While it’s true that GLP-1 medications, like Ozempic and Wegovy, can make you lose weight, it’s not wise to run to your nearest pharmacy. These medications work best when you also eat healthy foods and get regular physical activity. Most people lose about 1–2 pounds per week while taking weight loss medicines, and sometimes even more. Your body makes more insulin when you take these medications. They also lower blood sugar in people with diabetes. Due to the demand for these medications to help with weight loss, pharmacies have experienced a surge in prescriptions that has outstripped supply. Ozempic and Mounjaro are drugs which originally were formulated to help people manage their diabetes. Someone who had tried to get weight loss drugs to help with their lipoedema was unable to get them from their consultant or their GP and talked about the impact of having to give up entirely. People told us that access to weight loss drugs was the only way they would lose enough weight to have a vital operation, and they were making big financial sacrifices to afford a private prescription. The medication is contraindicated in patients with uncontrolled hypertension, history of cardiovascular disease, or untreated hyperthyroidism. Phentermine/topiramate ER leads to treatment discontinuation for adverse effects, with an NNH of 10 (95% CI, 7 to 16). Phentermine/topiramate extended-release (ER; Qsymia) and naltrexone/bupropion ER (Contrave) are effective oral medications to consider if glucagon-like peptide-1 agonists are contraindicated, poorly tolerated, inaccessible, or not preferred. Liraglutide leads to treatment discontinuation for adverse effects, with an NNH of 20 (95% CI, 14 to 30). Although current anti-obesity medications are expected to improve obesity-related complications and cause weight loss, for weight loss maintenance, a strategy that promotes both appetite suppression and energy expenditure is most likely to succeed. Especially recently developed incretin-based drugs semaglutide and tirzepatide result in dramatic reductions in body weight comparable to bariatric surgery (Fig. 1). At least 5% weight loss is required to prevent obesity-related complications, and it is reflected in the guidelines for weight management drugs. Although phase 2 trials have used oral semaglutide at a dose of 40 mg, the Oral Semaglutide Treatment Effect in People with Obesity (OASIS) 1 trial used oral semaglutide at a dose of 50 mg once a day; this dose can cause greater reductions in body weight with a similar safety profile to 40 mg. However, you should work with an obesity medicine specialist to manage your dosage, monitor for side effects, and give medical guidance.Agonists are substances that mimic the actions of certain chemicals in the body—neurotransmitters or hormones—to produce a response upon binding to a specific receptor on a cell."We understand the difficulties of weight loss, and we’re here to support you though your weight loss journey."The semaglutide treatment effect for people with obesity (STEP) program includes five phase-3 trials to evaluate Semaglutide 2.4 mg once weekly for the degree of weight loss, efficacy, and tolerability .If you take insulin for diabetes, let your doctor know before you take phentermine, as you may need to adjust your insulin dose.At 68 weeks, the STEP 1 trial reported a mean WC reduction of 13.5 (SD not available) cm in the intervention group and 4.1 (SD not available) cm in the placebo group (p 82 In STEP 4-Maintenance trial, and after the run-in period, a mean WC reduction of 6.4 (8.3) cm was achieved with semaglutide group and an increase of 3.3 (8.3) cm in the placebo after 68 weeks (p 83 STEP 3- IBT trial showed the same pattern of change in WC as reported in STEP 184 (Appendix D).When you stop taking them, most people will regain some or all of the weight lost over time.The drug is sold under the brand name Xenical as a prescription and Alli as an over-the-counter drug.The medicines can also cause other side effects including gallbladder disease, an increased risk of fracture and possible pancreatitis.Some people qualify for patient assistance programs, coupons, or lower-cost generics when available. The best weight loss pills for women are no different from those meant for men. Prescription weight loss pills available today are Xenical, Contrave, and Qsymia. Some people find it difficult to adhere to the necessary lifestyle and dietary changes, whereas others simply may not respond to the medication. Gastrointestinal adverse effects of orlistat, including oily stools, may act similarly to negative reinforcement, encouraging those on the medication to adhere to a low-fat diet. Common side effects include a fast heartbeat, high blood pressure, trouble sleeping, dizziness, and restlessness. People with a history of certain thyroid cancers or a rare, genetic endocrine disorder should avoid the drugs, because it is not clear if tirzepatide causes thyroid problems, including cancer. Because people feel full longer, they eat less and lose weight. The drugs are delivered through once-weekly injections. They include Ozempic and Wegovy, which are two versions of the same medication, semaglutide. Now, a new drug made by Eli Lilly and Co., called tirzepatide, is poised to become the most potent obesity drug on the market, promising users losses of more than 30 to 50 pounds over time. Typically, your body tightly regulates your body set point just like it maintains healthy blood sugar levels. This is especially true if you’re taking other diabetes medications or insulin. They’re only approved for short-term use for weight