As an expert in the field of weight loss, I have seen many patients struggle to find the right medication to help them achieve their goals. One of the oldest and most commonly used weight-loss medications is phentermine. Originally used as a short-term solution, it has now been added to long-term therapy guidelines. Patients can typically 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, while setmelanotide (IMCIVREE) is limited to those with specific rare genetic disorders confirmed by genetic testing. These medications can be taken as long as they continue to benefit the patient and do not cause serious side effects. The newest additions to the list of approved medications for obesity are semaglutide (Wegovy) and tirzepatide (Zepbound). Other older medications include liraglutide (Saxenda), naltrexone-bupropion (Contrave), orlistat (Alli, Xenical), and phentermine-topiramate (Qsymia). GLP-1 agonists are considered the most effective for weight loss, with Wegovy, Zepbound, and Saxenda being current options.
If a patient does not lose at least 4% of their weight after 16 weeks of taking liraglutide, their doctor may recommend stopping the medication as it is unlikely to work for them. Other medications, such as Ozempic, may also be prescribed for weight loss, although it is not the intended use. Ozempic is given as an injection and is approved for use in adults and children aged 12 years and older who are obese (BMI ≥ 30 for adults, BMI ≥ 95 for age and sex for children) or in some overweight adults (BMI ≥ 2 (overweight) who also have weight-related medical problems. If you are considered obese, with a body mass index (BMI) of 30 or more, weight-loss medications may be an option for you. While studies have evaluated drugs that target metabolic tissues like adipose tissue or muscle to promote weight loss, they have not yet been brought into clinical practice.
If lifestyle changes alone are not enough to help you lose weight or maintain your weight loss, your healthcare professional may prescribe medications as part of your weight management program. These medications are designed to be used alongside a low-calorie diet and can also help reduce the risk of regaining weight. It can be challenging to stay motivated and on track when trying to lose weight. That's why it can be helpful to recruit friends and family to hold you accountable or consider participating in an accredited weight loss program. On average, adults who take prescription medications as part of a lifestyle program lose 3% to 12% more of their initial body weight after one year compared to those who do not take medication.
However, insurance coverage for these medications varies and can impact a patient's decision to take them. Semaglutide, also known as Wegovy, has been approved by the FDA for weight loss in adults. It is also approved under the brand name Ozempic for the treatment of type 2 diabetes. In my opinion, it was a wise decision for the FDA to authorize Wegovy for those who truly need to lose weight. These medications can also help patients make the necessary lifestyle changes to improve their overall health. You may have heard the term "face from Ozempic" used to describe the physical transformation of individuals who have lost a significant amount of weight.
This type of weight loss can lead to other health improvements, such as lower blood pressure, blood sugar, and blood fats, as well as improved joint pain and sleep apnea.
