It is also semaglutide, but approved to treat type 2 diabetes. For each individual case, the doctor and patient should discuss the patient’s current health issues, other medications, and family medical history. FDA approves first treatment for weight management for people with certain rare genetic conditions. Weight management medications aren’t for everyone with a high BMI. For example, some medications may help you feel less hungry or full sooner. 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. Your health care professional can assess your individual risk caused by your weight. GLP-1s (glucagon-like peptide-1 receptor agonists) are a class of medications that mimic a natural hormone in the body responsible for regulating blood sugar and appetite. Prescription appetite suppressants – such as phentermine or GLP-1 receptor agonists like semaglutide and liraglutide – can decrease cravings and help promote the feeling of fullness sooner. The weight loss it produces is “profound” and might be a good fit for people with a very high BMI, Levy added. At the one-year point, excess weight loss compared with placebo was 5.3 kg (95% CrI -6.06 to -4.52 kg). Liraglutide is a subcutaneous GLP-1 agonist, which is used daily for the management of diabetes mellitus type 2 and obesity/weight management . Further limitations include the inability to use naltrexone in patients taking opioid analgesics, while bupropion is contraindicated with medications that lower seizure threshold and monoamine oxidase inhibitors. At the one-year point, excess weight loss as compared to placebo was 5.0 kg (95% CrI -5.94 to -3.96). The aforementioned studies suggest that the benefits outweigh the risks of adverse effects by causing weight loss and reduction of weight-related complications when used in an appropriate patient population. Originally, Zonisamide is an anti-seizure medicine, but it can also be prescribed for weight loss because it improves metabolic control and decreases appetite. Overall, it has shown a 3.1% body mass reduction compared to a placebo. It has shown significant results in different studies among overweight adults leading to average weight loss of 19.5% and 20.9% with 10 mg and 15 mg doses. Conversely, there was a trend for an increase in SBP and DBP, in the placebo groups (p 64 At 56 weeks, CONQUER trial reported mean SBP and DBP reductions of 4.7 (13.6) mmHg and 3.4 (9.2) mmHg respectively for the low dose phentermine/topiramate, 5.6 (15.1) mmHg and 3.8 (9.8) mmHg respectively for the high dose phentermine/topiramate, and 2.4 (14.5) mmHg and 2.7 (9.8) mmHg for the placebo group (p 65 The decrease in BP seen in the EQUIP trial was relatively small compared to the changes reported in the CONQUER trial. In fact, the EQUIP trial enrolled normotensive participants while the CONQUER trial recruited a population with hypertension and other cardio-metabolic disorders. At 52 weeks, SEQUEL, the extension of CONQUER trial reported similar changes in SBP and DBP (Table 2).66 In the STEP 3 trial LDL-C level dropped with semaglutide by 4.7%, while it increased by 2.6% with placebo (p Table 2).84 After 56 weeks of treatment, the SCALE maintenance trial showed no significant difference in lipid parameters between treatment arms, except for triglycerides level that did not change in the intervention arm, but increased by 8.86 (44.29) mg/dL in the placebo group (p 0.03) (Table 2).77 Similarly, there was no significant difference in lipid parameters between arms in the SCALE-IBT trial (Table 2).78 Although the changes in HDL-C, LDL-C, and triglycerides were significantly different in liraglutide arm compared to placebo (p 0.001, p 0.002, p 76 The 160-week SCALE extension trial did not report on lipid parameters (Table 2).79 The CONQUER trial showed similar, though larger, effects on lipid parameters after 56 weeks of treatment, possibly due to the addition of lifestyle modifications to all participants. Semaglutide was first approved as a diabetes medication under the brand name Ozempic — the brand name Wegovy is only approved for weight loss. The main weight loss medications approved by the Food and Drug Administration (FDA) include the following. Most weight loss medications are by prescription only, except for orlistat (Alli), which is available over the counter. GLP-1s are a popular class of weight loss medications originally made to treat Type 2 diabetes. While medications may be part of the answer for some, exercise is beneficial for everyone.On average, the trendy GLP-1 medications have helped people lose 12 percent of their total weight.The American Gastroenterological Association performed a systematic review to publish guidelines for managing obesity with medications.A single-arm, open-label, multicenter phase 3 trial of 21 participants aged 6 years and older evaluated the efficacy of setmelanotide for weight loss in patients with POMC deficiency (homozygous or compound heterozygous variants in POMC or PCSK1) or LEPR deficiency (83).Liraglutide – This drug was first approved in 2010 for the treatment of Type 2 diabetes.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. Phentermine/topiramate combination In EQUIP, at 56 weeks, mean WC reductions, were 5.6 (9.8) % for the low dose group, 10.9 (10.3) % for the high dose group, and 3.1 (10.3) % for the placebo group (p 64 Similarly, at 56 weeks, CONQUER trial reported a similar pattern in the drop in WC65 (Appendix D). The range of mean BMI was 37.8–38.4 kg/m2.82, 83, 84 For STEP 1 trial, the mean age of all participants was 46.0 years, and 74% were women.82 The STEP 1 trial included individual counseling sessions every 4 weeks to help with the adherence to a reduced calorie diet of 500 kcal deficit and an increased physical activity prescription of 150 min per week. Topiramate acts on the hypothalamus and the hippocampus, as shown in animal models39 and the nucleus accumbens, in a proof-of-concept study for the treatment of alcohol dependence, not for weight management.40 GLP-1, glucagon-like peptide-1; HCl, hydrochloric acid. That’s why developing healthy eating and exercise habits should be part of your treatment plan, too. The weight can come back if you stop the medication. Weight loss medications are relatively new. Thorough knowledge of side effects, precautions and contraindications of these medications is essential and we caution against their prescription by practitioners without expertise in obesity management. Analysis of randomised controlled trials (RCTs) indicates weight loss at six months of 3.6 kg, compared with placebo.9 More recently, phentermine 15 mg was shown to induce a weight loss of 4.5 kg over placebo after six months of therapy (Table 1).10 Phentermine is available in a slow-release resin preparation in doses of 15, 30 and 40 mg, and given as a single daily dose early in the day. Orlistat, phentermine and liraglutide have been approved by the Therapeutic Goods Administration (TGA) for the treatment of obesity in Australia, and topiramate is an