loss (up to 12 weeks) because some are amphetamine-based and there’s a concern of addiction. Pharmaceutical treatments offer a new way of helping people with obesity gain a healthier weight and this new pilot will help determine if these medicines can be used safely and effectively in non-hospital settings as well as a range of other interventions we have in place. This next generation of obesity drugs have the potential to help people lose significant amounts of weight, when prescribed with exercise, diet and behavioural support. The £40 million pilots will explore how approved drugs can be made safely available to more people by expanding specialist weight management services outside of hospital settings. There is evidence from clinical trials that, when prescribed alongside diet, physical activity and behavioural support, people taking a weight-loss drug can lose up to 15 per cent of their body weight after one year. There is strong evidence to suggest that obesity management is beneficial for the treatment of T2DM.8 Table 2 summarises the common antidiabetic agents used, based on their effects on body weight. For this reason, the decision by the NHS to roll out access to the diabetes drug tirzepatide (also known by its brand name, Mounjaro) for weight loss was welcomed. Learn about popular GLP-1 medications for weight loss and how Walgreens Weight Management can help you on your weight loss journey. However, in the UK these medications are not available to everyone, making conventional weight loss methods the only option for the majority. That said for some people these medications may be the trigger that helps them implement healthier behaviours, such as increased activity, and improved food choices and portion sizes. Evidence suggests that certain medications may help with obesity, but they are not a magic bullet and no one drug works for everyone. Most weight loss takes place within the first 6 months of starting the medication. Losing weight also can improve some other health problems related to overweight and obesity, such as joint pain and sleep apnea. Weight management medications don’t replace physical activity and healthy eating habits. Similarly, if the medication produces satisfactory weight loss and is well tolerated, it should not be discontinued empirically.Sibutramine (Meridia) was removed after it was linked to heart attack and stroke in people at highest risk for them.The extended observational trial DPP Observation Study showed that the group on metformin maintained 3% weight reduction compared to placebo for 6-15 years after DPP ended (123).In addition to improving blood sugar, this drug also seems to help people lose weight."In fact, people who stop taking these drugs will often regain the weight unless they have truly established a consistent and effective change in their eating and physical activity habits."With fervent consumer demand for weight loss medications, combined with rising obesity rates, more medications are bound for the market in the coming years.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.Learn more about the side effects of weight-loss medications. Some individuals may be tempted to exceed recommended dosages in the pursuit of faster results, increasing the risk of addiction and severe side effects. Common side effects include nausea, headache, and constipation. In rare cases, people have had serious liver injury while taking orlistat. It also frequently causes gastrointestinal side effects such as gas, oily spotting and loose stools. But it’s not as effective as GLP-1 agonists or phentermine-topiramate. Table 1. A summary of anti-obesity drugs for long-term use. Especially when combined with reduced mobility or a decrease in the ability to engage in recommended physical activity (e.g., those with brain dysfunction or injury), hypothalamic dysfunction can substantially contribute to positive caloric balance and increased body fat . Hypothalamic efferent signals to other parts of the brain may affect hunger and appetite, and may affect thermogenesis, energy expenditure, increase blood pressure, and stimulate lipolysis in adipose tissue . Beyond the potential for high fat food intake to promote hypothalamic inflammation , managing obesity due to hypothalamic trauma, surgery, or dysfunction is often challenging. Table 4 describes challenges with past anti-obesity pharmacotherapies. Orlistat is contraindicated in patients with chronic malabsorption syndrome or cholestasis, and in patients with known hypersensitivity to orlistat or to any component of this product. 6.2. Potential Drug Interactions 12,13,44,45,84,85 The prescription medications approved by the FDA for long-term use, along with healthy lifestyle habits, are expected to be effective for controlling obesity over a long period. Before having weight loss surgery, tell your healthcare team (including the anaesthetist) if you're taking liraglutide, semaglutide or terzepatide. However, it appears that if people taking the drugs stop, they regain the weight they lost — and the health problems that came with it. An earlier trial of tirzepatide showed weight loss of between about 15% and about 22% of body weight, or about 35 pounds to about 52 pounds, depending on the dose. It showed weight loss of up to 16% of body weight, more than 34 pounds, when using the highest dose of the drug. "But whether they can be safely used for all people who simply want to lose an extra 10 to 20 pounds is questionable." Thank you for your interest in supporting KFF Health News, the nation’s leading nonprofit newsroom focused on health and health policy. It’s