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The Most Common Weight Loss Prescription Medications

Written by:
Rabia Khaliq
MSc in Applied Psychology
Medical Disclaimer
The medications listed on this website are provided for informational purposes only. Their inclusion does not guarantee that they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. This list is not exhaustive, and healthcare providers may prescribe other medications, including non-stimulant options, based on the patient’s unique health circumstances and needs. Read more

Highlights

  • Medications can be prescribed when weight loss is necessary for medical reasons and lifestyle changes don’t bring the desired results.
  • Weight loss medications have different mechanisms of action, uses, efficacy, and side effects. Only a medical professional can recommend the most suitable medication.
  • In addition to positive effects, weight loss medicines have potential risks, so identifying the risk-benefit ratio is essential.
  • To obtain a prescription for weight loss medicines, see a healthcare provider who can define whether your situation meets the criteria for medication prescription.

In 2023, 55% of women and 47% of men in the US wanted to lose weight, according to Statista [1*] . Among those making attempts to do so, 62,9% tried eating less and exercising more. Although popular, sometimes, these steps may not help people lose weight. In this case, when the situation also aligns with medical criteria, a healthcare provider can recommend pharmacological methods.

Consult a healthcare expert online and obtain personalized recommendations.

Medicines Commonly Prescribed for Weight Management

Before prescribing a medication, doctors thoroughly evaluate a patient’s health profile and individual needs. Commonly chosen medicines are listed below.

Phentermine (Adipex-P)

Adipex-P is an appetite suppressant. Its active ingredient phentermine [2*] is a sympathomimetic amine anorectic. This medication can be used short-term or long-term but always in combination with other methods: diet, exercise, caloric restrictions, and behavioral modifications. A healthcare professional defined the duration of treatment and other instructions individually.

Potential Side Effects

  • Hyperactivity
  • Anxiety or restlessness
  • Lack of sleep
  • Tremors
  • Dizziness
  • Headache
  • Mood changes (euphoric or dysphoric mood)
  • In extreme situations, psychosis
  • Bad taste
  • Dry mouth
  • Constipation
  • Diarrhea

Key Considerations

Phentermine may not be the best option for weight loss in the following cases:

  • A history of heart issues, high blood pressure, substance abuse, hyperthyroidism, glaucoma, or restlessness.
  • Phentermine may interact with other medications, including MAOIs, insulin, oral hypoglycemics, and adrenergic neuron-blocking medications.
  • Prolonged use or taking high doses might cause withdrawal symptoms.
  • It cannot be used for children under the age of sixteen or older patients with other health concerns.
  • It can impair the ability to perform activities that require increased alertness.

It may not be suitable for people with digestive and kidney diseases.

Phentermine-Topiramate (Qsymia)

Under a brand of Qsymia, this medication combines an antiepileptic medication (topiramate) and a sympathomimetic amine (phentermine). It enhances the sense of fullness and suppresses the appetite. Qsymia can be used for short-term (up to 12 weeks) and long-term weight management, and several clinical studies [3*] support its effectiveness.

Potential Side Effects

  • Dry mouth
  • Constipation
  • Paresthesia
  • Insomnia
  • Dizziness
  • Change in taste sensation
  • Increased heart rate

Key Considerations

  • Not recommended for people with glaucoma or hyperthyroidism.
  • Careful observation is needed in patients having mood disorders or cardiovascular disease.
  • Neuropsychiatric and cognitive side effects.
  • Not recommended during pregnancy.
  • Not recommended for patients taking MAOIs.

Semaglutide (Ozempic and Wegovy)

A GLP-1 receptor agonist semaglutide is available under names Ozempic and Wegovy. It helps to lose weight by reducing appetite and delaying gastric emptying when used along with a healthy diet and lifestyle changes. Semaglutide can be used long-term, and several studies have approved its effectiveness.