effective off-label agent that is currently available for the management of epilepsy and migraine. It promotes weight loss by inhibiting gastrointestinal lipases, thereby decreasing the absorption of fat from the gastrointestinal tract. Orlistat (trade name Xenical) is approved for adult and adolescent obesity (ages 12 to 16) (48). As discussed below, phentermine in combination with topiramate has been approved for long-term use. Weight loss outcomes reported are based on intention-to-treat or intention-to-treat last observation carried forward analyses from RCTs using the maximum doses of medications for 56 weeks unless otherwise stated (17). The voluntary recall of lorcaserin in 2020 occurred among significant confusion, as long-term data from the CAMELLIA-TIMI 61 trial did not demonstrate an imbalance in adverse events between treatment groups (39,40). At 1 and 4 years of treatment, the XENDOS trial did not report on any glycemic parameter (Table 2).58 The trials that investigated the efficacy of orlistat in patients with overweight/obesity and DM (baseline HbA1c 8–9%) showed a significant decrease in glycemic parameters in participants taking orlistat compared to patients on placebo.59, 60, 61, 62 A 20-week RCT, followed by a 1-year extension, compared increasing doses of daily Liraglutide (1.2, 1.8, 2.4 or 3.0 mg) to placebo or open label Orlistat (120 mg TID).89 After 1 year, all Liraglutide and placebo groups were switched to Liraglutide 2.4 or 3 mg.89 At 1 year, total body weight loss was higher with liraglutide compared to placebo and Orlistat, with a difference in the achieved weight of 5.8 (3.7–8.0) kg and 3.8 (1.6–6.0) kg, respectively, favoring liraglutide; at 2 years, total body weight loss remained significantly higher in liraglutide groups (5.3 kg) compared to the orlistat group (2.3 kg) (p 89 Pooled data from 3 RCTs on weekly semaglutide (2.4 mg) to placebo showed a mean difference in total body weight loss 12.6% (95% CI 10.3–14.8) at 68 weeks, favoring the intervention.86 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 Mean percent (%) weight change reported in the main phase 3 and extension trials of the FDA approved anti-obesity medications. 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. For example, if you don’t have diabetes, you can eat a bag of sugar or eat very little for several days. Who Is Eligible for Weight Loss Drugs Many people who took Wegovy lost at least 5% of their body weight in 68 weeks. As obesity rates continue to rise globally, patients and providers are turning to new treatment options to help manage weight. To achieve and maintain long-term weight loss, you should combine medication with healthy lifestyle changes, including a balanced diet and regular physical activity. It is contraindicated in patients with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2. Side effects include nausea, diarrhea, constipation, vomiting, headache, decreased appetite, dyspepsia, fatigue, dizziness, abdominal pain, increased lipase, and renal insufficiency. Liraglutide is also approved for Type 2 Diabetes, under the brand name Victoza. Liraglutide is a daily injectable medication that acts on hormones that send signals from the gut to the brain to make the patient feel full quicker and decrease hunger signals. It can be easy to overlook first-generation AOMs, but these may be appropriate for some patients, especially when cost is a factor. Progress in pharmacotherapy for obesity. New drug therapy approvals 2022. Overview of weight loss medications He says that the weight range you tend to stay in is your body’s set point. As Dr. Butsch explains, obesity is a chronic disease that needs long-term treatment. In theory, the GLP-1 drugs could potentially affect your kidneys, thyroid and pancreas. What drugs are approved for weight loss? However, lifestyle interventions alone are often ineffective in achieving sustained weight loss.2 This is in part due to the physiological changes and metabolic adaptation that occurs with weight loss and the ongoing influence of factors that contributed to weight gain in the first place, such as appetite regulation.23 It is therefore not surprising that obesity, like other chronic conditions, is not ‘cured’ by the initial phase of treatment (in this case, weight loss), and requires long-term, multidisciplinary management to address the drivers of obesity. Pharmacotherapy is indicated in addition to lifestyle intervention in people with overweight and weight-related health problems, or people with obesity This page summarises the evidence for the use of medications, gastrointestinal devices and bariatric surgery to treat adults with overweight and obesity. Several medications are considered helpful in lowering appetite, such as tirzepatide, phentermine, and liraglutide among others. OTC medications are generally considered mild but it’s still important to consult with a healthcare professional before taking them to lose weight. These medications have side effects, some of which could be severe. Another approved drug, setmelanotide (IMCIVREE), is limited to people who have been diagnosed with one of four specific rare genetic disorders, which must be confirmed by genetic testing. Four of these drugs are approved for adults and children ages 12 and older. It also allows the government’s Medicare Plan Finder to include the information as potential enrollees shop for standalone Part D prescription plans and Medicare Advantage coverage. The long lead time for Part D participation allows plans to include GLP-1s in their drug coverage lists, update their computer systems and fine-tune their marketing before next year’s open enrollment Oct. 15 to Dec. 7. Get the latest health tips and articles delivered directly to your inbox. It also isn't for people who are pregnant, may become pregnant or are breastfeeding. Weight loss medications Only prescribes compounded semaglutide injections. Prescriptions administered by licensed health care providers. If you continue the same habits you had before, you could find yourself gaining weight back. This ensures that it is not a rogue online pharmacy and complies with all telehealth pharmaceutical regulations. For instance, Sesame charges $65 a month without the cost of medication and Ro charges $145 a month without medication, plus a $99 enrollment fee. But new weight loss drugs may be just what you need to accomplish your health goals. A new drug which works by suppressing appetite (a similar response to our current weight loss programmes) has been found to reduce bodyweight by up to 20% in major international trials. Typically, patients on a GLP-1 medication will lose 10-20% of their body weight. Gastrointestinal side effects were reported with semaglutide and discontinuation of treatment due to side effects was reported to be higher than with placebo in one trial (3.4% with semaglutide vs 0% with placebo) . By using CONTRAVE along with healthy habits, like daily walks, Jennifer was able to see results.