A full guide to weight loss medication

When you think about weight loss medication, the term “diet pill” may come to mind. But in 2022, that term is as outdated as pink shag carpet. We now understand overweight and obesity to be much more complex than what the next fad diet or pill can treat. Overweight and obesity are chronic conditions that can adversely affect our health in many ways and because of this, it’s important to treat these conditions. The good news is that losing even 5 to 10% of your starting weight can help to reduce the risk of complications from excess body weight and improve overall health. The best approach to achieve these results includes comprehensive treatment with a medical professional or team of professionals advising on nutrition, physical activity, and behavior changes and, if patients aren’t successful with these changes alone, using science-backed tools like prescription medication. 

Prescription weight loss medications have been around for many years, but it hasn’t been until the last decade that pharmaceutical companies have made significant progress in giving patients multiple options. You might be thinking - “Options, great! But do weight loss pills work?” 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. And their safety is also unknown. Keep reading to learn more about prescription weight loss medications that have proven to be safe and effective for the treatment of overweight and obesity. 

What is prescription weight loss medication?

Prescription weight loss medication is FDA-approved medication used for weight management in persons with overweight and obesity. These medications are used in combination with a reduced calorie diet, regular physical activity, and behavior changes that promote weight loss. 

Clinicians use medications for the treatment of overweight or obesity because we know that these are complex conditions. Research has shown that patients are far 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 primarily work by reducing appetite and cravings, helping you to eat less. There is one medication that works by decreasing the absorption of fat. 

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 keep it off. As discussed, overweight and obesity are chronic conditions, so long-term treatment is needed, just like with many other chronic conditions. 

Who can take weight loss medication?

It’s important to remember that prescription weight loss medications are not meant to replace having a healthy lifestyle. Adopting healthy eating habits, increasing physical activity, and incorporating behavior changes that help you to do these things long-term are the foundation of weight management. If these changes alone don’t help you to achieve weight loss that improves your health and quality of life, it may be time to consider a prescription weight loss medication. 

Prescription weight loss medication is indicated for people with a body mass index (BMI) of 27 kg/m² or greater (overweight) who have a weight-related medical problem or people with a BMI of 30 kg/m² or greater (obesity). 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. 

Do prescription 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. But results will vary from person to person and 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 Health 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 simply transformative, helping them be successful at something that had been a lifelong struggle.” The program she has helped develop at Form Health 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 dietary counseling and support for behavior changes. Patients of Form Health lose an average of 15% of their starting weight at 12 months.  

How does weight loss medication fit into your daily life?

Taking medication as prescribed is important for efficacy and safety and how you take weight loss medication is going to vary depending on the medication. Some of the medications are daily pills, others are weekly injections. 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 shared with the prescribing healthcare provider.
 

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. When having the intended effect, these medications can help people to stick to those lifestyle changes more easily; making something that has potentially been a lifelong struggle more doable. 

FDA-approved weight loss medication list

There are five FDA-approved weight loss medications for chronic weight management - naltrexone-bupropion (Contrave^®), liraglutide (Saxenda^®), semaglutide (Wegovy^®), phentermine-topiramate (Qsymia^®), and orlistat (Xenical^®, Alli^®). 

Setmelanotide (Imcivree^®) was approved by the FDA in 2020 for the treatment of obesity related to three rare genetic conditions confirmed by genetic testing. 

There are also four medications that are indicated for short-term use - 12 weeks or less. These are phentermine (Adipex-P^®, Lomaira^®), benzphetamine, diethylpropion, and phendimetrazine although the last three listed here are not commonly prescribed. 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 dosed twice daily. 
• Liraglutide (Saxenda®) is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) that mimics a naturally produced hormone involved in regulating 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. This medication is a once-weekly injectable. 
• Phentermine-topiramate (Qsymia®) is another combination medication that works in the brain to reduce hunger and cravings. This medication is taken as a once-daily pill. 
• Orlistat (Xenical®, Alli®) is a medication that blocks the absorption of fat from a meal. It is a pill taken around meal time, so up to 3 times per day. Alli is the only over-the-counter FDA approved medication for weight loss. Sometimes, combining Orlistat with other weight loss medications may be considered by your doctor.
  
  

What are the risks of taking weight loss medication?

It is important to understand potential side effects and safety with starting any medication. Common side effects of weight loss medications include nausea, changes in bowel habits, fatigue, headaches, and changes in mood. 

There are other less common side effects that vary from medication to medication, so you should discuss these in more detail with your healthcare provider prior to starting. Weight loss medication should not be used in any person who is pregnant and prevention of pregnancy is recommended while taking these medications. It is also important to have regular follow-up with your healthcare provider while taking weight loss medication to monitor for tolerability and efficacy. Form Health makes this convenient by providing high quality care from obesity medicine specialists through a 100% virtual platform. 

How can you get prescription weight loss medication?

Weight loss medication is not right for everyone, so talk to your healthcare provider to determine if it is right for you. All 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 management and working with experts who can help you consider medications  as a tool to help you reach your weight loss goal, give Form Health a try! Our insurance-covered medical weight loss program uses tools like behavioral support, nutrition, physical activity, and FDA-approved medication, if appropriate, as parts of a comprehensive weight loss program to help you lose weight and improve your health. 

Get started with Form Health today by taking our quiz to see if medical weight loss is right for you.

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

Imcivree® is a registered trademark of Rhythm Pharmaceuticals

Adipex-P® is a registered trademark of Teva Pharmaceuticals USA, Inc.

Lomaira ® is a registered trademark of KVK Tech, Inc.