-counter diet aid in your efforts to reach a healthy weight and stay there. The more fat you eat, the worse the side effects are, so it's best to limit fat while you are taking this drug. Current GLP-1 agonists approved for weight loss include Wegovy, Zepbound and Saxenda. GLP-1 agonists are the most effective medications for weight loss. See what health experts have to say about Ozempic for weight loss The addition of medications like orlistat, which are FDA-approved and has an established safety profile, is not only helpful for initial weight loss but also its maintenance. Grabarczyk found that, after 20 weeks of treatment, patients receiving orlistat experienced a 2.1% decrease in weight from baseline, those receiving phentermine-topiramate 4.1%, phentermine alone 3.6%, whereas only 1.6% weight reduction was reported with MOVE! PubMed database was searched using the keywords “pharmacotherapy”, “weight loss”, “FDA-approved”, “orlistat”, “phentermine-topiramate”, “naltrexone-bupropion”, “liraglutide”, and “semaglutide”. There are many products for weight loss that you can buy without a prescription at drugstores and supermarkets and over the Internet. Choosing a sensible approach to weight loss They don't include expenses that are merely beneficial to general health. “There are many factors related to social determinants of health contributing to these differences.” Without insurance, semaglutide and tirzepatide medications can cost about $1,000 a month or more. “Some of these minority populations bear the biggest burden of obesity,” says Lu, who is also an assistant professor of biomedical informatics and data science at YSM and of chronic disease epidemiology at Yale School of Public Health. The SCALE Maintenance aimed to evaluate weight maintenance in non-diabetic participants who underwent a ≥4-week run-in with a low-calorie diet. Liraglutide was approved base on the results of three main RCTs; The SCALE Obesity and Prediabetes, the SCALE Diabetes and the SCALE Maintenance 58,60,61. Liraglutide (Saxenda®) is an injectable glucagon-like peptide 1 (GLP-1) derivative that was approved by the FDA in 2014 for weight management (dose, 3.0 mg subcutaneous SC daily). Common side effects of phentermine/topiramate ER include insomnia, paresthesia, dizziness, dry mouth, dysgeusia, and constipation . Topiramate, a gamma-aminobutyric acid agonist, glutamate antagonist, and carbonic anhydrase inhibitor, was approved for the treatment of epilepsy and prophylaxis of migraines . In studies, women lost about 5% to 10% of their initial body weight over a year on prescription weight-loss drugs. "The drugs prompt the body to produce more insulin after eating, limiting the elevation of blood sugar levels after meals, something particularly crucial for people with type 2 diabetes," says Dr. Caballero. A recent trial, funded by Eli Lilly, the company that makes tirzepatide (Mounjaro), found that around half of participants with both obesity and type 2 diabetes lost around 15% of their body weight on the medication. “We now have a generation of very effective weight loss drugs,” says Craig Primack, MD, an obesity medicine physician with Scottsdale Weight Loss Center in Scottsdale, Arizona. Both are appetite suppressants and both can lead to weight loss. Eating fruits, veggies, and whole grains, along with lean proteins, is a winning strategy for health and weight management. Weight loss drugs aren't the only way to curb your appetite. How to choose an over the counter weight loss medication thoughtfully The drug is a stimulant, and is thought to help with weight by suppressing the appetite. Still, for people with significant weight issues, the risk is worth the reward. Generally intended to be taken with meals, orlistat has been shown to inhibit absorption of as much as 25 to 30 percent of the fat content in any given meal. In rare cases, some people may have an allergic reaction to the drug, or be at risk for a dangerous buildup of lactic acid in the bloodstream. I know that I'm overweight because of some bad habits I've developed. I've tried to make healthy eating and exercise work, but I think I need more help. They may be helpful as you make important health decisions. Stay on top of latest health news from Harvard Medical School. 25 Gut Health Hacks is yours absolutely FREE when you sign up to receive health information from Harvard Medical School. Get the latest in health news delivered to your inbox! (Semaglutide is given weekly, while liraglutide injections are done daily.) Semaglutide prescribed for diabetes is now also available as a daily pill called Rybelsus. Studies have shown that, on average, orlistat, plus a weight-reducing diet and exercise, causes more weight loss than a weight-reducing diet and exercise alone. One way to help with weight loss is to reduce the amount of fat in your diet. These were originally developed to treat type 2 diabetes, but are increasingly used for weight loss treatment as well. Weight-loss products marketed as dietary supplements are sometimes adulterated with prescription drugs or controlled substances. Weight-loss supplements, like all dietary supplements, can have harmful side effects and might interact with prescription and over-the-counter medications. These treatments are aimed at diverse molecular targets in the CNS and/or periphery and, in some cases, at several targets simultaneously. Compared with other agents, adverse effects are limited, but include diarrhoea, flatulence, bloating, abdominal pain and dyspepsia (Bray and Greenway, 2007). Weight loss is relatively modest circa 3 kg at 12 months (Li et al., 2005), but of sufficient magnitude to have beneficial effects on cardiovascular risk, as reflected by a lowering of