Your doctor will want to know about any side effects you have. Sometimes the side effects are mild and go away over time. Some medicines are more likely to cause side effects than others. If you don't lose weight within 4 weeks after you start the medicine, it probably won't help you. People taking Orlistat lost 5-10% more weight over 6-12 months compared to lifestyle changes alone in studies. Our pharmacy team offers guidance to help you integrate these tablets into a comprehensive weight management plan safely and effectively. These tablets help block some of the fat you eat from being absorbed by your body, which is then eliminated in your waste. Let's explore some of the safest options backed by research to reach your weight goals. While no single solution is right for everyone, choosing an evidence-based treatment as part of a comprehensive wellness plan can set you up for sustainable success. Second, when the maximal therapeutic effect of a drug is achieved, a plateau will be reached. The decision to initiate drug therapy in an obese individual should be made after the risks and benefits are considered. Weight loss is extremely challenging to achieve and sustain, and long-term management of obesity often requires adjunctive pharmacological interventions. Only 2% of obese adults who are eligible for obesity pharmacotherapy receive prescriptions for these agents from their doctor . Similarly, SGLT-2 inhibitors combined with a GLP-1 agonist caused a greater weight reduction than individual administration of each agent . Some weight loss medications are meant for short-term use only. While most people may lose weight on these medications, there are other factors at play. Other medications, such as Ozempic, may be prescribed for weight loss although that's not the intended use. It typically takes about 8 to 12 weeks to notice weight loss with Qsymia. But it’s also commonly prescribed off-label for weight loss. Topiramate (Topamax) is an oral medication that’s FDA approved to treat seizures and migraines. The label includes warnings from both phentermine and topiramate labels but interestingly does not include all of the contraindications of the phentermine label. Benzphetamine, a category III drug, is another older sympathomimetic drug that is still in use but apparently less often used than diethylpropion or phendimetrazine. In the 2012 survey, 63% of surveyed physicians used diethylpropion in an average of 18% of their patients and 60% used phendimetrazine in an average of 20% of their patients. There is an extensive literature on the effects of ethanol and a wide variety of stimulants in animals and humans. Nor do such discussions differentiate between hedonic drug liking versus drug liking because of medical benefits. Participants on tirzepatide experienced significantly greater improvements in SBP, DBP, fasting insulin, fasting glucose, A1c, LDL cholesterol, HDL cholesterol, and triglycerides compared to placebo. The benefits of tirzepatide on cardiometabolic risk factors was consistent across all trials. From week 36 to week 88, participants lost an addition 5.5% with tirzepatide and gained 14.0% with placebo. A post hoc analysis showed that the proportion of participants who increased anti-diabetic therapy intensity decreased in the tirzepatide arms and increased in the placebo arm. A1c was equally reduced by 2.1% with both tirzepatide 10 mg and 15 mg vs 0.5% with placebo. NHS Digital Weight Management Programme It initially showed promising results in clinical trials. Oral Wegovy (semaglutide) tablets started the trend in December 2025, and orforglipron may be next in line. Fortunately, new weight-loss pills are emerging as alternative options to injectable glucagon-like peptide-1 (GLP-1) receptor agonists. They can have serious, often dangerous side effects. The body mass index or BMI predates the bathroom scale by more than half a century, but it has not changed with the times. OTC orlistat will be manufactured by GlaxoSmithKline under the name Alli and is indicated for use in adults ages 18 years and older along with a reduced-calorie, low-fat diet, and exercise program. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see a listing of the legal entities that insure or administer group HMO, dental HMO, and other products or services in your state). Clinical Review BoardAll Ignite Healthwise, LLC education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals. Learn about lifestyle habits to help you prevent or manage type 2 diabetes But not everyone loses weight while taking it. The different weight-loss medicines are described below. Some of these supplements can have serious side effects. However, the drug is also often prescribed off-label to moderate weight loss. This injectable drug was also originally approved to manage type-2 diabetes by lowering blood sugar levels (under the brand name Victoza). As a result, some doctors have prescribed dapagliflozin as an off-label treatment for weight loss. Although both drugs are generally well-tolerated, side effects of bupropion can include anxiety, irritability, restlessness, dry mouth, heart palpitations, trembling and trouble sleeping. It is administered via once weekly subcutaneous injection at doses of 2.5, 5, 7.5, 10, 12.5, and 15 mg. A narrative review of RCT and real-world data found no compelling link between semaglutide and thyroid cancer (103), and a systematic review and meta-analysis further concluded there was no increased risk of any cancer with semaglutide (104). In rodents, semaglutide was found to cause thyroid C-cell tumors, but no human cases have been linked to semaglutide use. Like liraglutide, semaglutide is contraindicated in the setting of a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2. 