appetite suppressants

Top Weight Loss Medications

 

Weight loss medications play a critical role in managing obesity alongside lifestyle interventions. This article explores current and emerging therapies, their mechanisms, efficacy, and considerations for use.

Criteria for Weight Loss Medication Prescriptions

 

Weight loss medications are typically prescribed to adults with BMI >=30 or >=27 who suffer from weight-related conditions. Diet/exercise changes must accompany therapy, and patient histories related to cardiovascular, metabolic, and mental health will also be reviewed before prescribing.

Currently Available Weight Loss Medications

Semaglutide

 

Semaglutide (Wegovy, Ozempic) is a GLP-1 receptor agonist approved for chronic weight management. Clinical trials demonstrate 15-20% average weight loss using Wegovy at 2.4 mg weekly dose. Also effective against type 2 diabetes at lower dosages.

Tirzepatide (Zepbound, Mounjaro)

 

Tirzepatide combines GLP-1 and GIP agonism for optimal HbA1c reduction and weight reduction by up to 15-20% in obesity studies. Furthermore, its dual mechanism targets both appetite suppression and energy expenditure.

Liraglutide (Saxenda)

 

Liraglutide is an FDA-approved GLP-1 analog administered as daily injection. This treatment typically results in weight reduction between 8-8.0%; common side effects may include nausea, vomiting and gastrointestinal distress.

Phentermine (Adipex, Suprenza)

 

Phentermine is an FDA-approved appetite suppressant approved for up to 12 weeks use, available as both immediate release (IR) and extended release (ER) formulations and associated with increased heart rate and hypertension risks.

Phentermine-topiramate (Qsymia)

 

Phentermine-topiramate is a combination of phentermine and topiramate ER that reduces weight by approximately 8-10% at max dose (7.5/46 mg). There may be birth defect risks and pregnancy contraindications.

Naltrexone-bupropion (Contrave)

 

Naltrexone-bupropion can block opioid receptors while increasing norepinephrine/dopamine production, with results showing 3-5% weight loss on average in clinical studies. Monitoring for mood changes or depression history should occur throughout treatment.

Setmelanotide (Imcivree)

 

Setmelanotide is an MC4R agonist prescribed to those suffering from genetic obesity (such as pro-opiomelanocortin mutations). Although effective, genetic testing must first take place to establish eligibility.

Orlistat (Xenical and Alli)

 

Orlistat inhibits fat absorption in the GI tract. At 120 mg dosed as oral supplement Xenical can provide 5-7% weight loss; Alli's 60 mg OTC version provides lesser results; common side effects of Orlistat include oily spotting and fecal urgency.

Hydrogel (Plenity)

 

Non-drug capsule that uses hydrogel components that expand in stomach. Shown to reduce caloric intake by 25-40%. Used as adjunct therapy; no FDA approval necessary.

Emerging Weight Loss Medications

 

Future weight loss medications in development include GLP-1/GIP/GDF-15 triple agonists and MC4R modulators, with Phase III trials of tirzepatide weekly injections targeting sustained outcomes post-treatment discontinuation.

Frequently Asked Questions About Weight Loss Medications

How effective are weight loss medications?

 

On average, weight loss medications tend to cause 5-15% excess weight loss over 6 months depending on adherence, diet/exercise regimen and individual physiology.

What is the strongest weight-loss medication currently available by prescription?

 

Studies conducted to date on Semaglutide (Wegovy) demonstrate its superior effectiveness by showing sustained weight losses at 12-52 weeks in clinical trials.

 

How do weight loss medications work?

 

 

    • GLP-1 agonists delay gastric emptying and reduce hunger

 

    • Naltrexone-bupropion alters neurotransmitter signaling for satiety

 

    • Orlistat blocks fat absorption in intestines

 

Are there medications that can cause weight gain?

 

Corticosteroids, antipsychotics (e.g. olanzapine), and some antidepressants (mirtazapine) have all been associated with significant weight gain.

How should medications be combined with other treatments?

 

For the best outcomes, medications should be combined with 500-750 kcal deficit diets, moderate physical exercise (150 mins/wk) and behavioral counseling to achieve maximum effects.

How long must they be taken?

 

GLP-1 agonists require ongoing dosing to maintain weight loss. Discontinuation often leads to regain without sustained lifestyle changes.

What recent trends have emerged in medications?

 

An increase in combination therapies (e.g., GLP-1/GIP agonists) as well as expanded FDA approvals of lower BMI thresholds since 2020 has been noted.

How do medication categories compare by cost?

 

MedicationMonthly Cost
Semaglutide (Wegovy)$1,250–$1,400
Liraglutide (Saxenda)$980–$1,300
Phentermine-Topiramate$700–$1,200
Orlistat (Xenical)$450–$600

How do they affect weight regain?

 

Ongoing treatments correlate with sustained results; randomized trials show 20-30% weight regain within one year without alternatives being used as treatments.

What’s the difference between OTC and prescription meds?

 

In general, prescription medications require medical supervision such as Wegovy while OTC options such as Alli and Plenity tend to have milder effects without clinical trial support for significant weight loss.

How are antidepressants related to weight loss?

 

Bupropion (in Contrave) stands out as being an exception; most antidepressants lead to weight gain. Lisdexamfetamine shows some evidence of modest weight loss benefits when treating OCD.

Which medications suppress appetite?

 

GLP-1 agonists, phentermine and naltrexone-bupropion act on appetite centers in the brain to decrease hunger signals and suppress your appetite.

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