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.You want to be certain that the provider you’re working with only gives out weight loss medications with a prescription.Your body makes more insulin when you take these medications.Numerous studies have reported low mortality rates, such as 0.1% in an Australian national registry of patients,45 and 0.03% to 0.2% in US studies.55 Defined adverse events (unplanned readmission, intensive care admission and re‐operation; death) at 90-days post-surgery are reported in 3.6% of procedures in Australia.45 Reduced gastric capacity may result in gastrointestinal side effects such as vomiting, reflux, and pain upon eating.56 Dumping syndrome, while rare and more common after bypass procedures, can be particularly problematic with symptoms including abdominal cramps, diarrhoea and hypoglycaemia.“Our main goal is to get people healthy and not necessarily to lose weight.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). Thus, taking orlistat with each meal prevents the absorption of all the fat from the food into the body. The drug is a lipase inhibitor, meaning it works to prevent the action of a pancreatic enzyme called lipase, which breaks down fat in the small intestine. Orlistat is meant to treat obesity in conjunction with a low-fat, low-calorie diet, according to the FDA. Usually the side effects improve with time, then you may be able to increase the dose if needed. Ozempic and Rybelsus may be prescribed off-label to help with weight loss. It is also prescribed in a lower dose, as Ozempic or Rybelsus, to help patients with type 2 diabetes manage their blood sugar. Semaglutide, prescribed as Wegovy, is FDA-approved to treat obesity. It is approved for long-term use to treat type 2 diabetes. The improvement in HFpEF symptoms may be mediated by weight-independent mechanisms and measurable via reductions in N-terminal pro–B-type natriuretic peptide (NT-proBNP)(101). There were also significant improvements over placebo in SBP, triglycerides, C-reactive protein and physical functioning scores. Conducted in Japan and South Korea, STEP 6 diversified the eligible population by enrolling adults with BMI ≥ 27 with at least two weight-related comorbidities or BMI ≥35 with at least one weight-related comorbidity. All patients received standardized counseling for diet and lifestyle modification. AThe mean weight change in the orlistat group is in kg not in percent (stripped bar charts). The grey color represents placebo arms; the red color represents intervention arms. "Off-label" refers to when a doctor uses a medication to treat a condition or symptom that it wasn't originally made for or officially approved for. You should always discuss a drug’s side effects with your provider before taking it. Ignore the jokes about celebrities and influencers using these drugs to keep their famous frames. The long-term use of these drugs is coupled with a reduced-calorie diet and regular physical activity. The Success by Sesame program is just $99/mo., including access to medication for eligible patients, ongoing provider support, unlimited messaging & more. The efficacy of any weight loss medication depends on various factors, from the mechanism of action to individual health specifics. If you qualify for weight loss medication, your clinician will write a prescription and send it digitally to a local pharmacy. Most commonly prescribed weight loss medicines, such as phentermine, liraglutide, and tirzepatide, have been subjected to intense testing to measure their safety. Whether weight loss medication is “worth it” depends on your health goals, medical needs and commitment to lifestyle changes. In Phase 2, participants lost up to 24.2% of body weight at 48 weeks. Setmelanotide is a melanocortin-4 receptor agonist indicated for chronic weight management in adult and pediatric patients six years and older, with obesity due to certain rare genetic disorders. 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. Is Saxenda® covered by my insurance? The once-weekly injection from Novo Nordisk combines cagrilintide, an amylin analog, with semaglutide — the active ingredient in Ozempic and Wegovy. Both of them work at the level of the pancreas and at the level of the brain and other organs in the body,” adds Jay, who has also done consulting work for Novo Nordisk. She's also co-author of a new book about obesity with Oprah Winfrey, called "Enough." “Not everybody responds to GLP-1,” she tells TODAY.com. Clinicians are still hesitant to prescribe these medications due to concerns about adverse events, but this approach should be reconsidered, as obesity should be treated as a disease with an individualized management plan for the individual patient. Moreover, having clear guidelines would likely help ensure insurance coverage of those medications when obesity is the sole indication. For those who can tolerate semaglutide, it can be added to behavioral therapy and diet modification for achieving and maintaining significant weight loss in the obese/overweight population. Semaglutide is a long-acting GLP-1 receptor agonist that is administered subcutaneously once weekly for the management of diabetes mellitus and has been shown to also induce weight loss . Perhaps one of the reasons contributing to the treatment inertia in commencing or continuing pharmacotherapy to treat obesity is the concern regarding long-term adverse effects, especially cardiovascular and mental health safety. Despite the efficacy of pharmacotherapy in producing weight loss, drugs used for weight loss are often discontinued. Whenever possible, medications chosen should promote weight loss or be weight neutral. There is significant variability in individual responses, with regard to weight loss, to these medications. Treatment with pramlintide (up to 240 ug three time daily) for 16 weeks resulted in a placebo-corrected reduction in body weight of 3.7% (P131). 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). After an average follow-up of 2.8 years, patients in the metformin group achieved greater weight loss than placebo but less than the ILI group. Percentage losses of initial body weight for subjects completing 24 weeks were 5.0%, 7.2%, and 10.1% for placebo, bupropion SR 300, and 400 mg/d, respectively (113). Tirzepatide (trade name Zepbound) is approved for the treatment of obesity (BMI ≥ 30) or overweight (BMI ≥ 27) with at least one weight-related comorbidity. But despite adopting these lifestyle changes, many still struggle to maintain a healthy weight. It's essential to discuss potential side effects with your healthcare provider to make an informed decision. These benefits can reduce the risk of obesity-related conditions like heart disease and type 2 diabetes. This can be especially beneficial for those with slow metabolisms, making weight loss more achievable. These prices don’t include the cost of the GLP-1 medications.It can help weight loss by making you less hungry.Weight loss medications help with weight loss.Dr. Butsch recommends going to a healthcare provider specializing in obesity.This is possible when these weight loss medications are in shortage as determined by the FDA.Rossner et al. found that subjects receiving orlistat lost significantly more weight in the first year of treatment, and fewer regained weight during the second year of treatment, than those taking placebo (52).We can prescribe medicine to help you to lose the extra weight — providing it’s suitable for you.They can give you a better understanding of the many options available to treat obesity.” These medications target different aspects of weight regulation – such as appetite control, fat absorption, and metabolic rate – that may help patients manage their weight more effectively. Some people might tolerate amylin analogs better than GLP-1 drugs, or the new option could help people overcome a weight-loss plateau, Jay notes. 