Potential Side Effects

  • Nausea
  • Diarrhea
  • Vomiting
  • Dyspepsia
  • Constipation
  • Abdominal pain
  • Pancreatitis

Key Considerations

  • It is not recommended for people having a history of thyroid carcinoma or multiple endocrine neoplasia syndrome type 2, diabetic retinopathy, and pancreatitis.
  • If you are using any other antidiabetic medicines, this medication may potentially lead to hypoglycemia or low blood sugar.
  • Don’t use it if you are sensitive to any ingredients of the medication.
“With proper weight loss medication in place, often cravings and appetite are reduced. This puts the power in your hand to make those healthy eating choices consistently that will lead to weight loss. Keep in mind, weight loss medications are generally designed to be stopped at some point. So while you are on weight loss medication, it's important to build healthy habits for sustainable weight goals.”
Dr. Michael Chichak, MD
Dr. Michael Chichak, MD
Medical provider at MEDvidi

Liraglutide (Saxenda)

Liraglutide (brand name Saxenda) is also a glucagon-like peptide-1 receptor agonist. It should be paired with a low-calorie diet and exercise regimen and can be prescribed for long-term use. Clinical trials [4*] have shown that it helps sustain weight loss.

Potential Side Effects

  • Vomiting
  • Nausea
  • Diarrhea
  • Abdominal pain
  • Constipation
  • Hypoglycemia

Key Considerations

  • It is not recommended for people with the history of multiple endocrine neoplasia syndrome type 2 or medullary thyroid carcinoma.
  • Contraindicated in patients with a history of gallbladder disease or pancreatitis.
  • If you are using any other antidiabetic medicines, this medication may potentially lead to hypoglycemia or low blood sugar.
  • Don’t use it if you are breastfeeding or pregnant.
  • Don’t use it if you are sensitive to any of the ingredients of the medication.

Naltrexone-Bupropion (Contrave)

Contrave (naltrexone-bupropion) is a combination of opioid receptor antagonists and dopamine and norepinephrine reuptake inhibitors. It influences energy balance and appetite and is approved to treat obesity in the long-term. Clinical trials [5*] have also shown its effectiveness in maintaining weight loss over time.

Potential Side Effects

  • Headache
  • Nausea
  • Vomiting
  • Constipation
  • Lack of sleep
  • Dizziness
  • High blood pressure

Key Considerations

  • Not recommended for people with a history of opioid use disorder, seizures, or uncontrolled hypertension.
  • Contraindicated in patients with a history of suicidal ideation and/or suicide attempts as this medication can lead to increase in suicidal thoughts.
  • Don’t use it if you are breastfeeding or pregnant.
  • It is not a safe option if you have renal impairment or severe liver injury.

If you’re experiencing suicidal or self-harming thoughts and require immediate assistance, contact a crisis hotline, such as 911, 988 suicide & crisis lifeline (toll-free), or Samaritans (116-123 or via chat).

Orlistat (Xenical)

Orlistat is a lipase inhibitor that reduces the absorption of consumed fat. It can be prescribed for long-term weight management, and its effects are backed by clinical trials [6*] .

Potential Side Effects

  • Oily spotting
  • Fecal urgency
  • Flatulence
  • Abdominal pain
  • Headache

Key Considerations

  • Not recommended for people with cholestasis or chronic malabsorption syndrome.
  • Contraindicated in people with thyroid disease, eating disorders, kidney stones, and diabetes.
“Discuss with your provider the need for vitamins A, D, E, and K when using this medication. These are fat-soluble vitamins, meaning they can only be absorbed with fat in the diet. Because of this, it is possible to develop deficiencies of these vitamins while on orlistat. For most people this is a non issue, but it’s worth discussing with your healthcare provider.”
Dr. Michael Chichak, MD
Dr. Michael Chichak, MD
Medical provider at MEDvidi

Tirzepatide (Mounjaro, Zepbound)

Tirzepatide (Zebound, Mounjaro) acts as a GIP receptor and a GLP-1 receptor agonist. It has shown significant results in different studies among overweight adults [7*] leading to average weight loss of 19.5% and 20.9% with 10 mg and 15 mg doses. Overall, it has shown a 3.1% body mass reduction compared to a placebo.

Tirzepatide stands out with a majority (89% to 91%) of participants achieving a meaningful 5% or more weight loss associated with metabolic health improvement. Some participants achieved higher targets of 10%, 15%, 20% or more.

Potential Side Effects

During the dose-increasing period, the most often reported adverse effects were transient and mostly mild-to-moderate gastrointestinal events.

Although Mounjaro and Zepbound have the same main ingredient, their side effects differ to some extent. That is why it is advised to discuss that with your healthcare provider.

Key Considerations

Cholecystitis was noted more frequently with tirzepatide, but general incidence was low (≤0.6%).

Metformin (Glucophage)

Metformin can help by controlling blood sugar levels, reducing hunger, and optimizing the  use of glucose. Like some other medications prescribed for weight management, metformin was created for the treatment of diabetes, but it has been proven [8*] helpful for weight loss.

Potential Side Effects

  • Gastrointestinal issues (abdominal discomfort, diarrhea, nausea).
  • Lactic acidosis (rare but severe).

Key Considerations

  • Caution in the case of renal impairment.
  • It may cause vitamin B12 deficiency.

Topiramate (Topamax)

Topiramate, a medication mainly used for seizures and migraines, is also helpful in weight loss. By affecting certain neurotransmitters in the brain, it helps reduce appetite and influences taste perception.

Side Effects

  • Fatigue
  • Dizziness
  • Paresthesia
  • Cognitive issues

Key Considerations

  • Caution in patients with a history of kidney stones.
  • Monitoring for mood changes is required.

Zonisamide (Zonegran)

Originally, Zonisamide is an anti-seizure medicine, but it can also be prescribed for weight loss because it improves metabolic control and decreases appetite.

Potential Side Effects

  • Drowsiness
  • Headache
  • Anorexia
  • May cause kidney stones

Key Considerations

  • Caution in the case of renal impairment.
  • Monitoring for signs of heatstroke is required.
Each weight loss medication has pros and cons. Consult with a healthcare expert to choose the most appropriate option.

A Comparison of Common Weight Loss Prescription Medications

Medication Name

Mechanism of action

Typical Dosage

Long-term use

Phentermine (Adipex-P)

Stimulant, appetite suppressant

15-37.5 mg once daily

Phentermine-Topiramate (Qsymia)

Anticonvulsant, appetite suppressant

3.75/23 mg to 15/92 mg once daily

✔️

Semaglutide (Wegovy, Ozempic)

GLP-1 receptor agonist, appetite suppressor

Starting dose is from 0.25 mg once weekly via injection

✔️

Liraglutide (Saxenda)

GLP-1 receptor agonist, appetite suppressant

0.6 mg to 3 mg daily via injection

✔️

Naltrexone-Bupropion (Contrave)

A combination of an opioid antagonist and an antidepressant

8 mg/90 mg tablet twice daily

✔️

Orlistat (Xenical)

Lipase inhibitor, reduces fat absorption in the intestine

120 mg capsule 3 times daily

✔️

Tirzepatide (Mounjaro, Zepbound)

GIP and GLP-1 receptor agonist

Mounjaro: 15 mg once weekly.
Zepbound: 2.5 mg once weekly

Additional research is required

Metformin (Glucophage)

Biguanide; reduces glucose production and enhance insulin sensitivity 

500 mg twice daily or 850 mg once daily

✔️

Topiramate (Topamax)

Anticonvulsant; alters taste perception and reduce appetite

25 mg to 50 mg once daily

✔️

Zonisamide (Zonegran)

Anticonvulsant; enhances metabolic control and lessens appetite

100 mg daily

✔️

The table above serves informational purposes only. Consult with your medical provider on the individually chosen initial dosage, any further dosage adjustments, and the duration of treatment.

Who Can Take Weight Loss Medications?

Weight loss medicine is mainly suggested for people with a body mass index (BMI) of 30 or more, referring to obesity, or a BMI of 27 or higher with comorbid conditions, like hypertension or diabetes.

The choice of a specific medicine requires a detailed health assessment. Some of these medications are not recommended for those with cardiovascular issues. Importantly, pregnancy is not a good time to try to lose weight even if a person is significantly overweight. For a pregnancy to progress healthfully, the person needs to gain weight regardless of the starting weight. Because of that, weight loss medication should not be used during pregnancy.

Are Weight Loss Medications Safe?

Most commonly prescribed weight loss medicines, such as phentermine, liraglutide, and tirzepatide, have been subjected to intense testing to measure their safety. Still, like many pharmaceutical interventions, they may have side effects. For example, phentermine can cause overstimulation, restlessness, irritation, lack of sleep, and gastrointestinal disturbances. Tirzepatide has a boxed warning about the risk of thyroid C-cell tumors. People with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) are advised against using tirzepatide.

Safety is dependent on a number of factors, such as specific medications, medical history, and adherence to the treatment plan.

Consult with health experts at MEDvidi to know if you are eligible for weight loss medications.

7 Things to Know About Weight-Loss Medications

  1. Weight-loss medication is not a cure but a supportive tool for lifestyle changes, including a balanced diet and regular physical activity. To maintain the reduced body weight, healthcare professionals encourage patients to keep up with these changes after stopping the medication.
  2. Awareness of the possible side effects empowers you to recognize and manage them promptly.
  3. Weight loss medications also have associated risks. You should discuss your health condition and preferences with your healthcare provider to weigh the possible benefits of these medications against the risks.
  4. Attend follow-up appointments with your doctor to discuss any side effects or other concerns, monitor your weight, and adjust your treatment plan.
  5. Each human body is unique and has different demands, so individual reactions to medications can be different. Your doctor will customize the treatment plan to your specific needs and condition, adjusting the treatment to your health goals and informing you about the possible risks or benefits.
  6. Your healthcare provider may recommend talk therapy sessions to help you achieve behavioral changes necessary for sustainable results.
  7. Your plan may require adjustments. Don’t hesitate to discuss not only your progress but also challenges to customize the treatment if needed.

How to Receive a Prescription for Weight Loss Medication

Consult a healthcare provider who will assess your medical history, general health, and weight loss goals. If you qualify for weight loss medication, your clinician will write a prescription and send it digitally to a local pharmacy. At MEDvidi, the process is straightforward:

  • Sign up and book an appointment.
  • Have a video consultation with a healthcare professional who will define if you require medicine and will provide you with a prescription if needed.
  • Check the prescription status in your Personal Portal and fill the prescription.
  • If recommended, attend follow-up appointments to monitor the results of treatment.

Cost and Insurance of Prescription Weight Loss Medications

The cost of the medications used for weight reduction varies depending on the dosage, pharmacy, insurance coverage, and the particular medication. The generic version (may be $10 to $70) cost less than the brand name versions($500 to $1400). 

You can also use an insurance plan; however, these plans vary based on the specific medication prescribed and several other factors. FDA-approved medications are highly likely to have insurance coverage.

In case you don’t have insurance here are a few tips to help you save money.

  • Discuss using generic versions of medicines with your doctor.
  • Compare prices in different pharmacies.
  • Some pharmacies may offer discounts or coupons which reduce the cost.
  • Try to look for patient assistance programs that offer lower-cost of medicines.

Conclusion

Weight loss medicines can be effective. However, it’s important to create long-lasting habits that improve overall well-being and help maintain the results achieved while taking medication. Consult with your healthcare provider to discuss what approach can suit you best and create a weight reduction plan tailored to your requirements and health objectives.

Frequently Asked Questions

The efficacy of any weight loss medication depends on various factors, from the mechanism of action to individual health specifics. One of the biggest variables is eating habits. It is actually possible to gain weight while on a weight loss medication if a person’s diet is not in proper order. Sustainable weight is fully possible when proper habits are in place. It is important to get advice from your doctor depending on your unique needs.

Tirzepatide is a new GLP-1 medication. Approved in 2022, it is considered a beneficial weight-loss solution, as supported by several studies [9*] .

OTC medicines have different potencies, intended uses, and approval processes than prescription weight loss medications. OTC medications are generally considered mild but it’s still important to consult with a healthcare professional before taking them to lose weight.
Several medications are considered helpful in lowering appetite, such as tirzepatide, phentermine, and liraglutide among others.
It’s important to maintain regular physical activity and a healthy diet after stopping weight loss medications to decrease the risks of weight gain. You can also consult with your doctor to learn what additional steps can be helpful in your situation.

Sources

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9 sources
  1. Percentage of U.S. adults who wanted to lose weight from 1951 to 2023, by gender
    Source link
  2. Effects on Weight Reduction and Safety of Short-Term Phentermine Administration in Korean Obese People
    Source link
  3. Several Drugs Are Effective for Weight Loss in Obese or Overweight Adults
    Source link
  4. Clinical Impact of Liraglutide as a Treatment of Obesity
    Source link
  5. Naltrexone/Bupropion ER (Contrave)
    Source link
  6. Orlistat
    Source link
  7. Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: the SURMOUNT-3 phase 3 trial
    Source link
  8. Effects of metformin in obesity treatment in different populations: a meta-analysis
    Source link
  9. Tirzepatide Once Weekly for the Treatment of Obesity
    Source link
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Written by:
Rabia Khaliq
MSc in Applied Psychology
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