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). While the main trials of FDA approved AOM excluded participants with mental illness, the EQUIP, CONQUER and SEQUEL included 16–22% of participants with a history of depression or on anti-depressant medications, suggesting the potential safe use of phentermine/topiramate in this specific population.64, 65, 66 The change in triglycerides differed between arms, with a ratio of change over baseline of 0.78 for patients taking semaglutide compared to a ratio of 0.93 in patients on placebo (Table 2).82 The STEP 4 maintenance trial reported mean percent changes in lipid parameters at 68 weeks of treatment. In patients with obesity and DM (mean baseline HbA1c 8.1%), there was a drop in HbA1c by 1.5–1.6% in semaglutide arms, and by 0.4% in the placebo arms.85 There was no significant difference between semaglutide doses.85 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. Eli Lilly's diabetes drug Mounjaro is viewed as a better treatment than Novo Nordisk's Ozempic, he noted. While new competitors and lower-cost pills could allow drugs to reach more patients, access will largely depend on how companies like Novo Nordisk and Eli Lilly choose to price their drugs in the years ahead. While some experimental drugs are further along than others, all are likely years away from hitting the market, and their competitive potential will depend on future data showing their effectiveness and how well patients tolerate them. Although there is a widespread presumption that phentermine abuse is common, actual phentermine abuse is not common and appears limited to the use of the drug as a stimulant among people trying to stay awake and those trying to boost their energy level. It is common knowledge among obesity medicine practitioners that obese patients with attention deficit often experience clinical improvement when treated with phentermine, particularly if they are not currently being treated for their attention deficit. The prevalence of overweight and obesity in patients with attention deficit is high, perhaps as high as 30%,26 and patients with this combination frequently present at weight management clinics. 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). 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). 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. Metreleptin also resulted in a significant decrease in 24-h energy expenditure, by 5.0% (121 (152) kcal/day; p 0.006) and 7.9% (190 (272) kcal/day; p 0.04) at 2 weeks and 6 months, respectively, compared to baseline.32 It also resulted in a reduction in lean body mass of 2 (10) kg (p 0.005) at 6 months compared to baseline.32 In a post-hoc analysis combining data from 4 studies, it appeared that individuals with very low leptin levels at baseline could possibly respond to Metreleptin with a reduction of their body weight. We included in our manuscript 46 original RCTs (including landmark phase 3 trials and other trials in individuals with obesity (with or without comorbidities), assessing various cardio-metabolic parameters) and 8 SR/MAs on FDA-approved AOM. Medicare does not cover Wegovy or other weight loss drugs, and many insurers follow Medicare's lead. But, the drugs aren't intended for cosmetic weight loss. Prescription medications may also enhance weight loss results for some. By doing this, you can achieve your weight loss goals and improve your overall health. For lasting weight loss, using OTC weight loss meds with healthy habits is key. Side effects may lessen as your body becomes accustomed to the medication. GLP-1 medications can lead to GI side effects like nausea and bloating in about half of users. Remember, following the guidelines for OTC weight loss medication administration is key. It works on the same targets in the body as Ozempic, plus an additional target.Sympathomimetics, such as phentermine (Adipex-P, Lomaira) and diethylpropion, are taken as oral pills.Together, we’ll build an individualized plan and work to achieve your weight loss goals.FDA approves treatment for chronic weight management in pediatric patients aged 12 years and older.These healthy changes include eating a balanced diet and moving more each day.In 2016, its extended released (XR) form (once daily QD 20 mg of lorcaserin) was approved by the FDA following twice-daily (BID) 10 mg of lorcaserin in 2012.Some experts and analysts believe they could fundamentally shift the market, helping more patients access treatment and alleviating the supply shortfalls of existing injections.Or when new data shows that a medication can effectively lower body weight.US physicians treating obesity, well aware of these statuary boundaries, continued to use phentermine and the other sympathomimetic amine anorectic drugs off-label long-term (personal communication; WL Asher, Denver, Colorado, USA, May 2011). It can help weight loss by making you less hungry. To keep off extra weight, you should make these healthy changes a way of life. Some people may need more exercise than this to lose weight and keep it off. You can list a healthy action that you'll use to lose weight. This sort of program generally lasts eight to 16 weeks (although it can be longer) with weight loss of 1.5–2.5 kg a week – and should be supervised by a doctor or dietitian.In situations like these, weight-loss medications may be beneficial.Whatever the theoretical explanation, doses higher than 37.5 mg/day have been found effective and safe in a number of observational studies.6,14,15,19–23The protective effects of these drugs are so striking that, given current evidence, Lu believes the benefits outweigh potential negative side effects that the drugs might confer, such as nausea, vomiting, and stomach pain.Over-the-counter (OTC) weight loss medications can help in managing weight, but they should be used wisely.Ozempic belongs to a growing class of medications known as glucagon-like peptide-1 (GLP-1) agonists.That means Eli Lilly's treatment is absorbed more easily in the body and doesn't require dietary restrictions like Novo Nordisk's does. Diet pills and surgery can help with weight loss when combined with a healthy diet and physical activity. 