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. GLP-1 drugs now account for more than 7% of all prescriptions in the U.S., according to Truveta Research, a health data company. Some medications also help you feel fuller sooner. Saxenda is a long-term medication that makes your body feel full. This medication can be used for extended periods, but patients taking the medication must be on a low-fat diet in addition to taking the medication. Some patients struggle to lose weight while taking Wegovy or Ozempic. Are they the game-changers they're touted to be in the realm of weight loss? Additional contra-indications for specific medications are described in Table 1. Lisdexamphetamine is FDA approved for moderate and severe binge eating disorder.160 The AOM suggestions for patients with history of medullary thyroid cancer, pancreatitis, seizures and opioid users take into consideration AOM contra-indications, as described in Table 1. Phentermine/topiramate, NB and liraglutide were investigated in patients with depression. For instance, in patients with tachycardia or hypertension, phentermine/topiramate and NB should not be considered. A pooled analysis of liraglutide phase 2 and 3 trials showed no difference in the incidence of depression and anxiety, but a potential increased risk of suicidality ideation.121 Of people taking CONTRAVE lost at least 5% of their body weight vs 18% with placebo On average, people taking CONTRAVE lost 3.7% (or 8.5 lbs) of their starting body weight vs 1.7% (or 4 lbs) of body weight lost by the placebo group Participants were overweight (body mass index of 27 or greater), had type 2 diabetes, and had not been able to reach a blood sugar level below 7% with oral antidiabetic medications or diet and exercise alone. Of people taking CONTRAVE lost at least 10% of their body weight vs 7% with placebo 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). A single-arm, open-label, multicenter phase 3 trial of 21 participants aged 6 years and older evaluated the efficacy of setmelanotide for weight loss in patients with POMC deficiency (homozygous or compound heterozygous variants in POMC or PCSK1) or LEPR deficiency (83). The primary endpoints were percent change from baseline body weight and the proportion of patients achieving at least a 5% reduction in body weight. If an individual does not lose 5 percent of body weight after 12 weeks on the highest dose, phentermine-topiramate should be discontinued due to lack of response. A two-year extension of the CONQUER trial was published (SEQUEL) demonstrating mean placebo-subtracted weight loss of 7.5% in the mid-dose group and 8.7% in the maximum-dose group (63). Drugs prescribed for weight gain, cosmetic purposes, fertility, hair growth and treatment of sexual or erectile dysfunction also aren’t allowed to be covered. If the federal Food and Drug Administration (FDA) approves a different GLP-1 called orforglipron that’s now being studied to treat type 2 diabetes and obesity, it also will be about $350 a month. On Nov. 6, the White House announced that leading GLP-1 manufacturers Eli Lilly and Novo Nordisk will lower prices for the popular medications when they’re purchased through Medicare. “Today’s announcement builds upon our … goal of democratizing access to weight-loss medication, which has been out of reach for so many in need,” says Dr. Mehmet Oz, CMS administrator. All signs point to the future of weight loss drugs continuing to grow along with demand. Yes, you can buy weight loss medication over the counter, but the only FDA-approved pill available is Alli. Current trials underway for GLP-1 oral pills find they’re equally as effective for weight loss as injectables and many patients like the ease of a pill over an injection. Choosing a weight loss medication should only be done under the guidance of a licensed health care provider who can provide oversight and help you compare the benefits and drawbacks of each option. No matter what, long-term success comes from finding the right approach, eating well, staying active, and taking care of your overall health. It’s also important to think about possible side effects and costs since insurance coverage isn’t always the same for everyone. Instead, focus on balanced meals with whole foods, lean proteins, healthy fats, and fiber-rich carbs. 🔹 Find foods you enjoy that also fuel your bodyStrict diets do not last. Consult with your medical provider on the individually chosen initial dosage, any further dosage adjustments, and the duration of treatment. That is why it is advised to discuss that with your healthcare provider. Although Mounjaro and Zepbound have the same main ingredient, their side effects differ to some extent. During the dose-increasing period, the most often reported adverse effects were transient and mostly mild-to-moderate gastrointestinal events. Semaglutide can be used long-term, and several studies have approved its effectiveness. The fourth SGLT2 inhibitor, ertugliflozin, also resulted in about 2kg weight loss over placebo in adults with T2D treated for 26 weeks (136).Brian’s journey included numerous diets, exercise, and trying a GLP-1 medication before he found CONTRAVE.It has performed well in clinical trials, with patients reported as experiencing significant weight loss.People who have a BMI between 25 and 30 are considered to be overweight.Novo Nordisk’s Ozempic and Wegovy have the same underlying product, but they come in slightly different dosages and are approved for different reasons.The combination tablet of bupropion and naltrexone (trade name Contrave) was FDA-approved for weight loss in September 2014.Four of these drugs are approved for adults and children ages 12 and older.When people stop treatment, "rapid weight regain" can happen, a 2026 review of studies found.Learn how the higher dose boosts weight loss results and what it means for patients. The exact neurochemical effects of CONTRAVE leading to weight loss are not fully understood. With support from his doctor, Brian added the medication to his weight-loss plan, alongside healthier eating habits, portion