important to note, not everything on kffhealthnews.org is available for republishing. You must credit us as the original publisher, with a hyperlink to our kffhealthnews.org site. Another option is new pills to treat obesity, which will be cheaper than their injectable counterparts. When co-administrated with other therapies, the weight loss effect of cagrilintide is more prominent. Phase 2 studies using ecnoglutide for T2DM showed a 2.26 kg body weight reduction after ecnoglutide 1.2 mg administration (Zhu et al., 2024). There were four reported cases of adjudication-confirmed pancreatitis, which were evenly distributed across treatment groups, including the placebo group. In addition, tirzepatide resulted in significantly lower blood pressure and blood sugar levels and improved lipid profiles compared to placebo (Qin et al., 2024). In November 2023, tirzepatide became the first GLP-1/GIP dual RA approved by the FDA for chronic weight management. Metformin is therefore considered a first line drug in treating patients with T2D and obesity. The extended observational trial DPP Observation Study showed that the group on metformin maintained 3% weight reduction compared to placebo for 6-15 years after DPP ended (123). The average weight loss was 0.1 kg, 2.1 kg, and 5.6 kg in the placebo, metformin, and ILI groups, respectively (P14). In patients without Type 2 diabetes, 38 percent using the drug lost 5 percent or more of their body weight, which is the clinical standard for a successful obesity treatment. Total weight loss for participants in the EQUIP and CONQUER studies ranged from 3.5% to 6.6% for the 7.5 mg/46 mg dose and 8.6–9.3% for the 15 mg/92 mg dose.34,35 SEQUEL, an extension of the CONQUER study, showed prolonged health benefits and greater weight loss in both groups treated with phentermine/topiramate when compared with the placebo group after completing the 52-week extension.26 EQUATE investigated the difference in weight loss for phentermine and topiramate monotherapy compared with the combined treatment. The semaglutide treatment effect for people with obesity (STEP) program includes five phase-3 trials to evaluate Semaglutide 2.4 mg once weekly for the degree of weight loss, efficacy, and tolerability . The company has a patient assistance program for people who qualify. According to the company that makes Victoza, Novo Nordisk, the list price is between about $543 and $815 for a 1-month supply, depending on your dose. Liraglutide has been shown in studies to cause thyroid tumors in animals, but it's not yet known if it can cause thyroid cancer in people. Liraglutide has been shown in studies to cause thyroid tumors in animals, but it is not yet known if it can cause thyroid cancer in people. From a hormone output standpoint, hypothalamic dysfunction may alter hormone release potentially applicable to body composition and body weight, such as corticotrophin-releasing hormone, dopamine, growth hormone-releasing hormone, somatostatin, gonadotrophin-releasing hormone, and thyrotrophin-releasing hormone .Summary of findings and weight reduction in the tirzepatide SURPASS studies for treatment of type 2 diabetes mellitus and cardiovascular disease and SURMOUNT program for obesity.The benefits of tirzepatide on cardiometabolic risk factors was consistent across all trials.Semaglutide delays gastric emptying, which may impact absorption of concomitantly administered oral medications.While also marketed as a resin decades ago in the US, phentermine resin is now almost exclusively marketed outside the US.Together, these mechanisms result inaltered plasma concentrations of certain medications (particularly lipophilicmedications) in obese compared to normal-weight individuals 24, 25.Common side effects of liraglutide are gastrointestinal in nature, including nausea, vomiting, diarrhoea, constipation and dyspepsia, which can be mitigated by gradual dose escalation.Yes, having type 2 diabetes or cardiovascular risks often qualifies for coverage under approved indications. “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. Some weight regain (on average 5-10% at 10 years) is expected in the longer term.43 Additionally, international guidelines34, including a position statement from Diabetes Australia35, recommend consideration of bariatric surgery for individuals with type 2 diabetes and BMI ≥30 kg/m2. Bariatric surgery should be considered as part of a comprehensive multidisciplinary treatment program taking into account the individual’s situation and treatment goals. 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). If you're taking medicine for another serious health condition, such as type 2 diabetes, high blood pressure or kidney disease, it may be necessary to change the dose of your medicine. In a trial, adults who took Wegovy saw a weight loss of nearly 35 pounds, or about 15% of their body weight. The drugs that have drawn the most attention have been a class of medications that activate a hormone known as GLP-1. Here’s what to know about these new prescription drugs that promise weight loss. Tirzepatide and other medications spur weight loss by targeting the metabolic conditions that lead to extra pounds. This will help you avoid gaining weight, and may help you to lose weight. The undigested fat is not absorbed into your body and is passed out with your poo. These types of medicines may not be safe for you and could cause serious side effects. Never take a medicine for weight management if it has not been prescribed for you. All medicines for supporting weight management should be used alongside a reduced-calorie diet and