If you are an adult with serious health problems that are a result of your weight, and you have not been able to lose enough weight through diet and exercise alone, you may want to consider a weight-loss drug that requires a prescription.
You should be aware that weight-loss drugs are meant to be used in combination with diet and exercise, not as a replacement.
Who is a candidate for weight-loss drugs?
Your doctor may consider a weight-loss drug for you if you haven't been able to lose weight through diet and exercise and you meet one of the following:
- Your body mass index (BMI) is greater than 30.
- Your BMI is greater than 27 and you have a serious medical problem related to obesity, such as diabetes or high blood pressure.
Your doctor will take into account your medical history and any health problems you have before deciding if prescription weight-loss drugs are right for you. They will also explain the potential benefits and risks of taking these drugs.
It's worth mentioning that weight-loss drugs aren't always the right choice for everyone. For example, you shouldn't take prescription weight-loss drugs if you're hoping to get pregnant, are pregnant, or are breastfeeding.
How well do weight-loss drugs work?
There are several prescription weight-loss drugs that are approved to be used for more than 12 weeks and they have been shown to cause a significant amount of weight loss when compared to taking a placebo. If these weight-loss drugs are combined with lifestyle changes, then there is an even greater chance of losing weight than if the person only changed their lifestyle.
The text is discussing how much weight one can lose over the course of a year with a weight loss plan. They state that a weight loss of 5%-10% of total body weight can have important health benefits, such as lowering blood pressure, blood sugar, and triglyceride levels.
What you should know about weight-loss drugs
The side effects of the treatment are mild and common, such as nausea, constipation, or diarrhea. They may lessen over time. In rare cases, there may be serious side effects. Therefore, it is important that you talk to your doctor about all of the treatment options.
What will your insurance company cover regarding weight-loss drugs? You may have to pay out of pocket if they are not willing to cover the costs.
Many people gain back some of the weight they lost when they stop taking weight-loss drugs, but adopting healthy lifestyle habits may help to limit this weight gain.
How long does drug therapy last?
How long it takes to lose weight using a weight-loss drug varies depending on if the drug is effective. If the drug is working and the person has lost a significant amount of weight, improving their health, the doctor may suggest taking the drug long-term.
After being on a full dose of a weight-loss drug for 3 to 6 months, if you haven't lost at least 5% of your body weight, your doctor will most likely change your treatment and prescribe a different drug.
What drugs are approved for weight loss?
Four weight-loss drugs have been approved by the U.S. Food and Drug Administration for long-term use:
- Bupropion-naltrexone (Contrave)
- Liraglutide (Saxenda)
- Orlistat (Xenical)
- Phentermine-topiramate (Qsymia)
Most weight-loss drugs either work by suppressing appetite or making someone feel fuller after eating. Orlistat is the exception; it works by preventing the absorption of fat.
Bupropion-naltrexone is a combination drug consisting of naltrexone to treat alcohol and opioid dependence, and bupropion as an antidepressant and quit-smoking aid. Bupropion-naltrexone raises blood pressure and needs monitoring at the start of treatment, with common side effects including nausea, headache and constipation.
Liraglutide
There are also some side effects associated with liraglutide, such as nausea and vomiting, which may limit its use.
Orlistat
Orlistat is available in a weaker form without a prescription, called Alli. It can cause uncomfortable side effects like gas and diarrhea. You need to follow a low-fat diet while taking this medicine. There have been a few reports of serious liver damage with Orlistat, but it's not clear if there's a cause-and-effect relationship.
Phentermine-topiramate
This is a combination of a weight-loss drug (phentermine) and an anticonvulsant (topiramate). Phentermine may be abused as it is similar to an amphetamine. Other side effects could include an increase in heart rate and blood pressure, insomnia, constipation, and nervousness. Topiramate use could lead to birth defects.
Phentermine can be used on its own for weight loss, and is one of four drugs in its category that are approved for short-term use. The other drugs in this group are not commonly prescribed.
Prescription Weight Loss Drugs
The fundamentals of sustainable weight loss are reducing calorie intake and increasing physical activity. For some people, medications prescribed by a doctor can also be helpful.
You will still need to pay attention to your diet and exercise habits even if you are taking these drugs, and they are not appropriate for everyone.
If your BMI is 30 or higher, or if it's at least 27 and you have a condition that may be related to your weight, like type 2 diabetes or high blood pressure, doctors usually prescribe them.
The drug semaglutide has been approved by the FDA for the treatment of obesity as of 2021. Other drugs that are more commonly prescribed for weight loss and have been in use for longer include liraglutide, naltrexone-bupropion, orlistat, phentermine, and phentermine-topiramate.
Before getting a weight loss drug prescription, it is important to tell your doctor about your medical history, including any allergies or other conditions you have. Additionally, be sure to mention any medicines or supplements you take, even if they are herbal or natural. Finally, let your doctor know if you are pregnant, breastfeeding, or planning to become pregnant soon.
Liraglutide (Saxenda)
Liraglutide is a higher dose of the type 2 diabetes drug Victoza. It increases the levels of a hormone called GLP-1, which helps to control appetite by making you feel fuller for longer.
Approved for long-term use? Yes.
Possible side effects of taking Liraglutide include feeling nauseous, vomiting, having diarrhea or constipation, and experiencing low blood pressure. Some more serious potential side effects that have been observed in studies of animals include an increased heart rate, pancreatitis, gallbladder disease, and kidney problems. It's not currently known if Liraglutide has any effect on increasing the risk of developing thyroid cancer in humans.
If you do not see a 4% weight loss after taking Liraglutide for 16 weeks, your doctor may tell you to stop taking the medication. The FDA has stated that it is unlikely to be effective for you at that point.
Contrave is a combination of two drugs that are both approved by the FDA. The first drug, naltrexone, is approved to treat addiction to alcohol and opioids. The second drug, bupropion, is approved to treat depression, seasonal affective disorder, and help people stop smoking.
Approved for long-term use? Yes.
There are a number of common side effects which include nausea, constipation, headache, vomiting, dizziness, insomnia, and dry mouth. However, it is important to be aware that there is an increased risk of suicidal thoughts and behaviors associated with bupropion. Additionally, there have been reports of serious neuropsychiatric issues linked to bupropion. It is also important to note that the drug can cause seizures and must not be used by patients who have seizure disorders. Finally, the drug can also increase blood pressure and heart rate.
If you do not lose five percent of your weight after twelve weeks of taking Contrave, the FDA says that your doctor will likely tell you to stop taking the medication.
The medication works by blocking your body from absorbing about a third of the fat you eat. Orlistat is a prescription medication that comes in two forms: Xenical and Alli. Xenical is the stronger of the two medications, while Alli is half as strong.
Approved for long-term use? Yes.
Some possible side effects from taking this medication may include stomach cramping, passing gas, having oily or loose bowel movements, having more frequent bowel movements, and/or losing control of bowel movements.
The side effects of this medication are usually mild and only last for a short time. However, if you eat foods that are high in fat, the side effects may become worse.
In very rare cases, people taking orlistat have reported severe liver injury. It is not clear if the drug was the cause of those problems.
Before taking orlistat, you should be on a low-fat diet where less than 30% of your daily calories come from fat.
Take a multivitamin at least 2 hours before or after taking orlistat. The drug temporarily stops your body from being able to absorb vitamins A, D, E, and K.
Orlistat is the only drug in its class that's approved in the U.S. All other prescription weight-loss drugs work by suppressing appetite, including the following.
How it works: Curbs your appetite.
Your doctor my prescribe this drug under the names Adipex or Suprenza.
The drug is not approved for long-term use, only for short-term use for a few weeks.
The side effects of the drug can be serious, including high blood pressure and heart palpitations, restlessness, dizziness, tremor, insomnia, shortness of breath, chest pain, and difficulty with activities you could do before. Less serious side effects include dry mouth, unpleasant taste, diarrhea, constipation, and vomiting.
Appetite suppressants can have the potential to cause dependency.
Do not take it in the evening as it may cause insomnia.
If you have diabetes and take insulin, tell your doctor before you start taking phentermine. You may need to adjust your insulin dose.
of drug abuse. Phentermine may not be right for you if you have any of the following conditions: -A history of heart disease -A history of stroke -Congestive heart failure -Uncontrolled high blood pressure -Glaucoma -Hyperthyroidism -A history of drug abuse
The FDA recommends that you stop taking Qsymia or increase your dose if you don't lose at least 3% of your weight after 12 weeks. If that doesn't work, you should gradually stop taking it.
sooner How semaglutide works: Semaglutide imitates an intestinal hormone that stimulates insulin production, lowering your appetite and making you feel full more quickly.
Semaglutide was approved as a treatment for type 2 diabetes and obesity. It is prescribed for diabetes under the names Ozempic and Rybelsus, and for obesity under the name Wegovy.
Approved for long-term use? Yes.
The side effects of this medication include abdominal cramping, constipation, vomiting, passing gas, headache, fatigue, and gastro reflux.
These side effects are generally mild and temporary.
If you experience kidney problems or blurred vision, consult a medical professional immediately as semaglutide has been linked to pancreatitis in rare cases. Pancreatitis symptoms include severe abdominal pain and vomiting.
Do not take this medication if you are struggling with drug abuse, or if you are pregnant or nursing.
Phentermine is an amphetamine which is a controlled substance that requires a special type of prescription due to the risk of addiction or abuse.
How it works: Curbs your appetite.
The diet drug Qsymia is a combination of phentermine and topiramate. Topiramate causes weight loss in several ways, including making people feel fuller, making foods less appealing, and burning more calories.
This medication has been approved for long term use as it is much lower in phentermine and topiramate than if these drugs were given alone.
Some people express a “pins and needles” sensation on their skin. The most common side effects of the medication are tingling in the extremities, dizziness, insomnia, constipation, and dry mouth. Some people have also reported a “pins and needles” sensation on their skin.
Potential serious side effects of the medication include certain birth defects (cleft lip and cleft palate), an increased heart rate, suicidal thoughts or actions, and eye problems that could lead to permanent vision loss if left untreated.
If you are a woman who could become pregnant, you should get a pregnancy test before taking Qsymia. You should also use birth control and get monthly pregnancy tests while you are taking the drug.
You also shouldn't take Qsymia if you have glaucoma, hyperthyroidism, heart disease, or stroke. Check with your doctor regularly, especially when starting the drug or increasing the dose, to make sure your heart is healthy.
Weight-loss drugs are not a magic pill that will make you thin. However, they may help you make the lifestyle changes necessary to lose weight and improve your health.
Naltrexone HCl and bupropion (Contrave)
Orlistat (Xenical)
Phentermine
Semaglutide (Wegovy)
Phentermine and topiramate (Qsymia)
The bottom line