control, and a more active lifestyle. The exact neurochemical effects of CONTRAVEleading to weight loss are not fully understood. Innovators are also exploring peripheral targets outside of NuSH mechanisms that do not rely on anorexigenic effects to mediate weight loss. Orforglipron is a small molecule GLP-1RA that has also demonstrated about 15% weight loss in a phase 2 trial (166). None of the identified reviews presented an algorithm for drug therapy consideration based on the available safety and efficacy data.The most common side effects are nausea, constipation, or other gastrointestinal discomfort.Similar weight loss efficacy was reported in COR-II (25) and COR-Diabetes (68) trials.The reduction in apnea-hypopnea events was more favorable in patients taking phentermine/topiramate compared to placebo; a reduction of 31.5 (19.9) events per hour in the intervention and 16.6 (19.9) events per hour in the placebo (p 0.0084).105They can decrease your appetite, make you feel full or change how your body stores and burns fat.Sesame offers an affordable and comprehensive online weight loss program to help you get started on your weight loss journey.Weight loss treatments and plans we offerCurrently, the only FDA-approved OTC weight loss drug is Alli, which uses a 60-milligram dose of orlistat versus 120 milligrams in its prescription counterpart, Xenical. What are the benefits of weight loss medicines? Interactions may occur during or within 14 days following the use of monoamine oxidase (MAO) inhibitors, sympathomimetics, alcohol, adrenergic neuron-blocking drugs, and possibly some anesthetic agents. Tirzepatide was previously approved to treat type 2 diabetes as Mounjaro, and it goes by that name only in some countries. Like semaglutide, it works by reducing appetite and is meant to be used in combination with diet and exercise to lose weight. Zepbound is approved to treat obesity in adults with a BMI of 30 or greater. All of the medications discussed here are contraindicated for pregnancy. Compounded GLP-1 medications cost less than brand-name equivalents, but they aren't FDA-approved. You usually have an initial assessment where you will review your health history and weight loss goals. A 2024 study found it’s possible to stop weight regain by maintaining regular exercise after your weight loss prescription ends. A study from 2022 states that people gained back two-thirds of the weight they lost a year after stopping semaglutide (Wegovy). You should also check to confirm that the footer of a weight loss medication platform shows that it is LegitScript-certified. And it has a savings card for people without insurance. Retiree health insurance. You can pay out-of-pocket, taking advantage of the lower prices expected to be available on drug manufacturers’ websites linked to from TrumpRx. A global shift toward sedentary lifestyles and higher consumption of processed foods has increased the incidence of morbid obesity, encouraging adoption of innovative and effective fat reduction therapies and medications, thereby driving market expansion. The market is largely expanding due to the growing awareness about obesity-linked health risks, which has led to the growing adoption of precise medication with lifestyle management. Phentermine-topiramate is a combination of a weight-loss drug called phentermine and an anticonvulsant called topiramate. Your health care provider may suggest a weight-loss drug for you in some cases. One 12-week trial compared the effect of phentermine (37.5 mg daily) and orlistat (120 mg TID) combined to Phentermine (37.5 mg daily) and placebo in 51 participants with overweight/obesity. 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. However, several trials investigated the efficacy of orlistat, alone or in combination with Metformin or insulin treatment, in patients with overweight or obesity and DM with suboptimal control. The compliance with the drug administration from the first dose until treatment dissolution was 93% for both orlistat patients and placebo patients,58 and the overall dropout rate was 8%.21, 58 The XENDOS trial did not include patients with DM. 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. Phentermine reduces appetite, and topiramate is a migraine and seizure drug that also affects weight. If you are struggling to lose weight, your doctor may prescribe medication to help. They also look at your weight history, lifestyle, and overall health before making a recommendation. That said, these medications aren’t a shortcut. Eating well and staying active are key to losing weight, but for some people, they’re not enough. Subscriptions include regular health coaching. Offers personalized plans using semaglutide. Online weight-loss clinic focused specifically on women. Includes telehealth consultation with a board-certified doctor, nutrition counseling and a money-back guarantee. GLP-1 prescriptions and support at $129.99/month. Weight-loss medications can be expensive, but the price depends on the drug, your insurance, and the pharmacy you use. Most people start noticing changes within a few weeks to a few months, but the timeline depends on the medication and how your body responds. How much and how fast you lose weight depends on the medication, your lifestyle, and personal factors like metabolism and overall health. Prescription weight-loss medications can help, but results vary for everyone. In the SCALE Obesity and Prediabetes trial, at 56 weeks, the mean drop in HbA1c was 0.3 (0.3) % in the liraglutide arm and 0.1 (0.3) % in the placebo arm (p 76 At 160 weeks from baseline in the Extension trial, the mean drop in HbA1c was 0.4 (0.3) % in liraglutide group, while there was an increase of 0.1 (0.3) % in the placebo group, p 79 The SCALE maintenance and the SCALE-IBT trials reported small changes in HbA1c that differed significantly between arms, favoring the intervention (Table 2).78 Participants weighing less than 91 kg at randomization were prescribed 1200 kcal per day, while a caloric prescription was calculated for participants weighing between 91 and 136 kg by body weight in pounds multiplied by 6. After randomization, Semaglutide group achieved a weight reduction of 7.9 (8.3) % while the placebo group had a weight gain of 6.9 (8.8) % (Fig. 2).83 Dropout rate for both arms was very low of 0.8%.83 STEP 3- IBT trial included 611 participants, mean age 46 years, and 81% were women.84 All participants received a low-calorie diet prescription of 1000–1200 kcal followed by a hypocaloric diet of 1200–1800 kcal, in addition to a physical activity prescription. In STEP 4-Maintenance trial, mean age was 46.0 years, and 79% were women.83 Participants were prescribed a reduced-calorie diet (500-kcal/d deficit relative to estimated energy expenditure) and increased physical activity (150 min/wk) in addition to Semaglutide 2.4 mg weekly for 20 weeks, after which mean body weight of participants dropped by 10.6%. Find out if you're eligible for GLP-1s and get started