Table of ContentsView AllTable of ContentsXenical (Orlistat)Alli (Orlistat)Contrave (Bupropion-Naltrexone)Saxenda (Liraglutide)Qsymia (Phentermine-Topiramate)Imcivree (Setmelanotide)Wegovy (Semaglutide)Zepbound (tirzepatide)Frequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Xenical (Orlistat)
Alli (Orlistat)
Contrave (Bupropion-Naltrexone)
Saxenda (Liraglutide)
Qsymia (Phentermine-Topiramate)
Imcivree (Setmelanotide)
Wegovy (Semaglutide)
Zepbound (tirzepatide)
Frequently Asked Questions
For people withobesity, weight loss is often a difficult journey that requires lifestyle changes. Sometimes, when dietary changes and exercise are not enough, your healthcare provider may prescribe a weight loss medication.
Your provider may recommend one of these medications if you:
This article will discuss eight current Food and Drug Administration (FDA)–approved weight loss drugs on the market.
Xenical (orlistat) can help you lose weight and keep it off. It belongs to a class of medications called lipase inhibitors.
Orlistat reduces the amount of fat absorbed in the gut after eating. When taking it, no more than 30% of your calories should come from fat. Because of how it works, orlistat is often a better choice for people who tend to eat fatty foods.
Dosing for Xenical is usually 120 milligrams (mg) three times daily. It comes as capsules that should be taken with food or up to one hour after a meal.
Orlistat can reduce the absorption offat-soluble vitaminsin the body; therefore, it’s recommended to take a daily multivitamin at bedtime.
How Effective Is It?
Clinical trials have suggested that orlistat provides modest weight loss in people with obesity.
The XENDOS study evaluated orlistat’s ability to prevent diabetes in individuals with obesity over four years. Over the course of the study, orlistat users lost, on average, about 13 pounds compared to 7 pounds in the placebo group. Orlistat also lowered the risk of developing type 2 diabetes.
If orlistat works for you, you might expect to lose at least 5% of your body weight in one year.
Orlistat has also been shown to reduce BMI, waist circumference, cholesterol, andlow-density lipoprotein (LDL) levels(considered “bad” cholesterol).
However, it may not be as effective as other weight-loss medications. In another study, people who took the drug liraglutide (sold under the brand names Saxenda and Victoza) lost more weight (about 17 pounds) than those on orlistat (about 7 pounds) over seven months.
BMIBody mass index is a dated, biased measure that doesn’t account for several important factors, such as body composition, ethnicity, race, gender, and age. Despite being a flawed measure, BMI is widely used today in the medical community because it is an inexpensive and quick method for analyzing potential health status and outcomes.
BMI
Body mass index is a dated, biased measure that doesn’t account for several important factors, such as body composition, ethnicity, race, gender, and age. Despite being a flawed measure, BMI is widely used today in the medical community because it is an inexpensive and quick method for analyzing potential health status and outcomes.
Other Considerations
You should not take Xenical if:
Additionally, certain medications can interact with Xenical, such as:
While taking Xenical, you may experience these side effects:
Taking a fiber-containing supplement, likepsyllium, along with Xenical can reduce some of the gastrointestinal (GI)–related side effects.
Like Xenical, Alli contains the active ingredient orlistat. This version is available over the counter (OTC) and comes in a 60 mg capsule.
Because Alli has the same active ingredient as Xenical, it has similar side effects and safety considerations to account for. However, Alli tends to be better tolerated than Xenical because it is a lower dose.
In clinical studies, most people who took the 60 mg version of orlistat lost 5 to 10 pounds over six months.
Orlistat 60 mg has been shown to have 85% of the efficacy of the 120 mg orlistat dose.
Contrave is a combination medication that consists of bupropion, an antidepressant, andnaltrexone, an opioid antagonist. The two work together to help you lose weight along with a low-calorie diet and appropriate exercise.
In four clinical trials, people who were overweight or with obesity took Contrave for up to 56 weeks.
Overall, people who took Contrave lost more body weight than those who took a placebo. For example, in one study, 40% of participants who took Contrave lost at least 5% of their body weight, and 20% of participants lost at least 10%.
The average weight loss across all four studies ranged from 11 to 22 pounds for those taking the medication.
Contrave also helped lower hemoglobin A1c in people with type 2 diabetes.
Do not use Contrave if you:
While taking Contrave, the following side effects are possible:
Safety WarningLike other antidepressants, bupropion comes with the risk of increased suicidal thinking and behaviors, especially in children, adolescents, and young adults. Contrave’s labeling includes a boxed warning to highlight this risk.While taking Contrave, be aware of any changes in your mental well-being and contact your healthcare provider immediately if you notice any mood changes or have suicidal thoughts.