increased physical activity. The SCALE Obesity and Prediabetes reported mean change in lipid parameters at 56 weeks of treatment. In the COR-I trial, HDL-C increased significantly in intervention arms compared to placebo (p Table 2).70 The changes in the COR-II trial followed the same pattern (Table 2).71 The COR-I, COR-II, and COR-BMOD trials report data on HDL-C, LDL-C, and triglycerides after 56 weeks of treatment. Finally, triglycerides dropped only in the high dose arm, while it increased in the low dose and placebo arms (p Table 2).64 In patient with obesity and DM (baseline mean HbA1c of 8.0%), there was a significant decrease in HbA1c by 0.6 (1.3) in NB32 group compared to 0.1 (1.6) in the placebo group, p 73 The liraglutide 3.0 mg SC daily group achieved an additional weight loss of 6.2% (0.2%, placebo) . After 56 weeks, a weight loss of 8.0% was achieved in the liraglutide group (vs. 2.6% of placebo) and 63.2% and 33.1% of the participants in the liraglutide group achieved ≥5% and ≥10% weight reduction, respectively (vs. 27.1% and 10.6% in the placebo group, respectively). The final study, the COR-DM trial, evaluated weight loss in 505 patients with T2DM who were either overweight or obese . Naltrexone was approved for the treatment of opioid and alcohol addiction and antagonizes an opioid-dependent feedback loop that limits the effects of bupropion on the POMC neurons; hence, this drug combination works synergistically . In the EQUIP study, the mean weight loss at 1 year for participants in the phentermine/topiramate ER 15/92 mg group was 10.9%, compared to 1.6% in the placebo group. Orlistat and other health conditions It's important to note that, while phentermine is an FDA-approved drug, it is a controlled substance and so any phentermine-containing product cannot be prescribed via a telehealth provider. Similarly to semaglutide, liraglutide is also a GLP-1 agonist medication that helps to control blood sugar levels. In addition to improving blood sugar, this drug also seems to help people lose weight. In the pursuit of weight loss, some individuals turn to medications to aid their efforts. New drug therapy approvals 2022.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.FDA approves treatment for chronic weight management in pediatric patients aged 12 years and older.Blue Cross Blue Shield coverage for weight loss injections like Wegovy and Zepbound depends heavily on your specific plan, location, and medical criteria.In the 4-year XENDOS study conducted in Sweden, the cumulative incidence of T2D was 9.0% in the placebo plus diet and lifestyle group and 6.2% in the subjects receiving orlistat (24), corresponding to a risk reduction in development of T2D of 37.3%.Bupropion (Wellbutrin), an aminoketone, is considered weight-negative and is prescribed both to assist in weight loss and to treat depression.However, in individuals without coronary disease and with well-controlled hypertension, it is considered safe to use this drug along with regular blood pressure monitoring.For example, it can help prevent and manage more than 20 conditions, such as reducing the risk of type 2 diabetes by 40%. 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. Currently, these medications are administered by injection, but oral weight loss drugs in the same category may soon follow. Prescription weight loss drugs can be an effective treatment for obesity. When studies that measure how a 2-milligram dose of semaglutide affects weight loss in people with type 2 diabetes are analyzed, tirzepatide still comes out on top. Medicare Part D may cover weight loss drugs if they're prescribed to treat another health condition like diabetes. The result of Phase 1 metabolism is the alteration of the parent drug by introducing or exposing a functional group (-OH, -NH2, –SH). The most common CYP450 isoenzyme for drug metabolism is CYP450 3A4. Obesity increases SQ fat and may therefore decrease SQ absorption due to reduced SQ blood flow per unit volume of SQ tissue. If total testosterone is low and free testosterone is normal, then this may be due to a reduction in SHBG due to obesity. For example, semaglutide is over 99% bound to plasma albumin. The specific CYP450 isoenzyme/s responsible for drug metabolism and drug interactions are often listed in the respective drug prescribing information. Once a drug is affixed to a functional group, it usually becomes polar and may be excreted in the urine or bile. Large long-term trials are required to demonstrate the benefit of obesity pharmacotherapy on clinically relevant hard outcomes. In addition to weight and body mass index, only 4 articles included data on metabolic and cardiovascular parameters and adverse events. The higher the dose of the GLP-1 agonist, the greater its effects. That approaches what people can lose with weight-loss surgery. Weight loss on these drugs can be significant. Over the years, the authors of the OMA Obesity Algorithm have represented a diverse range of clinicians, allied health professionals, clinical researchers, and academicians. Beginning in 2013, OMA created and maintained an online Adult “Obesity Algorithm” (i.e., educational slides and eBook) that underwent yearly updates by OMA authors and was reviewed and approved annually by the OMA Board of Trustees. Illustrative potential comparative outcomes for early versus delayed intervention in the evaluation and management of pre-obesity or obesity 84,, , , , , , , , . Like the history of other metabolic diseases, a bias exists among many clinicians that limits pharmacotherapy to treat obesity , , , . However, as before, GIP receptor