low-density-lipoprotein (LDL) cholesterol, blood pressure and glycaemia (Broom et al., 2002; Torgerson et al., 2004). A substance that binds to the same receptor as an agonist, but its effects vary as a function of the presence (antagonist action) or absence (inverse agonist action) of the agonist. They’re legit health conditions, and not entirely in your control Foods high in protein and fiber can help suppress your appetite, as can exercise, sleep and other healthy habits They can give you a better understanding of the many options available to treat obesity.” “Specialty training in obesity for doctors began in 2007. You can restrict your calories for several years, but your body is always trying to push you back to that dysfunctional set point. I was all set to start using a diet aid, but my doctor talked me out of it. But we agreed on a plan where I will check in with her often so she can monitor my progress and any side effects I may have. I plan to use an over-the-counter diet aid. Tirzepatide is also a GLP-1 medication approved for weight loss. Research done as part of the drug's approval process for treating type 2 diabetes found people lost as much as 21 pounds over 10 months. The FDA approved it for type 2 diabetes management in 2022 and for weight control in November 2023. It can also improve or reverse weight-related health conditions like high blood pressure, diabetes, joint pain and sleep apnea.” “Research shows that losing just 5-10 percent of body weight can dramatically improve your health, so losing those extra pounds offers more than just a cosmetic reward. Their promise of percent weight loss is enticing to those who haven’t had success with diet and exercise alone,” says Dr. Khaitan. “GLP-1 medications like Wegovy and Ozempic are a relatively new addition to the weight loss toolbox. For many years, patients struggling with weight loss were told that success simply required more willpower – eat less, exercise more and the weight would eventually come off. If side effects are unpleasant people may stop taking the medication early, or miss doses, reducing its effectiveness. Weight loss medicines differ in how much weight loss they can help you with. Your BMI is an estimate of your body size and is calculated using your height and weight. However, according to a meta-analysis of 12 vitamin D supplementation trials (including 5 in which body composition measurements were primary outcomes), vitamin D supplements without calorie restriction did not affect body weight or fat mass compared to placebo .Over-the-counter (OTC) weight loss medications are products that people can buy without a prescription to help them lose weight.Choosing safely depends on your health profile, medications, and goals.Fat absorption blockers, such as Orlistat, allow you to lose up to 6 pounds (2.7 kg) or 3% of your weight.However, having healthy lifestyle may help to prevent or reduce weight regain.Prescription-only pills that are FDA approved for weight loss are summarized below.For instance, in patients with tachycardia or hypertension, phentermine/topiramate and NB should not be considered. When given a high dose weekly, people without diabetes can lose about 15 percent of their body weight, on average, after nearly 16 months. Ozempic is the brand name for the drug semaglutide; Wegovy, also semaglutide, has a higher maximum dose and is approved for weight loss. It’s the first time doctors have had obesity drugs that work so well, she says, approaching weight-loss levels previously seen only with bariatric surgery. For example, Medicare — one of the largest insurance programs for older adults — does not cover these drugs for weight loss, impacting many who could benefit from them. These medications have shown promise in clinical trials and are increasingly being used for weight management. They Suppress Appetite As summarized in Table 3, cost-utility analysis (CUA) is the major type of assessment method among all the included studies, with quality-adjusted life year (QALY) as a proxy of the health outcome (51–58, 61–64, 66–69). In another assessment of the cost-effectiveness of SEMA 2.4mg injection in a Canadian setting, the therapy showed a favorable ICER at CAD per QALY when compared with diet and exercise under the WTP threshold suggested in the relevant Canadian Guidelines (CADTH) (53). However, in the later study, this combination therapy was found to be not cost-effective relative to orlistat (58). In addition, in the studies on the cost-effectiveness of orlistat, a range of cost-effectiveness thresholds was employed in the probabilistic sensitivity analysis to evaluate the impact of this threshold on the probability of cost-effectiveness of this intervention investigated. The treatment duration either modelled or implemented in most studies normally lasted for around one year. Clinical trials are an important part of the process by which new drugs become available. Prescription weight loss drugs don't work for everyone. That kind of weight loss can lead to other health improvements like lowered blood pressure, blood sugar, and some blood fats, and can improve joint pain and sleep apnea. Doctors are studying new treatment strategies to help people lose weight and to stay at a healthy weight. Other drugs similar to phentermine that may be an option include benzphetamine, diethylpropion, and phendimetrazine. Why are so many Aussie adults overweight? If you have type 2 diabetes, it may take you longer to lose weight using orlistat, so your target weight loss after 3 months may be slightly lower. It's important to remember that as you lose weight your body needs less food (calories), so after a few months, weight loss slows and levels off, even if you continue to follow