Safety Warning
Like other antidepressants, bupropion comes with the risk of increased suicidal thinking and behaviors, especially in children, adolescents, and young adults. Contrave’s labeling includes a boxed warning to highlight this risk.While taking Contrave, be aware of any changes in your mental well-being and contact your healthcare provider immediately if you notice any mood changes or have suicidal thoughts.
Like other antidepressants, bupropion comes with the risk of increased suicidal thinking and behaviors, especially in children, adolescents, and young adults. Contrave’s labeling includes a boxed warning to highlight this risk.
While taking Contrave, be aware of any changes in your mental well-being and contact your healthcare provider immediately if you notice any mood changes or have suicidal thoughts.
Saxenda is a medication injected subcutaneously (under the skin).
You’ll usually take your dose once daily, with or without meals. When first starting treatment, your healthcare provider will have you start at a lower dose and then gradually increase it over the coming weeks.
Saxenda is also one of the obesity treatments that can be used in children ages 12 to 17 with obesity.Talk to your child’s healthcare provider about dosing, as it can vary for children.
A large trial evaluated liraglutide in individuals who were overweight or had obesity. The participants had diabetes or prediabetes. By the end of the study (56 weeks), Saxenda users reported statistically significant weight loss compared with those who took the placebo.
In this study, 63% of the participants who took Saxenda lost at least 5% of their body weight. About 33% lost at least 10% of their body weight.
In another study of people without diabetes, Saxenda was more effective for weight loss than lifestyle interventions alone. It also showed sustained weight loss over two years.
When taking Saxenda, common side effects can include:
Do not start Saxenda if you:
When starting Saxenda, talk to your healthcare provider if you develop abdominal pain, nausea, or vomiting that does not go away.
Qsymia is combination medication made up ofphentermine, a medication similar to amphetamines, and topiramate, an anti-seizure medication. It works in the brain to reduce your appetite.
Usually, Qsymia is taken once daily in the morning because it can causeinsomnia.
Children 12 years and older can take Qysmia if they have a BMI considered to be in the 95th percentile. Talk to your healthcare provider about your child’s BMI to determine if Qsymia is right for them.
At the maximum dose in initial clinical studies, 70% of adult participants who took Qysmia lost at least 5% of their body weight in one year. Almost half lost 10% or more of their body weight.
In additional studies, Qysmia resulted in an average weight loss of about 17 pounds compared with a placebo. The amount of weight lost was dependent on the dose.
For adults, common side effects can include:
For children, common side effects can include:
Do not start Qsymia if you:
When starting Qsymia, watch for any changes in your mood. Talk to your healthcare provider about monitoring your kidney function, heart rate, andsodiumandpotassiumlevels. If your child takes Qsymia, monitor for signs of stunted growth.
Certain medications can interact with Qsymia. These include:
Taking Qysmia SafelyQysmia is categorized as a Schedule IV controlled substance because it contains phentermine. Phentermine has the potential for abuse and physical dependence. Do not abruptly stop taking Qysmia, as this can cause withdrawal reactions.Do not stop taking Qysmia without consulting with your healthcare provider. They can help you safely come off the medication. Talk to your provider immediately if you feel you are becoming dependent on your medication.
Taking Qysmia Safely
Qysmia is categorized as a Schedule IV controlled substance because it contains phentermine. Phentermine has the potential for abuse and physical dependence. Do not abruptly stop taking Qysmia, as this can cause withdrawal reactions.Do not stop taking Qysmia without consulting with your healthcare provider. They can help you safely come off the medication. Talk to your provider immediately if you feel you are becoming dependent on your medication.
Qysmia is categorized as a Schedule IV controlled substance because it contains phentermine. Phentermine has the potential for abuse and physical dependence. Do not abruptly stop taking Qysmia, as this can cause withdrawal reactions.
Do not stop taking Qysmia without consulting with your healthcare provider. They can help you safely come off the medication. Talk to your provider immediately if you feel you are becoming dependent on your medication.
Imcivree belongs to a class of medications called melanocortin receptor agonists, which can affect fat formation in the body.
Imcivree is injected under the skin. It helps control your hunger and appetite if you have certain genetic dispositions that include:
If prescribed Imcivree, your dose may depend on your kidney health. It’s important to rotate the area where you inject Imcivree to prevent injection site reactions or scarring on the skin.
Two clinical trials studied how well Imicvree works in people with obesity due to gene deficiencies of POMC, PCSK1, or LEPR.
In these studies, 80% of people with POMC or PCSK1 deficiencies achieved at least 10% weight loss after one year. Forty percent of those with LEPR deficiency had a 10% weight loss in one year.