agonists may enhance some of the favorable effects of GLP-1 receptor agonists when administered concomitantly. After 12 weeks of treatment, one participant had a 20.5 kg weight reduction; while a 51.0 kg weight reduction was recorded for the other participant after 42 weeks of treatment. Setmelanotide is also being evaluated for the treatment of PWS, Bardet–Biedl syndrome, Alstrӧm syndrome, POMC heterozygous deficiency obesity and POMC epigenetic disorders.81 It has received Breakthrough Drug Designation from the FDA for the treatment of obesity related to pro-opiomelanocortin (POMC) deficiency and leptin-receptor-deficient obesity. One pilot study evaluated the use of topiramate at 75 mg daily compared with placebo in adolescents with severe obesity 12–17 years of age. Dose escalations are weekly, and the drug administration is daily via subcutaneous injection.33,55 Liraglutide should not be used in patients who are pregnant, have personal or family history of medullary thyroid carcinoma or type 2 multiple endocrine neoplasia. Treatment guidelines recommend consideration of additional therapies such as pharmacotherapy and bariatric surgery when lifestyle intervention alone has not achieved sufficient weight loss to improve health or quality of life.45678 Overweight and obesity have complex biological, psychosocial and environmental determinants, and are not simply the result of an unhealthy lifestyle.12 Lifestyle intervention, including changes in eating habits and physical activity, is the foundation of obesity management. Treatment guidelines recommend consideration of additional therapies such as pharmacotherapy and bariatric surgery when lifestyle intervention has not resulted in sufficient weight loss to improve health or quality of life. But these medications have risks and side effects. “We try to look for root causes and help them with that, whether that be challenges with understanding a healthy diet, being able to implement it, barriers to exercise, mental health issues or disordered eating. 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. Many insurance companies require that patients be monitored to ensure they are incorporating proper nutritional and exercise behaviors into their lifestyle. Development of anti-obesity medications is following the path of drug development of other metabolic diseases.With most weight loss medications, doctors usually assess your weight at around 6 to 12 weeks.Examples of sympathomimetic amines include phentermine, diethylpropion, phendimetrazine, and benzphetamine.Alli is approved for adults with a BMI over 25, whereas Xenical is approved for those with a BMI over 30 or over 27 with other risk factors like diabetes and hypertension.Funding allocated to each ICB however is fixed for 25-26, doesn’t increase as patients come forward and is not ring-fenced.By choosing an off-label medication to treat overweight and obesity, your health care professional may prescribeTherefore, tirzepatide is likely to be particularly effective in improving obesity and its related complications; clinical trials of tirzepatide’s effects on obesity and obesity-related complications are ongoing.Four medications meet that criterion.This difference is likely, at least in part, due tosubstantially greater weight loss observed individuals who underwent bariatricsurgery compared to lifestyle modifications (mean 21.8% vs. 9.6% at fiveyears). There are no published RCTsthat examined the effect of phentermine on body weight over at least 1 year.More importantly, there is lack of knowledge from RCTs regarding the time-courseof the effects of phentermine on blood pressure and the level of safetymonitoring that might be needed for patients newly prescribed phentermine. With the exception of orlistat, which works by reducing fatabsorption in the gut, all currently approved antiobesity drugs promote weight lossby increasing satiety and decreasing hunger . With the understanding that long-term weight management is imperative forachieving clinically meaningful health benefits, US Food and Drug Administration(FDA) now requires demonstration of weight loss efficacy over a minimum of 1 yearfor approval of antiobesity drugs . As a result, individuals with obesityoften require a greater number of antihypertensive medications to achieveadequate blood pressure control compared to normal-weight individuals, exposingthem to higher risk of adverse effects from medications. Although weight loss medications can be an effective adjunct tolifestyle modifications in individuals with obesity, there is limitedevidence regarding their benefit with regard to blood pressure. Summary: What do those taking or planning to take these medicines need to remember Another type of weight-loss medicine makes it harder for your body to absorb fat. But they may help you make the lifestyle changes that you need to practice to lose weight and improve your health. The other drugs in this group aren't often prescribed. Phentermine by itself (Adipex-P, Lomaira) also is used for weight loss. Some newer medicines, like Mounjaro, also act on a second hormone involved in appetite and blood sugar control. Glucagon-like peptide-1 receptor agonists (GLP-1s or GLP-1RAs) are medicines that help people feel fuller by mimicking a natural hormone released after eating. Progress in pharmacotherapy for obesity. New drug therapy approvals 2022. Always talk with your health care provider before you participate in a clinical study. Because of the risk of addiction or abuse, such stimulant drugs are "controlled substances," which means they need a special type of prescription. You