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. 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. For instance, in patients with tachycardia or hypertension, phentermine/topiramate and NB should not be considered. As for the NAFLD fibrosis score, a significant increase was seen in placebo treated group (p 0.025) compared to a non-significant decrease in orlistat treated group (p 0.715), suggesting a potential protective effect with orlistat, yet not confirmed.97 The main limitation of the study was the lack of liver biopsy data, considered the gold standard method to evaluate liver fibrosis.97 After 56 weeks, the COR-I trial reported minimal reductions in SBP and DBP in the NB and placebo groups (p 70 The reported changes in the COR-II trial were similar in magnitude.71 The COR-BMOD trial didn't assess for changes in SBPs or DBPs (Table 2).72 Related Weight Loss guides After April 15, the 4 mg dose will increase to $199 per month. Per Wegovy, the out-of-pocket cost is currently $149 per month for the 1.5 mg and 4 mg doses for those paying out of pocket. Like the injectable version of the GLP-1 drug, the new pill form still requires a doctor’s prescription. Higher doses of 9 and 25 mg will also be sold. EMERGING ANTI-OBESITY MEDICATIONS UNDERGOING CLINICAL TRIALS Older AOMs also have indications based on BMI and may be contraindicated for use with certain other medications. Bupropion (Wellbutrin), an aminoketone, is considered weight-negative and is prescribed both to assist in weight loss and to treat depression. Desipramine, nortriptyline, and protriptyline have variable effects on weight. Weight-positive medications in the tricyclic antidepressant category include amitriptyline, doxepin, and imipramine. It was a randomized, double-blind, placebo-controlled, multicenter, parallel group trial conducted between January 2014 and June 2018 in the US, Canada, Mexico, the Bahamas, Europe, South America, Australia, and New Zealand. This withdrawal came after the FDA's reviewing data from the Cardiovascular and Metabolic Effects of Lorcaserin in Overweight and Obese Patients – Thrombolysis in Myocardial Infarction 61 (CAMELLIA-TIMI 61) clinical trial to evaluate the risk of CVD problems . More importantly, it significantly lowered the risk of type 2 diabetes mellitus (T2DM), compared to placebo (6.2% vs. 9.0%), over 4 years . Common side effects of orlistat include fatty/oily stools, increased defecation, fecal urgency, and flatus with discharge. Today, it remains the longest licensed antiobesity drug for long-term use and is available over the counter (Alli®). You can lose weight without exercise, but it's harder to do. To lose weight, you need to lower the total calories you take in from food and drinks. You set action goals so that you can make healthy changes. You can list a healthy outcome that you aim to have. Those conditions include heart disease and type 2 diabetes. Be sure you understand the side effects of weight-loss medicines. Your body may not absorb important vitamins, minerals, and other nutrients from food while you are using orlistat. Many people regain most of the weight within 2 years after they stop using it. 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 . Five drugs—orlistat, lorcaserin, liraglutide,phentermine/topiramate, and naltrexone/bupropion—are currentlyapproved for weight loss therapy in the United States. 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 . We found evidence that all the drugs analyzed such as orlistat, phentermine/topiramate, naltrexone/bupropion, liraglutide, and semaglutide appear to be effective in inducing weight loss, with the suggestion that semaglutide may have superior efficacy. Reach out now to speak with one of our professionals about the right weight management options for your life and body. Once approved, have treatments quickly delivered discreetly to your door. Our online assessment determines if prescription weight loss pills are right for you. We provide proven medications like Orlistat and the expertise to use them safely along with lifestyle changes. Sleep Lean is an all-natural product that promotes quick and healthy weight loss.Each of these medications has pros and cons to consider.Patient preferences based on tolerability markedly affect adherence and can cause poor adherence or discontinuation, thereby negating the treatment effects 13,14.This is because your body may not absorb the contraceptive pill if you have diarrhoea, so it may not be effective.In addition, heart rate was higher on average in the survodutide group than in the placebo group (le Roux et al., 2024).The trials look to find new ways to prevent, detect, or treat disease and improve quality of life.In addition, co-administration of GLP-1 and glucagon increased energy expenditure, supporting the concept of a dual GLP-1/glucagon RA as a possible therapeutic for obesity (Cegla et al., 2014).If you have a history of pancreatitis, make sure your healthcare team is aware. Development of new drugs to combat