The term “diet pill” may come to mind when you think about weight loss medication. But in 2023, that term is outdated — we now understand obesity to be more complex than what the next fad diet can treat. It’s important to treat overweight and obesity as chronic conditions because they can adversely affect one’s health. The best approach to weight loss includes comprehensive treatment with a medical professional or team of professionals advising on nutrition, physical activity, and behavior changes. If patients aren’t successful with these changes alone, then tools such as prescription medication can be considered.
Prescription weight loss medications have been in existence for a while, but not until the last decade have pharmaceutical companies made significant progress in giving patients multiple options. You might be thinking – “But do weight loss pills work?” The answer is, that depends. The terms “weight loss pills” and “diet pills” include a number of untested, over-the-counter supplements that have never been proven to help people lose weight. Their safety is also unknown. Keep reading to learn more about FDA-approved prescription weight loss medications that have proven to be safe and effective for weight management.
What is Prescription Weight Loss Medication?
Prescription weight loss medication is FDA-approved medication used for weight management in patients with overweight and obesity. Used in combination with a reduced calorie diet, regular physical activity, and behavior changes, they can promote weight loss. Research shows that patients are more successful with long-term weight management and improvements in weight-related medical problems when using medication in combination with lifestyle changes versus lifestyle changes alone. These medications help you eat less by reducing appetite and cravings.
Most prescription weight loss medications are indicated for chronic weight management, which means they are used long-term to help someone not only lose weight, but maintain the weight loss. Overweight and obesity are chronic conditions, so long-term treatment is necessary, just like with other chronic conditions.
Who Can Take Weight Loss Medication?
Prescription weight loss medications are indicated for people with a body mass index of 27 kg/m2 or greater who have a weight-related medical problem or people with a BMI of 30 kg/m2 or greater. That doesn’t mean weight loss medication is right for every person with overweight or obesity. The decision to start a medication can depend on your health history, what other medications you take, and insurance coverage, so it should be a shared decision with your healthcare provider.
It’s important to remember that these medications are not meant to replace a healthy lifestyle. For the best possible outcomes, patients should also adopt healthy eating patterns, increase physical activity, and incorporate mindset changes that help you to do these things long-term.
Do Weight Loss Medications Work?
Yes, prescription weight loss medications have been shown to produce more weight loss when used in combination with diet and exercise than diet and exercise alone. Results will vary from person to person and also depend on which medication you take. Most of these medications can help you to lose 3-7% more than lifestyle changes alone with the exception of the newest medication, semaglutide (Wegovy®). In clinical trials, Wegovy helped people lose 12.4% more than placebo.
When discussing weight loss medication, Dr. Florencia Halperin, Chief Medical Officer at Form has said “I have been humbled by the impact that changing hunger signals in the brain with a weight loss medication can make. For some of my patients, these medications have been transformative, helping them be successful at something that had been a lifelong struggle.” The program she has helped develop at Form utilizes a team approach with Registered Dietitians and board-certified obesity medicine specialists who prescribe FDA-approved weight loss medication when appropriate in combination with extensive nutrition counseling and support for behavior changes.
How Does Weight Loss Medication Fit into your Life?
Some medications are daily pills, others are weekly injections. Taking medication as prescribed is critical for efficacy and safety and how you take weight loss medication is going to vary depending on the medication. Most prescription weight loss medications are indicated for long-term use and research shows that stopping a medication often leads to weight regain, so the decision to stop a medication should be discussed with your prescribing doctor.
It is also important to understand that these medications work far better when used in combination with lifestyle changes, so continuing to work on healthy habits should be part of your daily life as well. These medications can help patients stick to those lifestyle changes more easily; making something that may have been a lifelong struggle much more doable.
FDA-Approved Weight Loss Medication List
There are several FDA-approved weight loss medications for chronic weight management – naltrexone-bupropion (Contrave®), liraglutide (Saxenda®), semaglutide (Wegovy®), phentermine-topiramate (Qsymia®), and orlistat (Xenical®, Alli®).
Below you’ll find more detailed information about those indicated for chronic weight management:
- Naltrexone-bupropion (Contrave®) is a combination medication meant to target areas of the brain tied to cravings and appetite. This medication comes in pill form and is typically taken twice daily.
- Liraglutide (Saxenda®) is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) that mimics a naturally produced hormone that regulates appetite and blood sugar. This medication is a once-daily injectable.
- Semaglutide (Wegovy®) is like Saxenda in that it is a GLP-1 RA, so it helps to regulate appetite and blood sugar, but unlike Saxenda this medication is injected once a week.
- Phentermine-topiramate (Qsymia®) is another combination medication that works in the brain to reduce hunger and cravings. This pill is taken once-daily.
- Orlistat (Xenical®, Alli®) is a medication that helps block fat absorption from foods. It is a pill taken around meal time (up to 3 times per day). Alli is the only over-the-counter FDA approved medication for weight loss.
Are there Risks or Side Effects when Taking Weight Loss Medication?
It is important to understand potential side effects when starting any medication. Common side effects for this type of medications include fatigue, nausea, changes in bowel habits, headaches, and mood changes. There are other less common side effects that vary depending on the medication, so you should discuss these with your doctor prior to starting. It is important to have regular follow-up visits with your healthcare provider while taking weight loss medication to monitor to make sure you are tolerating the medication and that it is working for you.
How Can You Get Weight Loss Medication?
Weight loss medication is not right for everyone, so talk to your doctor to determine if weight loss medication is right for you. Most of these medications require a prescription and coverage is going to vary depending on your insurance carrier. If you’re interested in seeking medical care for weight loss and working with experts who can help you consider medications as a tool to help you reach your weight loss goal, give medical weight loss a try! Medical weight loss programs use tools like nutrition, physical activity, mindset shifts, and FDA-approved medication, if appropriate, as parts of a comprehensive weight loss program to help you lose weight and improve your health.
Contrave® is a registered trademark of Currax Pharmaceutical LLC
Saxenda® and Wegovy® are registered trademarks of Novo Nordisk A/S
Qsymia® is a registered trademark of Vivus LLC
Xenical® is a registered trademark of Hoffmann-La Roche Limited
Alli® is a registered trademark of GlaxoSmithKline