on your weight loss journey. Metsera, a company that was recently bought by Pfizer, is also investigating monthly GLP-1 and amylin analog drugs. That compares to a 15% average weight loss with a Wegovy injection. Jay believes it will be the next hot thing in the weight-loss drug space. How to buy weight loss medication online But they do not replace the basics of a healthy lifestyle.A large RCT has found that liraglutide 3 mg leads to 5.6 kg (5.4%) weight loss over placebo after one year.19 There were corresponding improvements in cardiometabolic risk factors, including inflammatory markers, glycaemic parameters, blood pressure and lipid levels.They will do this before prescribing weight loss medication.Orlistat is the only medicine of its kind to be approved in the U.S.If more than 5% weight loss is not achieved after 12 weeks of the maximum dose, the weight loss pill should be gradually discontinued.They target the hormones responsible for hunger and satiety, helping you feel full with smaller portions, reducing calorie intake, and making it easier to stick to a healthier eating plan.A 6-month double-blinded placebo-controlled RCT followed by an open-label 6-month extension in 69 adults with obesity demonstrated diethylpropion 50 mg twice a day resulted in average weight loss of 9.8% at 6 months vs. 3.2% with placebo (42).Weight management medications aren’t for everyone with a high BMI.Because orlistat reduces the absorption of fat, it can also impact the absorption of fat-soluble vitamins (A, D, E, and K), so a multivitamin supplement may be recommended when using this medication. “It’s a dysfunction of the complex system that controls body weight, which is largely based on genetics.” Use our handy online calculator to check your body mass index (BMI) and find out if you're a healthy weight Discover the differences between Saxenda vs Mysimba weight loss treatments. Wegovy, the latest weight loss drug, received approval from the Medicines and Health Products Regulation Agency (MHRA) in the UK in September 2021. Our Doctors have put together a useful guide to tell you everything you need to know about the new weight loss drug Wegovy. In this case, when the situation also aligns with medical criteria, a healthcare provider can recommend pharmacological methods. In 2023, 55% of women and 47% of men in the US wanted to lose weight, according to Statista. Speak with your doctor about potential benefits, risks and costs to determine if medication makes sense. After 40 years in law enforcement, Brian entered retirement—and quickly found himself struggling with weight gain. In combination with diet and exercise, CONTRAVE helped him get back to his goal weight. Brian’s journey included numerous diets, exercise, and trying a GLP-1 medication before he found CONTRAVE. Semaglutide also is used to help control type 2 diabetes. Other possible side effects include an increase in heart rate and blood pressure, insomnia, constipation, and nervousness. Phentermine has the potential to be misused because it acts like a stimulant drug called an amphetamine. But researchers haven't found that the drug causes liver injuries. In rare cases, people have had serious liver injury with orlistat. Find out if Wegovy really works for weight loss. Our guide explains the eligibility criteria and how our UK-registered clinicians can support your weight loss journey. Worried about regaining weight after your weight loss journey? These drugs are recommended for people who are obese. This is true for many medications that control other health conditions. “Our natural GLP-1 lasts seconds to minutes in our bodies, whereas the (prescription GLP-1) medications last over a week,” she notes. GLP-1 drugs are available only with a prescription and cost hundreds of dollars a month, while anyone can buy the patches and they may cost less than $1 per unit. GLP-1 drugs mimic a hormone the body produces after eating, which can decrease appetite. Utilizes a highly personalized approach to treatment. Promises a quick process from onboarding to prescription. Offers compounded semaglutide and tirzepatide. Free personalized health coaching with membership. Only compounded semaglutide and tirzepatide available. Continue meeting with your Care Team for regular check-ins while using the WeightWatchers app to build healthy habits. Otherwise, we'll send a prescription to your pharmacy or choice. Take a quick online quiz about your health history to see if you are a potential fit for the program. We also offer medication options included with your membership. Medications require eligibility and prescription. Research on Contrave shows people can lose at least 5% of their body weight on average after 12 weeks. Studies on Saxenda efficacy rates show people lost about 8% of their body weight. Another study in the New England Journal of Medicine found success rates of about 15% of body weight loss. Study participants in the FDA’s 2021 randomized-controlled trials lost an average of 12.4% of their body weight. Common side effects include nausea, headache and constipation. So your provider will need to check your blood pressure regularly at the start of treatment. Bupropion-naltrexone is a combination drug. It affects the way your body absorbs fat. These changes include exercising more, cutting unhealthy foods from their diets, and reducing the total amount they eat. But not everyone loses weight while taking them. Several weight-loss medicines are available in the United States. Sally had previously tried to lose weight with lifestyle interventions, including VLEDs and structured exercise programs, and achieved modest weight loss of 5 kg, which was not sustainable. Her medications included amlodipine 10 mg daily, perindopril 8 mg daily and atorvastatin 40 mg daily. 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. The FDA says compounding pharmacies can step in and make compounded versions of medications during times of shortages. Since the medications are meant to be taken long-term, it can add up. Injectable GLP-1 medications aren't cheap. For example, some are approved by the FDA for up to 12 weeks. Tirzepatide is a dual GIP and GLP-1 receptor agonist that suppresses appetite, improves satiety, and supports metabolic health. With more options available, doctors will be increasingly able to personalize treatments. The once-monthly injection entered Phase 3 clinical trials in March 2025. Amgen is developing MariTide, a monoclonal antibody designed to increase GLP-1 receptor activity while reducing GIP receptor activity. Book an appointment to get your symptoms assessed and obtain a prescription online. Sign up to receive mental health news and tips delivered right in your inbox every month. Approved in 2022, it is considered a beneficial weight-loss solution, as supported by several studies. Sustainable weight is fully possible when proper habits are in place.It is important to get advice from your doctor depending on your unique needs. However, it’s important to