excessive adiposity has been very slow and there have been prolonged delays in approval of new drug by the US Food and Drug Administration (FDA). US physicians have turned to off-label drug use in their effort to care for increasing numbers of patients with excess adiposity. The global pandemic of obesity and overweight now affects between 2.8 and 3.5 billion of the world population and shows no signs of abatement. The label suggests the drug not be used in pediatric patients aged 27 and as old as 88 years.23 Surveys indicate that the average phentermine dose employed in the USA is about 60 mg/day, and that some physicians have used up to 112 mg/day. Current treatment recommendations for attention deficit call for a starting dose of amphetamine of 0.3 mg/kg/day, then titrating up, if needed, to a maximum of 1.0 mg/kg/day. The phenomenon referred to may be related both to intra-species variability of drug metabolism and dose–time induction of more rapid drug metabolism. Treatment with orlistat should only continue beyond 3 months if you've lost 5% of your body weight. With the advent of highly effective nutrient-stimulated hormone therapies (NuSH) (e.g., semaglutide, tirzepatide) achieving weight loss thresholds of ≥15% necessary to resolve comorbid diseases, a new generation of AOMs have arrived to significantly shift the trajectory of the obesity epidemic. Whenever possible, the clinician should consider alternatives to medications known to cause weight gain (163), or should consider measures that would ameliorate the weight-gaining effect of the prescribed drug. When evaluating a patient with obesity for the first time, the clinician should perform a thorough review of all current prescription and over-the-counter medications to investigate for potential weight-gaining medications. Topiramate (trade name Topamax) is an antiepileptic agent that has been found to reduce body weight in patients with a variety of disorders including epilepsy, bipolar disorder, and binge eating disorder (153). And, it’s only approved for adults, so children can’t take it. At this time, Contrave is only prescribed as a brand-name medication. A healthcare professional may be more inclined to prescribe Contrave if you experience emotional eating. You gradually increase your dose during the first month of taking it. FDA-approved weight loss drugs are prescription medications (and one over-the-counter option) that have undergone extensive clinical trials to ensure safety and efficacy. Several medications prescribed for conditions other than obesity have been found to be effective weight loss drugs in patients with obesity. The one-year EQUIP trial, a phase three 56-week RCT enrolled 1267 patients with obesity (mean BMI of 42.0 kg/m2) and showed 3.5% weight loss in the starting dose group (3.75 mg/23 mg) and 9.3% placebo-subtracted weight loss in the top treatment dose (15 mg/92 mg) group (27). In phase 2 clinical trials for obesity, survodutide (0.6, 2.4, 3.6, or 4.8 mg) reduced body weight dose-dependently and resulted in a body weight loss of 6.2% to 14.9%, compared with −2.8% after placebo, at 46 weeks. Wegovy (semaglutide) is an injectable, once-weekly weight-loss medication. And around 20% of adults lost at least 10% of their body weight. In studies, about 40% of adults lost at least 5% of their body weight after taking Contrave for 1 year. And close to half of those taking Qsymia lost at least 10% of their body weight. Qsymia is considered one of the most effective oral weight-loss medications. In rare cases, more serious side effects have been reported by people using GLP-1 medications. The oldest and most widely used weight loss medication is phentermine. Here will look at the side effects of phentermine with and without topiramate, naltrexone-bupropion, liraglutide, semaglutide, orlistat, and tirzepatide. A 2023 analysis found that 68% of people taking semaglutide or liraglutide for weight loss stopped within a year. Side Effects of Metformin 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. Possible side effects vary by medication and how it acts on your body. Most weight loss takes place within the first 6 months of starting the medication. Compared to switching to placebo after 20 weeks, continued treatment with semaglutide can sustain weight loss.7Mineral supplements, such as chromium and 7-keto-DHEA, are also being studied for OTC weight loss medications that work.Tirzepatide is approved as Mounjaro for Type 2 diabetes and as Zepbound for weight management and sleep apnea.Most cases have been in people with severe side effects that lead to dehydration.As society and the scientific community furthers our understanding of obesity, obesity management will evolve to match the standard of care of other chronic conditions, recognizing polypharmacotherapy as a vital component of comprehensive care.In XENDOS, at 1-year, and compared to baseline, the waist circumference (WC) decreased by 9.6 cm with orlistat and by 7.0 cm in the placebo group (p 58 (Appendix D).But the drug does carry a black box warning because in rodent studies it caused thyroid tumors. How They Differ from Prescription Options Social media often refers to berberine as “nature’s Ozempic,” with claims that it’ll help you lose a lot of weight. The following six supplements may help your body increase its GLP-1 levels. GLP-1 is a hormone your body makes naturally. A phase 1 study showed AMG 133 had an acceptable safety and tolerability profile and resulted in dose-dependent weight loss (Veniant et al., 2024). Considering that 6 mg was not enough to achieve the desired weight loss target for individuals with a higher BMI, mazdutide administration at a dose of 9 mg, exclusively for adults with a BMI ≥30 kg/m2, is under evaluation (Table 4). Thus, glucagon action can reduce body weight both by increasing energy expenditure and reducing food intake (Sandoval and D’Alessio, 2015). In addition, compared with monotherapies of cagrilintide 2.4 mg or semaglutide 2.4 mg, cagrilintide 2.4 mg/semaglutide 2.4 mg (CagriSema) resulted in a significant reduction of hemoglobin A1c in individuals with T2DM and overweight or obesity. 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). Some of the medications aren’t suitable for those under 18. Some medications also help you feel fuller sooner. The most common side effects of the drug are GI symptoms. "Some of the people who need it the most are unable to access it," Robinson says, pointing out that people with low incomes experience obesity at disproportionately higher rates. Given her long struggle with weight loss, she'd finally found something that was working. However, the history of AOM was marked by the failure of several ones after their widespread use in the market, secondary to serious adverse effects, namely cardio-vascular events, suicidality, risk for abuse and dependence12 and recently cancer.13 Therefore, the Food Drug Administration (FDA) and European Medicines Agency (EMA) revised their regulatory approval criteria of AOM, highlighting in particular the importance of cardiovascular and central nervous system safety.14,15 Importantly, this is also what most insurance companies would need to see to get AOM approved. Obesity is a major public health threat, and obesity rates have been alarmingly increasing in the last few decades.1 The highest prevalence is reported in the Pacific Islands states, where obesity affects more than 50% of the population.2 In United States, individuals with obesity constitute almost one third of adults, with a prevalence ranging between 23% and 38% across various states.2 The worldwide situation has worsened recently following the COVID-19 pandemic.3,4 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. Pfizer drops twice-daily version of obesity pill over side effects. At least 5% weight loss is required to prevent obesity-related complications, and it is reflected in the guidelines for weight management drugs. A phase 2 trial demonstrated body weight changes from baseline to week 24 of −6.7% with mazdutide 3 mg, −10.4% with mazdutide 4.5 mg, −11.3% with mazdutide 6 mg, and 1.0% with placebo. Preclinical studies show that it reduces body weight by increasing energy expenditure and reducing food intake compared to the maximally effective dose of semaglutide (Zimmermann et al., 2022). Due to the concerns regarding the potential effect of lorcaserin on other types of 5-HT receptors, which could thus affect valvular competency, patients were monitored with serial echocardiograms during these phase III trials. In the BLOSSOM study, 4,008 patients between 18–65 years of age with a BMI from 30–45 kg/m2 received either 10 mg QD or 10 mg BID of lorcaserin or placebo. Approximately 96% of patients completed the study, and 62% who completed remained on treatment at the end of study. In the GLOW study, those taking Plenity reduced their waist circumference by 6.7 centimeters versus only 5.0 centimeters in the placebo group. While not a perfect determinant of health as it doesn’t always account for muscle mass, BMI remains one of the most common measures used in the medical world. Research suggests that methyl cellulose forms a gel when exposed to body temperature that could lead to a satiety effect. Over time, when taking Plenity consistently, many people report feeling full sooner during meals and in between, which can also reduce snacking. It can help people identify hunger and full cues, which some people cannot identify with,” says Amy Beney, RDN, CDCES, of My Nutrition Insights, who based in Lockport, New York. In 2025, weight-loss GLP-1s accounted for an average of 10.5% of total annual claims among employers, up from 8.9% in 2024 and 6.9% in 2023, IFEBP found. Limited insurance coverage for GLP-1s is blocking out patients who can't afford their roughly $1,000 monthly price tags. Nedelcovych likened shutting them down to "a case of whack-a-mole." Eli Lilly and Novo Nordisk's lawsuits against telehealth companies, pharmacies and others since 2023 have consumed time and resources, with mixed legal outcomes. In August, Novo Nordisk executives noted that around 1 million U.S. patients are taking compounded GLP-1s. The FDA declared an end to the shortages of tirzepatide and semaglutide over the last year. Of these medicines, only liraglutide is approved by the FDA to treat weight-loss in people without diabetes. If you have a body mass index in the obese range, you may also want to consult an obesity medicine physician about prescription medications or surgical options. If you have any existing medical conditions or are taking any prescription medications, it’s essential to speak to your doctor before you start taking a weight loss supplement. If you have any medical conditions or if you’re taking prescription medications, you should also speak to your doctor before you start using a weight loss supplement. In the landmark Diabetes Prevention Program (DPP), 3234 participants without T2D but with fasting and post-prandial hyperglycemia were randomized to intensive lifestyle intervention (ILI), metformin, or placebo (14). Caution should be used in patients with hypertension, mania/hypomania, psychosis, and angle-closure glaucoma. Bupropion is contraindicated in patients with seizures, current or prior diagnosis of bulimia or anorexia