should not take phentermine if you have a history of heart disease, stroke, congestive heart failure, or uncontrolled high blood pressure. Orlistat is the only drug of its kind that's approved in the U.S. Also, take a multivitamin at least 2 hours before or after taking orlistat because the drug temporarily makes it harder for your body to absorb vitamins A, D, E, and K. However, there are much lower rates of sustainedweight loss due to lifestyle modifications than bariatric surgery . Medical management of hypertension, Schiavon et al. found that 84% ofparticipants who underwent bariatric surgery experienced a ≥30% reductionin the total number of antihypertensive medications, compared to 13% ofparticipants randomized to medical management . Considerable weight loss afterbariatric surgery corresponds to high rates of remission of hypertension. Surgical interventions have a more substantial and lasting effect onweight loss than lifestyle modifications. It is not recommended if you're pregnant, trying to get pregnant or breastfeeding or have certain health conditions, such as liver or kidney problems. Most people should get all the nutrients they need by having a varied and balanced diet, but if you are less hungry and eating less food, you may need to take extra supplements. This is because your body may not absorb the contraceptive pill if you have diarrhoea, so it may not be effective. For all other drugs, the results are basedon pooled data of phase 3 RCTs in patients with obesity without diabetes asdrawn from the FDA advisory committee briefing documents .That’s according to a small clinical trial run by Novo Nordisk, so real-life results may vary.Weight loss resulting from dietary modifications with or withoutincreased physical activity has the potential to significantly reduce bloodpressure 34, 35.The manufacturers report making the decision based on Wegovy® being more effective for weight loss.1718 The choice of medication is dependent on individual factors and preferences.When they are successful, they result in an average weight loss of about 5% over a period of six to 12 months.The dose should be increased to 3 mg in increments of 0.6 mg, with intervals of at least one week to improve gastrointestinal tolerability.Like semaglutide, it works by reducing appetite and is meant to be used in combination with diet and exercise to lose weight. Phentermine + topiramate – Also approved in 2012, this drug combination is sold under the brand name Qsymia. Because lorcaserin affects serotonin receptors, it can't be used alongside other drugs with the same target, such as selective serotonin reuptake inhibitors (SSRIs), which are used to treat depression. Approved in 2012, lorcaserin was the first weight-loss drug to get an FDA nod since orlistat. However, the weight loss is likely to be modest. The advancements in technology, a more sedentary lifestyle, along with increased access to high-calorie foods, have become the fundamental cause of the increased prevalence of obesity . Obesity is a global epidemic that is still on the rise, affecting billions of people worldwide . We included only studies pertaining to adult patients that have been published between 2012 and 2022. The medicines can also cause other side effects including gallbladder disease, an increased risk of fracture and possible pancreatitis. Many people will experience gastrointestinal issues that can include nausea, vomiting, constipation, diarrhea and heartburn. Many patients do benefit, particularly in the short term or when surgery is not suitable. Only a small fraction of people who meet eligibility criteria ever receive it. 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 56 weeks, the COR-I trial a mean WC reduction of 5 (10.3) cm with NB16, 6.2 (10.4) cm with NB32, and 2.5 (10.4) cm in the placebo70 (p 71 while the drop in WC was larger in the COR-BMOD trial; mean WC reduction of 10.0 (11.7) cm with NB16 compared to 6.8 (10.9) cm in the placebo arm72 (Appendix D). 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. 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. The optimal dose of liraglutide for weight loss is 3 mg daily; however, to prevent the side effects of nausea and vomiting, treatment should be initiated with 0.6 mg QD and gradually escalated each week by 0.6 mg up to 3 mg . All anti-obesity medications are contraindicated in patients with hypersensitivity to the drug (e.g., anaphylaxis, angioedema), and should not be used in patients with overweight/pre-obesity or obesity who are pregnant or planning to become pregnant. Expanding how to access these innovative new drugs will ensure as many eligible patients as possible have the opportunity to try these treatments if they are right for them to help achieve a healthier weight. Lifestyle modifications with and without weight loss in hypertension The combination of phentermine-topiramate allows minimal side effects with proven efficacy for weight loss. Lei et al. found phentermine-topiramate effective in the reduction of body weight as well as waist circumference, blood pressure, lipid levels, and plasma glucose levels . Special consideration should be given to patients with thyroid disease, blood coagulation disorders, epilepsy, and HIV, as orlistat interacts with some anti-epileptics, anti-retroviral medications, levothyroxine, and warfarin, requiring close monitoring in these patients . You’ll only be prescribed a weight loss medicine by a health professional if you meet certain criteria based on your body mass index (BMI) and any other health conditions you may have. For most overweight people, their body tries to prevent permanent weight loss. Some insurance plans cover weight loss medications, while others don’t. MPs have also heard calls for a longer-term, funded and national obesity strategy to widen access to weight loss medications, alongside behavioural interventions and food industry measures. As the previous story shows, people who can’t access NHS funded weight loss drugs feel they have no option but to go private to access the weight loss drugs that they felt they needed. Rybelsus is also a prescription-only medication licensed for the treatment of type 2 diabetes, however, both Rybelsus and Ozempic are sometimes used unofficially as a weight loss tool. These medications work because their active ingredient, semaglutide, is a GLP-1 receptor agonist – this means it has the same appetite-controlling effects on the body. Find out all you need to know about Ozempic and other weight loss drugs, including the dangers and side effects Does Blue Cross Blue Shield Cover Weight Loss Injections? The Direct Answer The new study found that patients with diabetes — who find it notoriously difficult to lose weight — could shed about 16% of their body weight, or more than 34 pounds using tirzepatide. Researchers have long looked for medications that can help people lose weight, mostly with disappointing and, in some cases, dangerous results. Further studies need to be conducted, preferably clinical trials, to yield statistically significant results regarding efficacy as well as adverse events and safety of anti-obesity medications. The optimal dose of liraglutide for weight loss is 3 mg daily; however, to prevent the side effects of nausea and vomiting, treatment should be initiated with 0.6 mg QD and gradually escalated each week by 0.6 mg up to 3 mg .However, due to its sympathomimetic effects, it should not be used in patients with uncontrolled hypertension.It's released when you eat and tells your body to make insulin to control your blood sugar.The gastrointestinal side effects of orlistat, including fatty/oily stool, fecal urgency, oily spotting, increased defecation, fecal incontinence, flatus with discharge, and oily evacuation (48), are the main reasons for discontinuation of therapy.Some people find it difficult to adhere to the necessary lifestyle and dietary changes, whereas others simply may not respond to the medication.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.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.Some weight loss medications have been on the market for many years, and new ones emerge frequently. 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. A reduction in body weight of 5-10% significantly lowers inflammatory and pro-thrombotic makers, as well as chronic disease incidence (13,14). 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). What is the strongest weight loss prescription medication? Food and Drug Administration (FDA)-approved for use longer than 12 weeks. The use of orlistat in children is only recommended in exceptional circumstances, such as if a child is severely obese and has an obesity-related complication. Read more about the physical activity guidelines for children and young people. Your GP should be able to advise you about a recommended daily limit, and they may also be able to refer you to your local family healthy lifestyle programme. Your health care professional can assess your individual risk caused by your weight. Health care professionals use the Body Mass Index (BMI), a measure of your weight in relation to your height, to define overweight and obesity. Anaerobic exercise, such as weight training, is also good because it adds muscle mass to your body. To keep the weight off, you must eat a healthy diet and be physically active on a regular basis. For about two years, compounded versions of semaglutide and tirzepatide were permitted in the U.S. due to shortages. In April 2025, they banned the sale of “counterfeit” semaglutide and tirzepatide. Some online healthcare providers claim to sell Ozempic, Wegovy, or Zepbound at reduced prices. None are approved for use in someone who is pregnant. These programs apply only to self-pay patientsand are not covered by insurance. The Ultimate Nutrients for Health + Metabolism: Omega 3s 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. Numerous studies show that prescription weight loss drugs are effective when combined with other lifestyle changes. 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. "It is paramount to remember that all weight-loss medications are recommended as an aid in the overall strategy that centers around a healthy meal plan and regular physical activity," 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. The other versions of these drugs—Victoza and Ozempic — are for people with type 2 diabetes. Particularly, biomarkers of acute pancreatitis—amylase and mainly lipase—increase in a non-dose dependent manner during treatment with GLP-1 receptor analogs. Despite initial considerations of the risk of acute pancreatitis, long-term trials suggest that the risk of this disease does not significantly increase with liraglutide 63,64. Particularly, HbA1c (−0.30%±0.28%) and fasting glucose levels (−7.1±0.8 mg/dL) were significantly reduced in subjects administered liraglutide 3.0 mg compared to placebo. Yes, weight loss pills are effective when used as directed and when accompanied by lifestyle changes like diet and regular exercise. There’s no one “best” medication since everyone’s health needs and goals will differ. When starting any new medication, you should be closely supervised by your medical provider to ensure the side effects are tolerable. You'll have a review after taking liraglutide for 3 months.You'll then usually only carry on taking the medicine if you've lost at least 5% of your body weight. 