create long-lasting habits that improve overall well-being and help maintain the results achieved while taking medication. Weight loss of 5% to 10% of your starting body weight may help improve your health by lowering blood sugar, blood pressure, and triglyceride levels. Your health care professional may prescribe a medication to treat your overweight or obesity if you are an adult with Prescription medications to treat overweight and obesity work in different ways. Most of these medicines are designed for people who weigh 20% or more above what is ideal for their height and body type. Another type of weight-loss medicine makes it harder for your body to absorb fat. Improving healthcare infrastructure and access to specialty care are enhancing diagnosis and treatment rates. New-generation GLP-1 drugs and their demonstrated clinical effectiveness are propelling market growth across the region. Prescription weight loss medication may be an option to help you lose weight and keep it off when diet and fitness alone are not effective. This article will examine topiramate’s efficacy as a weight loss drug, how it works, and what to consider before taking it. Only Wegovy is specifically approved for weight loss. Discover how clinically-proven weight loss medication can help you achieve your weight management goals for just $99/mo. It is also available in prescription medications like Adipex-P and Lomaira. In the STEP 1 trial, these gastrointestinal side effects occurred more often in those receiving semaglutide vs. placebo (74.2% vs. 47.9%). 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). In March 2024, semaglutide 2.4 mg received FDA-approval for the treatment of CVD in adults with preexisting CVD and obesity or overweight. In addition, it's likely the weight will be regained when the medicines are stopped. She discontinued liraglutide six months ago because of cost constraints. Sally was unable to tolerate higher doses because of gastrointestinal side effects. She had a past medical history of obesity, hypertension, dyslipidaemia and polycystic ovary syndrome. The unease is understandable given the safety issues that have led to the withdrawal of anti-obesity agents in the past (eg fenfluramine, sibutramine, rimonabant). You want to be certain that the provider you’re working with only gives out weight loss medications with a prescription. According to one report, Qsymia is actually the most cost-effective medication among semaglutide and other weight loss medications, at $134 for a month’s supply. When you take weight loss medications, you can more successfully lose weight if your treatment plan includes an exercise and nutrition plan. Originally approved for Type 2 diabetes under the brand name Mounjaro, tirzepatide was renamed Zepbound as a medication for weight loss. Consult a healthcare provider who will assess your medical history, general health, and weight loss goals. Safety is dependent on a number of factors, such as specific medications, medical history, and adherence to the treatment plan. Because of that, weight loss medication should not be used during pregnancy. Topiramate, a medication mainly used for seizures and migraines, is also helpful in weight loss. For Semaglutide, SUSTAIN trials in patients with diabetes mellitus showed that efficacy is preserved regardless of age.155 The COR program included only 2% of participants from the elderly population,156 and the XENDOS included none. In older patients and those with co-morbidities and polypharmacy, the choice of AOM needs to account for the availability of safety and efficacy data in this specific population, and the potential interaction with other drugs (Fig. 3). All obesity treatment guidelines recommend pharmacotherapy, in addition to lifestyle modification and behavioral therapy, when BMI is ≥30 kg/m2, or ≥27 kg/m2 in the presence of comorbidities related to excessive weight.10,140, 141, 142, 143, 144, 145, 146, 147, 148, 149 Lifestyle modifications are the first line treatment for all. The FDA has recently granted tirzepatide a Fast Track designation to investigate its effect as a treatment for individuals with obesity or overweight with metabolic co-morbidities.139 A recent trial sequential analysis exploring the optimal dose of tirzepatide in patients with DM, showed a dose dependent effect on glycemic control and weight reduction, without a significant increase in the rate of adverse events with higher doses.131 Interestingly, pooled data from SURMOUNT-1 and SURPASS clinical trials programs showed a significant relative risk reduction in major adverse CV events and CV death, by 48 and 49% respectively, with Tirzepatide, compared to control.132 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. But both experts say not everyone needs to lose that much weight. In a phase 2 trial, 320 patients with biopsy proven non-alcoholic steatohepatitis (NASH), using the definition of the NASH Clinical Research Network, were randomized to receive semaglutide (0.1, 0.2 or 0.4 mg daily) or placebo.104 Histologic findings at 72 weeks showed that the proportion of NASH resolution was higher in semaglutide groups, and the highest proportion 59% reported in the 0.4 mg semaglutide group and only 17% of the placebo group (p 104 However, there was no difference in the fibrosis parameters between groups.104 Whether total body weight loss, rather than the intervention per se, is responsible of the beneficial impact of NASH still needs further investigation.104 In a 6-month trial in 170 Chinese patients (76% with nonalcoholic fatty liver disease (NAFLD)), orlistat (at a dose of 120 mg TID) compared to placebo showed no difference in liver enzymes levels, but a higher drop in liver fat, measured by MRI, in the orlistat arm, compared to placebo (mean difference in total fat of 4%, drop of 5.5% in orlistat and drop of 2.0% in the placebo, p 96 The treatment effect remained significant even after adjusting for total body weight loss.96 Conversely, in another RCT, the effect of orlistat on liver fibrosis parameters, assessed by the fibrosis-4 index and NAFLD fibrosis score, was studied.97 The fibrosis-4 index did not show a significant decrease after 12 weeks of treatment with placebo (p 0.959) or orlistat (p 0.510). According to clinical trials looking at different weight loss drugs, patients can expect to lose 5% to 15% of their starting body weight. Several medications prescribed for conditions other than obesity have been found to be effective weight loss drugs in patients with obesity. Weight loss medication may not be prescribed to pregnant women, women who are trying to conceive, or women who are breastfeeding. You should also tell them about your health history. Let them know if you have a history of drug reactions or if you have any drug allergies. We need a more proactive approach to treat obesity, especially for those who are clinically severely obese, with a focus on psychological, physical and metabolic complications. The low uptake of all effective