nervosa, and concurrent use with MAOs (115). The manufacturer recommends caution in patients with active gastrointestinal reflux diseases. It should be avoided in patients with esophageal anatomic anomalies, suspected strictures, or post-operative complications that affect gastrointestinal transit and motility. Weight Loss Pills It’s not for everybody and should only be prescribed under the care of an endocrinologist.However, these results should be interpreted cautiously and an intensive post-marketing surveillance of liraglutide should be performed as the studies were not designed to assess cancer risk and the incidence of medullary thyroid carcinoma was too low for detection in the trials.FDA-approved weight loss drugs offer a scientifically backed option for those seeking to manage obesity or overweight conditions.Keep in mind that obesity is a disease, and no drug can permanently “cure” it.Puravive wants to help people of all ages on their path to long-term, healthful weight loss.Losing weight can be challenging, especially if you are trying to do it quickly. Sean Hashmi, MD, is an experienced nephrologist and obesity medicine specialist based in Southern California. If you experience these symptoms, contact your healthcare provider right away. “With all four legs on the ground, you have a pretty stable base to lose weight,” Primack says. 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. For FDA approved AOM, we conducted a systematic search on Medline and Embase to identify relevant trials (period 2017–2022) and systematic reviews/meta-analyses (SR/MAs) (period 2012–2022) on specific outcomes/parameters, to update a previous review on the topic.21 We used Medical Subject Heading (MeSH) terms and keywords related to obesity or fat, adipose tissue, body composition and those related to FDA approved AOM (naltrexone/bupropion, liraglutide, orlistat, phentermine/topiramate (combination), semaglutide) (Appendix C). Metreleptin and Setmelanotide are currently indicated for rare obesity syndromes, and 5 other medications (orlistat, phentermine/topiramate, naltrexone/bupropion, liraglutide, semaglutide) are approved for non-syndromic obesity. Lu is already working on investigating these prescribing trends further, comparing the real-world benefits of these weight loss medications to clinical trials, and looking at prescription rates in different subgroups such as patients with heart failure and severe obesity. In the XENDOS (XENDOS (XENical in the prevention of Diabetes in Obese Subjects) trial, the largest randomized controlled trial (RCT) that evaluated the effect of orlistat in 3,305 patients, orlistat was found to cause a total body weight loss of 2.4% after 4 years. 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. According to GoodRx, phentermine can be had for as little as $10. Orlistat helps you lose weight by lowering the amount of fat deposited in your intestines. This medication should be taken in conjunction with a low-calorie diet and increased physical exercise. It is intended to help overweight individuals 18 years, and older lose weight when combined with a low-calorie, low-fat diet. 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. She is passionate about health education and loves using her experience and knowledge in her writing. Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. Hashmi founded the nonprofit organization SelfPrinciple.org to provide accessible and accurate health, nutrition, and wellness information to the public. Prescription orlistat is approved for adults and adolescents ages 12 and older. Orlistat (Xenical) is an older medication that may also be a phentermine alternative. Have your healthcare team review your medication list for any possible interactions with Contrave. It takes about 4 weeks to notice weight loss from Contrave. The products are low in carbohydrate, which helps keep the hunger pangs at bay, while also causing a mild state of ketosis, where the body burns fat as fuel. VLEDs are very well-studied compared with other weight-loss products, and have been used in clinical settings for more than 40 years. But they don’t come cheap – you’re looking at upwards of $100 a month for medication and $300 for meal replacements. Wegovy is a weekly injection approved by the FDA in 2021 for long-term weight management. Wegovy is a popular weight-loss medication made by the same company as Ozempic, which has been in the news a lot recently. Any weight-loss medicine should be taken along with lifestyle changes, such as exercise and a healthy diet – not in place of them. There are many types of prescription weight loss medicines that work differently to help with weight loss. However, due to the scarcity of information on long-term side effects, a longer prospective observational study would likely help address some of those concerns.(A PubMed search for “stimulants and ethanol” February 21, 2017 yielded 2,255 papers.) However, there are no specific reports on the effects of combining phentermine and ethanol in humans among 15 papers yielded in a PubMed search for “phentermine and ethanol” on the same date.Treatment response to most of these drugs should be evaluated at around 12 weeks using the maintenance dose.It’s one of the best weight loss pills, which has no side effects and you can use free from any worries.Let's explore some of the safest options backed by research to reach your weight goals.Supplements such as green tea extract, garcinia cambogia, and ginger are gaining attention for their weight loss benefits.No emphasis is placed on treating patients with excess adiposity but with a BMI below the thresholds and pharmacotherapy for such patients is off-label. In most clinical trials that evaluated pharmacologic interventions for more than 12 months, a weight loss of 4% to 8% was typical ; however, this is rather disappointing considering the high prices of these drugs. As a highly stigmatized disease, there remains a misconception that obesity is mainly due to a lack of willpower and representative of laziness; thus, these patients are considered undeserving of proper treatment with medications or surgery . 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 . Similarly, in the CONQUER trial, participants administered the same dose of phentermine/topiramate ER for 1 year achieved a 9.8% reduction in weight from baseline, compared to 1.2% in the placebo group. Additionally, the dose is only increased if the patient fails to achieve a total body weight loss of 3% after 3 months. In a 2-year study, people with obesity taking Ozempic weekly lost an average of 15% of their body weight. In clinical trials, obese individuals taking Saxenda lost an average of 8% more body weight over 56 weeks compared to placebo. Although the individual drugs may be prescribed ‘off label’ by a doctor and taken together when other treatments have failed or are unsuitable, the TGA has warned about the serious risks of using topiramate for weight loss. “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.That phenomenon goes back to the metabolism of our caveman ancestors when weight loss was a danger.Naltrexone (NAL) is an opioid receptor antagonist approved as a treatment for opioid dependency and alcohol dependence.FDA approved OTC orlistat based on the review of the sponsor's safety data and after submitting the product for the consideration by an FDA advisory committee in January 2006.Your healthcare team can help you choose a phentermine alternative based on your other health conditions, medication list, and insurance coverage.The trial included 70 adults with obesity.The plethora of on- and off-label AOMs creates the unique challenge for physicians to decide which medication may be most appropriate for the individual patient.But others raise questions about how much of a role pills will play in the space given that some appear to be less effective than injections and bring greater side effects.Elevated renin-angiotensin aldosterone system activity inindividuals with obesity is likely stimulated by adipokine activity , and does not seem to be systemicallyregulated. Do you need to qualify for tirzepatide? Some like phentermine because they have lost weight taking it and enjoy a better quality of life. In phentermine post-marketing studies, we found that long-term phentermine use, even at doses higher than 37.5 mg/day, did not induce phentermine cravings, and that abrupt cessation of long-term phentermine did not induce a stimulant withdrawal syndrome.23,34 The warning against combining weight-loss medicines appeared in the phentermine label in 2000 after 1997 reports of valvulopathy induced by the combination of phentermine and fenfluramine, and both dexfenfluramine and fenfluramine were taken off-market. It may be reasonable to prescribe phentermine for subjects who have a history of recovery from drug abuse. This was compared to about 2% with placebo. It may be approved by March 2026. It mimics the effects of GLP-1, a gut hormone that’s involved in blood glucose (blood sugar) balance, digestion, and appetite management. Regardless, there are steps you can take to help you meet your health goals. Or maybe it’s related to a health issue your prescriber warned you about. Orlistat isn’t approved for kids or adolescents, and it can cause some bothersome side effects. Benzphetamine, diethylpropion, and phendimetrazine are weight-loss pills that are similar to phentermine, but they’re prescribed less often. However, since Qsymia contains phentermine, this medication is considered a controlled substance. Qsymia (phentermine / topiramate ER) is another combination weight-loss pill. Tirzepatide for weight management is suitable for adults living with obesity and another weight-related health problem. You may be prescribed tirzepatide by a healthcare professional at a specialist weight management service if they feel it is the right treatment for you. A specialist weight management service can prescribe semaglutide for obesity for a maximum of 2 years. Obesity is a major risk factor in the development of cardiovascular disease (CVD), type 2 diabetes (T2D), musculoskeletal disorders, and several cancers (2). Obesity is recognized as a major pandemic of the 21st century, contributing to increased morbidity, mortality, and the burden of healthcare costs (1). Clinical studies in food and nutrition are critical for determining how and why we consume affect our health. And, it’s only approved for adults, so children can’t take it.Weight loss medications can be helpful in promoting and maintaining weight loss as part of a comprehensive obesity treatment plan.Ministers say they want the drugs to be available more easily, through high street chemists, health centres and apps.Achieving sufficient weight loss to reduce obesity-related diseases requires a variety of interventions, including comprehensive lifestyle modification of diet and exercise, change in behavior, anti-obesity medications, and surgery.As of January 2026, 12 medications are FDA approved as weight-loss treatments.Of these, liraglutide, administered as daily subcutaneous injections, isapproved at the 1.8 mg dose for diabetes and 3.0 mg dose for obesity.Gas, bloating, cramps, and diarrhea are all common side effects. It helps you lose weight when used in combination