The most common side effects seen with Imcivree are:
Imcivree should not be used in infants or newborns as an ingredient found in Imcivree can be fatal to this population.
When taking Imcivree, watch for any changes in sexual function. For males, contact your healthcare provider if you develop an erection lasting longer than four hours. Watch for any changes in your mood.
Risk of Depression or Suicidal ThinkingImcivree has caused new or worsening depression and suicidal thinking. Be mindful of any changes in mood, thoughts, or behaviors if you or someone you are caring for is taking this medication. Contact your healthcare provider immediately if you experience any symptoms of depression or suicidal ideation.
Risk of Depression or Suicidal Thinking
Imcivree has caused new or worsening depression and suicidal thinking. Be mindful of any changes in mood, thoughts, or behaviors if you or someone you are caring for is taking this medication. Contact your healthcare provider immediately if you experience any symptoms of depression or suicidal ideation.
Like Saxenda,Wegovyis a GLP-1 receptor agonist. It stimulates the GLP-1 receptor in the brain, making you feel full.
Wegovy may be prescribed to children 12 and older with a BMI in the 95th percentile (considered obese).
Wegovy is given under the skin once weekly, at the same time every week, with or without meals.
In studies, semaglutide was more effective at reducing body weight and HbA1c than placebo. When used in addition to lifestyle interventions, 2.4 mg of semaglutide once weekly resulted in an average weight loss of 15%.
More people who took semaglutide (86%) lost at least 5% of their body weight compared with those on placebo (13%). About seventy percent of users lost at least 10% of their body weight.
Studies have also shown semaglutide to be superior to some other weight-loss agents. Compared with liraglutide, more semaglutide users achieved weight loss greater than 5% or 10%.
Common side effects seen with Wegovy may include:
Let your healthcare provider know if you are taking any other medications, as Wegovy can affect their concentrations in the body.
Do not start Wegovy if you:
What to Watch forWhile taking Wegovy, watch for the following side effects:When starting treatment, contact your healthcare provider if you develop abdominal pain, nausea, or vomiting that does not go away, as it could be a sign of a more serious side effect.Wegovy can also cause depression or suicidal ideation. If this occurs, see your healthcare provider as soon as possible. They may need to take you off of the medication.If you have type 2 diabetes, monitor for any changes in eyesight or a drop in your blood sugar.
What to Watch for
While taking Wegovy, watch for the following side effects:When starting treatment, contact your healthcare provider if you develop abdominal pain, nausea, or vomiting that does not go away, as it could be a sign of a more serious side effect.Wegovy can also cause depression or suicidal ideation. If this occurs, see your healthcare provider as soon as possible. They may need to take you off of the medication.If you have type 2 diabetes, monitor for any changes in eyesight or a drop in your blood sugar.
While taking Wegovy, watch for the following side effects:
Zepbound is a dual-acting glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist. Zepbound activates these hormones, making you feel full.
Zepbound is a medication injected subcutaneously and is approved for adults with obesity.
The recommended maintenance dosage of Zepbound is 5-15 mg, injected once weekly.
Two large trials evaluated Zepbound in individuals who were overweight or obese. By the end of the study (72 weeks), people who dieted, exercised and took Zepbound reported statistically significant weight loss compared to those who took the placebo.
Common side effects seen with Zepbound may include:
Zepbound (terzepatide) is an injectable weight-loss medication for adults with obesity. Terzepatide is also the active ingredient inMounjaro, which is approved to treat diabetes. Zepbound may interact with Synthroid and increase the risk of MTC. Those with a personal or family history of (medullary thyroid carcinoma) MTC or with multiple endocrine neoplasia syndrome type 2 (MEN 2) should avoid it.
Summary
Medications like the ones mentioned above may be beneficial when diet and exercise are not enough to reach your weight goal. Your healthcare provider can help you find the best option based on your health goals, medical history, and personal preferences.
However, these medications aren’t quick fixes. Lifestyle changes are strongly recommended in obesity treatment. Continue eating a healthy, well-balanced diet and engaging in a consistent exercise routine, even after achieving weight loss goals.
Frequently Asked QuestionsIt is not recommended to take more than one weight loss medication at the same time before speaking with your healthcare provider, as doing so may worsen possible side effects of the medication.Weight loss during pregnancy may cause complications for the fetus. Therefore, you should not take any weight loss medications while pregnant.No, these medications are indicated only if you are overweight or obese and should not be used with a BMI less than 27.
It is not recommended to take more than one weight loss medication at the same time before speaking with your healthcare provider, as doing so may worsen possible side effects of the medication.
Weight loss during pregnancy may cause complications for the fetus. Therefore, you should not take any weight loss medications while pregnant.
No, these medications are indicated only if you are overweight or obese and should not be used with a BMI less than 27.
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