therapies beyond lifestyle interventions for weight management would be unacceptable for other chronic diseases. Indeed, we have a responsibility to provide appropriate care for these common complications of obesity. Pharmacotherapy currently plays a major role in managing diseases of dysregulation, including hypertension, type 2 diabetes mellitus (T2DM), dyslipidaemia and cancer. Approval of the first AOM, desoxyephedrine, in 1947 led to the development of a number of amphetamine derivatives for weight loss that have all since been removed from the market due to this amendment (34). As with other chronic metabolic diseases, the initial management of overweight and obesity emphasizes sustainable nutritional, physical activity, and behavioral changes that have been shown to reduce weight and lower cardiometabolic risk. The Global Burden of Disease study reports that overweight and obesity are the fourth leading risk for global deaths, and more than 4.7 million adults die each year as a result of overweight or obesity (6). The AOMs reviewed in this chapter include the FDA-approved medicines for chronic weight management, FDA-approved medicines for short-term use of weight management, and off-label use of medicines that have demonstrated benefits for weight control. Similar in approach to other chronic diseases, AOMs are indicated in combination with lifestyle modification for the management of overweight and obesity. “We now understand obesity isn’t a character flaw,” says W. “Frustration” is probably the mildest (non-swear) word to describe the feeling when the scale doesn’t budge or after you gain back lost weight. And safety means checking your weight from time to time. PrivateDoc can help you lose weight and keep the weight off for good. Find support from our team, ask for advice from like-minded people and join live sessions with PrivateDoc. The following are medicines currently approved by the FDA for weight loss. Prescription weight-loss medicines are only for people who have obesity. The surge in telehealth services has further improved accessibility to weight loss management across diverse population groups. North America held the largest market share in 2025 due to key drivers such as the rising prevalence of obesity, highly advanced healthcare infrastructure, and rapid adoption of novel therapeutics that support long-term weight management. All weight loss medications work best in the context of a healthy eating plan and exercise. In a Phase 2 study, the medication showed up to 20% average weight loss at 52 weeks for people with obesity or overweight. With fervent consumer demand for weight loss medications, combined with rising obesity rates, more medications are bound for the market in the coming years. Nevolat is a once daily self-injectable pen used for weight loss. It contains semaglutide, a medication that helps control appetite and reduce food cravings. Wegovy is a once-weekly self-injection used for weight loss. Mounjaro is a weekly self–injectable pen used for weight loss. We provide simple instructions on how to take your treatment, and will follow up with advice and support on how to manage your weight. Tell your health care provider about all the medicines you take, including prescription, over-the-counter medicines, vitamins, and herbal supplements. Saxenda® may help adults with obesity and some children aged with obesity, and some adults with overweight (excess weight) and weight-related medical problems, lose weight and keep it off. We encourage you to discuss alternative treatment options with your health care provider and to work together to adjust your care plan appropriately. Because these drugs are on the FDA shortage list, they are able to be compounded. “A long time ago you only saw thin people in magazines and on television before the movement that emphasizes body positivity. Several trials have been conducted to study the effectiveness of this medication to induce weight loss when added to lifestyle modification. Patients can benefit greatly from the weight loss effects of liraglutide, and its use should be promoted in the appropriate patient population. Liraglutide is especially beneficial in overweight or obese diabetic patients as it has also been established as an effective therapy for better glycemic control in type 2 diabetics as an adjunct to oral anti-diabetic medications and/or insulin . Consider whether the cost, side effects, and the small weight loss you can expect are worth it to you. About 6 lbs (3 kg) or up to 6% of body weight can be lost when using this medicine. The amount of weight you are likely to lose with these medicines varies greatly from as little as 5 to 10 pounds (lbs) (2 to 4.5 kilograms kg) to 20% of your body weight or more. While weight-loss medicines can be helpful, the overall weight loss achieved is limited for most people. Three months after surgery, Sally lost 20 kg (18.5% of her body weight). Always consult with a healthcare professional before considering any weight loss injection, as they can help determine which one is most suitable for your specific needs and closely monitor any potential side effects. It’s crucial to consult with a weight loss clinic before starting any weight loss medication to determine which one is suitable for your specific needs and to closely monitor potential side effects. It’s important to note that these are general guidelines and the decision to prescribe weight loss medication is ultimately at the discretion of the healthcare provider. Anti-obesity medications for special conditions identified from clinicaltrials.gov. Several ongoing trials investigate the role of FDA approved AOM in patients with obesity and specific conditions (Table 4). Randomized controlled trials have shown that topiramate is both tolerable and effective in promoting weight loss (61). Dapagliflozin was recently approved by the FDA for the treatment of heart failure in individuals with or without T2D based on the results of the DAPA-HF trial (142). The fourth SGLT2 inhibitor, ertugliflozin, also resulted in about 2kg weight loss over placebo in adults with T2D treated for 26 weeks (136). In the landmark EMPA-REG CVOT, average placebo-subtracted weight loss of about 2 kg was maintained out to 220 weeks with empagliflozin 25 mg (135). Remember that losing weight and keeping it off is a lifelong effort. You must continue these healthy habits even after you stop taking the medicine. But once you stop taking them, the weight you lost may come back. Prescription weight-loss medicines can help you get off to a good start. Rapid urbanization and lifestyle changes are contributing to higher obesity incidence, expanding the addressable patient base. In addition, widespread awareness campaigns and routine screening are supporting early intervention and sustained treatment adherence across the region. Improved patient awareness and diagnosis rates are accelerating early treatment initiation. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox.