Medically reviewed by Jorge Moreno, MD — By Rachael Ajmera, MS, RD and Kris Gunnars, BSc — Updated on August 11, 2023
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Prescription weight loss medications, including GLP-1 agonists, orlistat, and setmelanotide, may be effective for some people. But other lifestyle changes are still necessary for long-term success.
If it’s challenging to lose weight despite making changes to your diet and increasing your physical activity, you may be wondering whether a prescription weight loss medication is right for you.
When paired with other lifestyle changes and taken under the supervision of a healthcare professional, these drugs may offer an effective way to lower your weight.
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We reviewed all of the weight loss medications that are currently available, including how they work, who they might be appropriate for, research on their effectiveness, and potential safety concerns.
The Food and Drug Administration (FDA) has approved several drugs for losing weight with overweight and obesity. These medications require a prescription from a doctor and should only be taken under medical supervision.
These medications should be combined with a balanced weight loss diet, as alone, they’re not likely a helpful long-term solution for obesity and may lead to weight regain over time.
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These medications are designed for people who haven’t been able to achieve weight loss through other methods, including diet or lifestyle changes.
Though they shouldn’t be considered a quick fix, these medications can be a useful tool to support weight management when combined with regular physical activity and a nutritious diet.
Keep in mind that weight loss medications are not suitable for everyone, including people who are pregnant, those with certain health conditions, or individuals taking specific medications.
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A healthcare professional can provide guidance on whether you might be a candidate for a prescription, depending on your personal goals, medical history, and health status.
Weight loss medications are not recommended during pregnancy and may not be safe for people who are pregnant or who may become pregnant, or anyone who’s breastfeeding. Contact a trusted healthcare professional, like your OB-GYN, before taking any weight loss medications or supplements.
Not only will adopting dietary and lifestyle changes help increase the effectiveness of weight loss drugs, they can help minimize weight regain, which often occurs after you stop taking these medications.
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Orlistat is an oral medication that’s available via prescription as Xenical. It can also be purchased over the counter as the brand Alli.
How it works: Orlistat works by blocking the activity of certain enzymes used to break down fats in the digestive tract, which
Of 80 people with obesity, those who took orlistat lost an average of 10.3 pounds (lb), or 4.65 kilograms (kg), after 6 months. They also experienced significant reductions in body mass index (BMI), belly fat, and total and LDL (bad) cholesterol levels.
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Side effects: Orlistat often causes digestive issues like loose or oily stools, gas, and frequent bowel movements, making the medication difficult for some people to tolerate. It could also contribute to nutrient deficiencies, including in fat-soluble vitamins A, D, E, or K.
Phentermine/topiramate is an oral medication that belongs to a class of drugs known as sympathomimetic amines. It requires a prescription from a doctor and is sold under the brand Qsymia.
Phentermine, a central nervous system stimulant and appetite suppressant with similar mechanisms to amphetamine. It also includes topiramate, an anticonvulsant that helps reduce appetite and enhance satiety (feeling full) to promote weight loss.
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Another review comparing the effectiveness of several weight loss medications found that people with overweight or obesity who took phentermine/topiramate lost an average of
Contraindications: This medication is not recommended for people with glaucoma (eye conditions that can lead to blindness), a history of hyperthyroidism, pregnancy, recent use of monoamine oxidase inhibitors, and current use of certain prescription medications.
A doctor can determine whether Contrave may be a good option for you and then provide a prescription. Some online services may also prescribe Contrave following a virtual consultation with a healthcare professional.
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Effectiveness: One review of four studies showed that naltrexone/bupropion was associated with significant weight loss compared with a placebo. Over 1 year, participants lost an average of
Contraindications: This medication is not recommended for people with a history of seizures, end-stage renal disease, pregnancy, and current use of monoamine oxidase inhibitors, opioids, or certain other prescription medications.
Two GLP-1 agonists have been approved for weight loss, including liraglutide (Saxenda) and semaglutide (Wegovy). Both are available as a self-administered injection, but liraglutide is administered once daily, while semaglutide is only injected once per week.
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Though not approved specifically for weight loss, some other GLP-1 agonists intended to treat type 2 diabetes are sometimes prescribed off-label for weight management,
GLP-1 agonists are only available through a prescription from a doctor or other qualified healthcare professional. Several telehealth services and weight loss programs may also provide prescriptions if you meet the eligibility criteria, including Ro Body Program and Calibrate.
For instance, one study in 1, 961 adults found that taking 2.4 milligrams (mg) of semaglutide per week combined with lifestyle changes resulted in a
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Though uncommon, severe side effects have also been reported, which may require medical attention. These include kidney problems, thyroid C-cell tumors, gallbladder disease, low blood sugar, and suicidal ideation. It’s important to be in regular contact with your healthcare professional to monitor for these side effects.
Contraindications: This medication is not recommended for people with multiple endocrine neoplasia (MEN) syndrome type 2, history of thyroid cancer or pancreatitis, pregnancy, and current use of certain prescription medications.
How it works: People with specific genetic mutations may experience insufficient activation of the MC4 receptor in the brain, which could contribute to obesity.
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Setmelanotide works by increasing the activation of this receptor, leading to reduced hunger, decreased calorie intake, and increased metabolism, all of which could promote weight loss.
Of participants achieved at least 10% weight loss after 1 year. Participants also experienced a significant reduction in hunger with no serious treatment-related adverse events reported.
That setmelanotide significantly improved quality of life as early as 5 weeks after starting treatment, which could be related to reduced hunger and body weight.
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Side effects: Some of the most common side effects of setmelanotide include injection site reactions, hyperpigmentation, nausea, headache, diarrhea, and stomach or back pain. Fatigue, vomiting, and depression have also been reported.
Effectiveness: One study in 3, 411 people compared the effectiveness of several medications for obesity and found that people taking phentermine lost the highest percentage of body weight over 12 weeks. Those taking phentermine lost an average of
However, keep in mind that these medications are only recommended for short-term use, as you can build up a tolerance after several weeks, resulting in decreased effectiveness.
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Other severe side effects have been reported and require immediate medical attention, including shortness of breath, chest pain, and swelling of the lower extremities.
Contraindications: This medication is not recommended for people with a history of heart disease, hypertension, hyperthyroidism, glaucoma, diabetes, pregnancy, and certain prescription medications.
In addition to prescription drugs, there are also a few over-the-counter (OTC) weight loss pills and supplements available. However, research on the effectiveness and safety of these products is limited.
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If you’re considering trying any of these weight loss supplements or pills, it’s best to check in with a doctor or other healthcare professional first.
If you’ve tried everything to lose weight and the scale still won’t budge, it’s worth talking with a healthcare professional, like a doctor or registered dietitian, about whether a weight loss medication might be right for you.
Because these pills can have serious side effects and are not safe for everyone, it’s important not to take any weight loss drugs or supplements without consulting a professional first.
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Some digital weight loss platforms, including Ro and Calibrate, include GLP-1 medications in their treatment plans for people who meet certain eligibility criteria.
For people with eating disorders (EDs), even if they’re at higher body weights, as there’s a risk of misuse of prescription or OTC diet drugs.
If you’re preoccupied with food or weight, feel guilt surrounding your food choices, or routinely engage in restrictive diets, consider reaching out for support. These behaviors may indicate a disordered relationship with food or an ED.
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They can be caused by any combination of biological, social, cultural, and environmental factors — not just by exposure to diet culture.
Safe for long-term use. Currently, only liraglutide (Saxenda) and semaglutide (Wegovy) are approved for weight loss, though some other GLP-1 drugs may be prescribed off-label.
Additionally, it’s important to follow a well rounded diet and healthy lifestyle. In addition to maximizing your potential results, it can increase the likelihood of maintaining weight loss in the long term.
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If considered medically necessary, insurance companies may cover certain prescription weight loss medications. Some manufacturers also offer savings cards, which can help lower the cost of your copay.
Prescription medications have strong evidence to support their effectiveness for meaningful weight loss. However, it’s important to consider eligibility criteria, potential side effects, and