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. VLCDs are usually only recommended if you have an obesity-related complication that would benefit from rapid weight loss. Currently, due to lifestyle changes brought on by technological advancements and the wide availability and affordability of high-calorie foods, millions of people around the world suffer from obesity and/or its sequelae.This is because your body may not absorb HRT while using tirzepatide.In EMPA-KIDNEY, adults with eGFR or eGFR with UACR ≥200 were randomized to empagliflozin 10 mg or placebo (147).Depending on your overall health, some side effects may be more dangerous than the risks of being overweight.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) .People can't go on the drugs for a short amount of time, lose weight, and then promptly stop taking the medication.Furthermore, whether this effect has been driven solely by total body weight loss, rather than a direct effect of the drug per se, and whether it differs between metabolically healthy and metabolically unhealthy individuals with obesity, has been poorly investigated.234 While some available data showed improvement in liver steatosis with GLP1-RA, there is no evidence of reduction in liver fibrosis with any AOM, a parameter that requires longer term studies to show benefit.Even without losing weight, you can be healthier by being physically active and eating healthy foods. 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). Sodium-glucose transport-2 (SLGT2) inhibitors are a class of medications used for the treatment of T2D. In another study with one year follow-up, placebo-corrected weight loss in those taking 120 μg three time daily and 360 ug twice daily averaged 5.6% and 6.8% (132). Efficacy–safety stopping rule That phenomenon goes back to the metabolism of our caveman ancestors when weight loss was a danger. When Wolver works with patients, she performs an extensive evaluation of all the factors that may contribute to their weight issues. “Also, the drugs are not covered by many insurances including Medicare and the cost is $1,300 a month if you are paying out of pocket. Women also need to be on reliable birth control if they're taking these medications. A study on Zepbound showed a more significant weight loss of 21%, “which is substantially more than you can expect to get from lifestyle alone,” Wolver said. Lorcaserin may be asuitable drug for the small percentage of patients who achieve ≥5% weightloss with it in the first 3 months, as these initial responders seem to have agreater chance of continued success. Although there are no RCTs that specifically examined the efficacy ofphentermine/topiramate in patients with obesity and hypertension, data from thesubset of patients with hypertension support its use in this patient population. Furthermore, approximately 8% ofpatients discontinued orlistat in clinical trials due to gastrointestinaladverse effects . Bupropion (trade name Wellbutrin or Zyban) is used for depression and smoking cessation and can cause weight loss as a side effect. The impact of Gelesis100 on the absorption of other medications was investigated only with metformin. The efficacy of Gelesis100 was evaluated in the Gelesis Loss of Weight (GLOW) randomized double-blind placebo-control trial (112). A phase 2 clinical study reported that HRS9531 given at a dose of 6 mg resulted in a 16.8% reduction in body weight from baseline at 24 weeks compared to 0.1% reduction in the placebo group. A preclinical study reported that ecnoglutide reduced blood glucose and body weight and increased insulin secretion significantly more than semaglutide (Guo et al., 2023). Phase 2 studies have used four different doses of orforglipron (12, 24, 36, and 45 mg); at week 26, the mean weight loss from baseline ranged from 8.6% to 12.6% across the orforglipron dose cohorts compared to 2.0% weight loss in the placebo group. The FDA approved the first GLP-1 agonist, exenatide, to treat type 2 diabetes in 2005. It's released when you eat and tells your body to make insulin to control your blood sugar. They're more likely to be covered if you need the drugs for an added purpose, like reducing your heart disease risk. 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. The drug is sold under the brand name Xenical as a prescription and Alli as an over-the-counter drug. Several recent cardiovascular outcome trials have reported positive data on patients with T2DM at high cardiovascular risk. In the cohort that tolerated the combination, further weight loss of 5% (6.7 kg) was observed after a mean duration of 22 months. Liraglutide may be well suited as a weight-loss agent for those at high cardiovascular risk, or with glucose intolerance such as T2DM or pre-diabetes. However, even that modest weight loss can improve your health and reduce your risk of heart disease, stroke, and diabetes. "We now have six FDA-approved drugs, but that is a tiny percentage of the number available to treat hypertension and other chronic diseases, so we need even more options to treat obesity most effectively." GLP-1 is the hormone that semaglutide drugs add to your body synthetically, which makes them so effective. These medications are often prescribed to help manage obesity and related health conditions when lifestyle changes alone are insufficient. Here we focus on the top 10 most commonly prescribed weight loss drugs.