with a reduced-fat diet and exercise program. It’s best to think of these medicines as tools to help you lose weight through a reduced-energy diet and exercise plan. Yet protein is likely to help you preserve muscle when you lose weight. Protein, in particular, was too low for most people, with the exception of younger, smaller women. Weight Loss Drug Options Many health plans, including Medicare, cover GLP-1s for the treatment of diabetes but not obesity. Real-world data and a head-to-head clinical trial have shown that Eli Lilly's obesity injection Zepbound leads to more weight loss than Novo Nordisk's Wegovy. But both firms are focused on ramping up supply, testing new uses for their medicines and bringing the next wave of obesity drugs to patients, including more convenient pills. But more research is needed to know exactly how cinnamon affects people with diabetes and weight-related conditions. This is important because GLP-1 medications often cause loss of muscle mass along with body fat. One small study in people with Type 2 diabetes showed that taking 1,500 mg of curcumin daily reduced weight and blood sugar. Common side effects of glucagon-like peptide-1 (GLP-1) medications include nausea and vomiting, stomach pain, and diarrhea. Both are FDA approved for weight loss, though Zepbound may lead to greater average weight loss based on available data. GLP-1 medications have been shown to have beneficial effects on the kidneys. But it may be due to rapid weight loss or indirect effects on the gallbladder. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Most combinations primarily focus on both controlling hunger/appetite/satiety and inhibiting peripheral calorie absorption (i.e., phentermine/sodium glucose co-transporter 2 SGLT-2 inhibitor, a GLP-1 agonist/other gut hormones, or an SGLT-2 inhibitor). However, these results should be interpreted cautiously and an intensive post-marketing surveillance of liraglutide should be performed as the studies were not designed to assess cancer risk and the incidence of medullary thyroid carcinoma was too low for detection in the trials. Additionally, the total risk of malignant and benign neoplasms, including pancreatic cancer, was not found to increase in the liraglutide vs. placebo group 63,64,70. More insulin in your body means you will have lower blood sugar. We also work with you to make lasting changes in your life and health. Our team offers all the necessary tools to help you lose weight. We’re here to help you get to the root cause of why you’ve gained weight—and what to do about it. Anything from your genetics to your environment and stress levels can affect your weight. This may lead to weight loss. After taking the medication once daily for 6 weeks, people in the study were able to perform better on an oral glucose tolerance test (OGTT). A phase 2 study found that the medication helps improve glucose tolerance in adults with prediabetes. The FDA recently added orforglipron to the second group of medications in its new Commissioner’s National Priority Voucher (CNPV) program. In turn, this may translate to orforglipron being a more affordable weight-loss medication. How long you will need to take weight management medication depends on whether the drug helps you lose weight and keep it off and whether you experience serious side effects. Choosing a medication to treat overweight or obesity is a decision between you and your health care professional. In the past, some weight management medications were linked to serious health problems, and they were removed from U.S. markets. 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. They don't reduce the amount of fat in your body. We cannot diagnose conditions, provide second opinions or make specific treatment recommendations through this website. Maybe they'll even join you on your health journey. These effects are related to the way you take the product and how much fat you consume when taking alli capsules. The most common are gastrointestinal (GI) and are referred to as diet-related side effects. The fat passes out of your body, so you may have bowel changes. There are lots of weight loss supplement and muscle development pills. Green tea is known as a natural fat burner and most of the weight loss supplement uses it in their formulation. As per me, best thermogenic supplement for weight loss is Java Burn. Most of the weight loss pills work on thermogenic process, some do it effectively, while other just fulfill it in their claims. All GLP-1 medications carry a boxed warning for the potential risk of thyroid C-cell tumors, based on animal studies. Most cases have been in people with severe side effects that lead to dehydration. But it’s not known if these medications directly cause this side effect, or if it’s due to something else. While rare, GLP-1 medications have been linked to pancreatitis, a serious inflammation of the pancreas. Discussion of OLDU in this review is limited to US obesity medicine physicians and the US FDA label, and is intended to review some of the data on how US physicians are actually using drugs off-label. Recent data suggest that at least some obesity drugs induce reductions in energy intake by generating beneficial changes in cravings and eating behaviors.3,4,19 Biannual ASBP courses had taught several generations of physicians to use measures of excess fat for treatment decisions before a 1985 US National Institutes of Health Consensus Conference suggested BMI cutoffs for diagnosis of overweight and obesity and an expert committee of the World Health Organization recommended in 1995 defining obesity more simply by a BMI at or above 30 kg/m2.