Prescription Weight Loss Drugs
Who Might Be Prescribed Weight-Loss Medications?
Healthcare providers recommend prescription weight-loss medications for adults who have not lost enough weight with a nutritious diet and regular exercise. These drugs are usually for people with a body mass index (BMI) over 30, which means obesity.
Sometimes, adults with a BMI over 27 and weight-related health conditions, like type 2 diabetes or high blood pressure, may also get these medications. The provider reviews a person’s medical history, health concerns, and previous efforts with lifestyle changes before suggesting any medication.
Prescription weight-loss medications do not suit everyone. Providers do not recommend them for people who are pregnant, trying to become pregnant, or breastfeeding. Children and teens rarely qualify unless they have specific genetic conditions causing severe obesity.
How Effective Are Prescription Medicines for Weight Loss?
When people use prescription medications along with healthy eating and regular exercise, they tend to lose more weight. Many of these medications are meant for long-term use—over 12 weeks—and help people lose more weight than just lifestyle changes alone.
Expected Weight Loss
Most people lose an extra 3% to 12% of their starting weight after using these drugs with lifestyle changes for at least a year. Losing 5% to 10% of body weight can lower the risk of health problems like high blood pressure, blood sugar issues, and high cholesterol.
Comparison Table: Sample Weight Loss and Benefits
| % Total Body Weight Lost | Health Benefits |
|---|---|
| 3% – 5% | Can improve blood sugar and blood pressure. |
| 5% – 10% | Reduces the risk of heart disease. |
| 10% – 12% | Greater reduction in risk of obesity complications. |
Results vary from person to person. Some lose less weight, and health improvements may differ.
Important Facts About Using Anti-Obesity Medications
Prescription weight-loss drugs work best when people continue a nutritious diet and regular exercise.
Common Side Effects
People may experience:
- Nausea
- Diarrhea
- Constipation
- Headaches
These side effects are usually mild and often get better over time. Some medications can cause more serious effects, such as increased blood pressure, changes in heart rate, or mood changes. Healthcare providers review the benefits and risks before prescribing any medication.
Insurance and Cost
Insurance does not always cover prescription weight-loss drugs. Without coverage, these medications can be expensive.
Weight Regain
Many people regain weight after stopping medication. Keeping healthy habits helps prevent weight gain.
Duration of Treatment with Weight Management Medications
How long someone takes a prescription weight-loss drug depends on how they respond to the medication. If a person loses at least 5% of their body weight within three to six months and does not have serious side effects, the provider may recommend continuing the drug long term.
If someone does not lose enough weight or has side effects, the provider may adjust the dose, switch medications, or stop treatment. Regular follow-up helps make sure the medication stays safe and effective.
List of FDA-Approved Medications for Weight Management
The U.S. Food and Drug Administration (FDA) has approved several medications for long-term weight management. Each works differently and has its own side effects. Here are some commonly used prescription drugs for ongoing weight management:
Table: Common Prescription Weight-loss Medications
| Drug Name | How It Works | Typical Side Effects |
|---|---|---|
| Bupropion-naltrexone | Reduces hunger and cravings | Nausea, headache, constipation |
| Liraglutide | Controls appetite | Nausea, vomiting, diarrhea |
| Orlistat | Blocks fat absorption in the gut | Gas, oily stools, rare liver issue |
| Phentermine-topiramate | Reduces appetite, increases fullness | Insomnia, constipation, higher heart rate |
| Semaglutide | Curbs appetite | Nausea, headache, tiredness |
| Setmelanotide | Targets a brain signal pathway related to rare conditions | Injection site reaction, mood changes |
Details on Specific Medications
Bupropion-Naltrexone: This combination affects the nervous system to reduce hunger. Bupropion also treats depression and helps people quit smoking. Naltrexone treats addiction to alcohol and narcotics. The drug can raise blood pressure and needs regular monitoring. It has a warning for possible suicidal thoughts.
Liraglutide: Originally used for diabetes, it helps control appetite. People take it as a daily injection, but stomach side effects can limit its use.
Orlistat: This drug stops the body from absorbing some dietary fat. A lower dose is sold over the counter. A low-fat diet helps reduce digestive side effects.
Phentermine-Topiramate: This combines phentermine, which lowers appetite, with topiramate. Phentermine can be habit-forming. Topiramate can cause birth defects, so pregnant women should not use it.
Semaglutide: Used for type 2 diabetes; people take it as a weekly shot. Side effects include stomach upset, headache, and tiredness.
Setmelanotide: Approved for children over 6 and adults with certain rare, genetic forms of obesity. It is given as a daily injection. Common side effects include irritation at the injection site, dark skin patches, and sometimes mood changes. It should not be used in children under 6.
Some medications, like phentermine alone, are only for short-term use—less than 12 weeks—because of possible side effects and the risk of addiction.
Weight-Loss Pills vs. Shots
Most new and effective drugs, such as semaglutide, are given by injection. Some pills are taken by mouth, including those that work by reducing fat absorption. Medical devices, such as hydrogel capsules, are also available but are less commonly used.
Key Points to Keep in Mind About Prescription Weight-Loss Drugs
- Prescription weight-loss medications work best when combined with a reduced-calorie diet and regular physical activity.
- They do not suit everyone. Providers consider medical history, current health problems, and possible side effects.
- Following the provider’s instructions and attending regular check-ups helps ensure safety and effectiveness.
- Insurance may not cover these drugs, and costs can be high without coverage.
- Side effects can range from mild stomach issues to more serious mood or heart problems.
- Many people regain weight after stopping medication, so healthy eating and exercise remain important for long-term results.
People considering weight-loss medications should talk with a health care provider and set realistic goals. Lifestyle changes should always be the main approach to healthy weight management. Prescription medications can help, but they do not replace a good diet and staying active.