a diet. These diets can lead to rapid weight loss, but they are not a suitable or safe method for everyone, and they are not routinely recommended for managing obesity. In that subsequent study, published in the New England Journal of Medicine, 12,000 people with overweight or obesity and cardiovascular disease (CVD) or risk factors for CVD took either lorcaserin or a placebo. It's also important for other areas of your health to be monitored including your waist measurement, cholesterol levels, blood pressure, nutrient levels and overall health. It may also depend on the dose of the medicine that works best for you without getting side effects. Different types of medicines may suit different people's needs. This may lead to weight loss. But, if needed, medication is another way to help promote weight loss. Still, some internal or external factors may be driving you to try to lower your body weight. Using electronic health records from across 280 health care systems in the United States, Yale researchers discovered that only 3% of eligible adults have received a prescription for these weight loss medications. While weight-loss drugs can be helpful, the overall weight loss achieved is limited for most people. Also, you should know that the FDA has cracked down on some weight loss supplements that had prescription drugs in them that weren't noted on the label. Most people regain the weight after they stop taking the medicine unless they have made lasting lifestyle changes. About 6 pounds (3 kilograms) or up to 6% of body weight can be lost when using this medicine. There have been reports that they may have had dangerous side effects in people who took bitter orange alone or combined with other stimulants such as caffeine. Natural Medicines says that bitter orange is "possibly unsafe" when taken by mouth as a supplement, and there's not enough evidence to know if it works for weight loss. After the FDA banned weight loss products containing ephedra, many makers switched to bitter orange, but it's not clear if it's safer. It could provide a welcome alternative for people who do not want injections. The first, orforglipron, is an oral GLP-1 inhibitor that completed a Phase 3 clinical trial in early 2025. Novo Nordisk is developing an oral version of semaglutide (50 mg)specifically for obesity. The little blue pill might help with physical arousal, but there are better treatments for low libido in women Lifestyle changes can bring a slight metabolic boost and health benefits And the one thing you can do to turn diabetes around Appetite suppressants are usually approved for use by adults based partly on their body mass index (BMI), a measure of their weight in relation to their height.Treatment with orlistat should only continue beyond 3 months if you've lost 5% of your body weight.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).Look for randomized, double-blind placebo-controlled human clinical trials.Considering that only a limited number of primary pharmacoeconomic studies on some drugs could be searched, three conference abstracts with relatively sufficient information on their methodological design were also incorporated into the synthesis of information in the current study.The best weight-loss pill for you is one that helps you lose about 5% to 10% of your initial body weight with few or tolerable side effects.If you're taking the oral contraceptive pill and you have severe diarrhoea while taking orlistat, use an additional method of contraception, such as a condom. The SCALE maintenance trial included a run-in period aiming at achieving a least 5% total body weight loss, with a 500 kcal per day deficit diet, based on estimated 24-h energy expenditure. A SR/MA of 6 RCTs on phentermine/topiramate compared to placebo showed a weighted mean difference in total body weight loss of 7.7 (6.6, 8.8) kg, favoring the intervention at 56–108 weeks, with a response that is dose dependent.69 The aim of this manuscript is to review the pharmacologic management of obesity in adults, suggest an algorithm for the treatment approach of excess weight, and describe potential drugs that are currently under investigation. Fat traveling through your digestive system can cause unpleasant side effects. Alli has little effect on your entire body. Fat that isn’t absorbed is passed through your body and eliminated in your bowel movements. Lipases break down the fat in the food you eat. Rare cases of severe liver injury have been reported in people taking orlistat, but it's not certain that the drug caused those problems. Contrave is a combination of two FDA-approved drugs, naltrexone and bupropion, in an extended-release formula. Under the brand name Zepbound, it's approved to treat obesity, while under the brand name Mounjaro, it's approved to treat type 2 diabetes. Medical weight management remains one of the options for the treatment of excess weight and recent advances have revolutionized how we treat, and more importantly how we will be treating obesity in the near future. Parents and teachers can play a critical role in intervention by making sure they help actively guide conversations about body ideals and weight loss by empathizing with the deep desire many girls have to look a certain way and acknowledging the amount of pressure they receive to do so. “I don’t think people fully understand the depth of the harm of this behavior, and the ongoing use of dangerous weight loss practices in girls is one example,” she said. “If you open up any social media platform and do any sort of quick search for content related to weight loss or related to health and wellness, you’ll very quickly come across promoted content or advertisements for weight loss supplements,” Raffoul said.