As a weight loss expert, I have seen the struggles that many people face when trying to lose weight. It can be a frustrating and difficult journey, but fortunately, there are medications available that can help. One of the oldest and most commonly used weight loss medications is phentermine. Originally used as a short-term medication to accelerate weight loss, it is now also recommended for long-term therapy.
Studies have shown that patients can lose around 5% of their body weight by taking phentermine. The FDA has approved six prescription drugs for chronic weight management, including orlistat (Xenical, Alli), phentermine-topiramate (Qsymia), naltrexone-bupropion (Contrave), liraglutide (Saxenda), semaglutide (Wegovy), and tirzepatide (Zepbound). Four of these medications are approved for adults and children ages 12 and older. Another approved medication, setmelanotide (IMCIVREE), is limited to people with specific rare genetic disorders. These medications can be taken as long as they continue to benefit the patient and do not cause serious side effects. The newest prescription drugs for obesity are semaglutide (Wegovy) and tirzepatide (Zepbound).
Other older medications include liraglutide (Saxenda), naltrexone-bupropion (Contrave), orlistat (Alli, Xenical), and phentermine-topiramate (Qsymia). These medications work by suppressing appetite or increasing feelings of fullness. Orlistat works by affecting the way the body absorbs fat. Naltrexone is typically used to treat alcohol and opioid addiction, while bupropion is used to treat depression and help people quit smoking. However, like all antidepressants, bupropion has a warning about the risk of suicide.
Therefore, it is important for healthcare providers to regularly monitor patients' blood pressure when starting treatment with these medications. Common side effects may include nausea, headache, and constipation. Liraglutide is also used to control diabetes and is administered as a daily injection. It is also available in a reduced strength form without a prescription (Alli). However, it may cause side effects such as gas and loose stools.
Rarely, people have experienced serious liver damage from taking orlistat. While researchers have not found a direct link between the drug and liver damage, it is important to be aware of this potential risk. Phentermine-topiramate is a combination of two medications: phentermine, which acts as a stimulant similar to amphetamines, and topiramate, an anticonvulsant. Due to its potential for misuse, phentermine has been classified as a controlled substance. Other possible side effects include increased heart rate and blood pressure, insomnia, constipation, and nervousness.
Topiramate also increases the risk of birth defects. Semaglutide is also used to help control type 2 diabetes and is administered as a weekly injection for obesity. To be prescribed this medication, patients must have test results showing they have one of these conditions. Setmelanotide does not treat the genetic disorders that cause obesity but can help with weight loss by reducing appetite and increasing calorie burn at rest. It is important to note that setmelanotide should never be given to children under 6 years old as it can cause dangerous reactions. Phentermine (Adipex-P, Lomaira) is a prescription medication that reduces appetite and can help with weight loss.
It can also help patients feel full for longer periods of time. Xenical (Orlistat) is a lipase inhibitor that can help with weight loss and maintenance. Saxenda (liraglutide) is a glucagon-like peptide (GLP) receptor agonist that regulates appetite. Qsymia is a combination medication of phentermine and topiramate that acts on the brain to reduce appetite.
It is usually taken once a day in the morning to avoid potential insomnia. Children over the age of 12 may be prescribed Qsymia if they have a BMI in the 95th percentile or higher. Patients taking Qsymia should be monitored for changes in mood, as well as kidney function, heart rate, and sodium and potassium levels. Additionally, parents should watch for signs of growth retardation in children taking this medication. Studies have shown that taking these medications for a year can result in a weight loss of 3-12% more than what is achieved through lifestyle changes alone. The length of time a patient will need to take weight-loss medications depends on their response to treatment and any potential side effects.
When used in conjunction with lifestyle interventions, semaglutide has been shown to result in an average weight loss of 15%.At the end of a 56-week study, Saxenda users reported significant weight loss compared to those taking a placebo. When combined with healthy eating habits and increased physical activity, prescription medications can be an effective tool for weight loss and maintenance. While the range of weight-loss medications continues to expand, some have been withdrawn due to lack of efficacy or safety concerns. In addition to helping with weight loss, these medications have also been shown to improve blood pressure and cholesterol levels, reducing the risk of heart disease. It is important to discuss with your healthcare provider which weight-loss medication may be right for you and to also consider lifestyle treatment programs that can complement medication use. Some weight-loss medications have been on the market longer and have generic alternatives, making them more affordable.
If you have not lost at least 5% of your body weight after taking a medication for 3-6 months, your healthcare provider may recommend changing your treatment. On ClinicalTrials.gov, you can find a list of ongoing clinical studies on prescription drugs for overweight and obesity that are funded by the federal government and open to candidates. BMI is an important factor in determining if a patient is a candidate for weight-loss medications. It is calculated by dividing a person's weight by the square of their height. If you are struggling with weight loss, talk to your healthcare provider about the potential benefits and risks of prescription weight-loss medications.
