Beyond Diet and Exercise: Exploring FDA-Approved Weight Loss Medications
- Dr. Koren
- Feb 17
- 4 min read
Losing weight can be a challenging journey. While lifestyle changes like diet and exercise are fundamental, many find it difficult to achieve and maintain significant weight loss. It's absolutely possible to lose weight without medication – resources like the National Weight Loss Registry showcase individuals who have successfully done so. However, studies show that dietary changes alone typically result in an average weight loss of around 5%. For many struggling with unhealthy weight, this may not be enough to achieve their health goals. This is where FDA-approved weight loss medications can play a supportive role.
While GLP-1 agonists like semaglutide (Wegovy, Ozempic) and tirzepatide (Mounjaro, Zepbound) are currently generating a lot of buzz – and rightfully so, given their impressive results in weight loss, cardiovascular benefits, and improvements in conditions like fatty liver disease, sleep apnea, and diabetes – it's important to remember that they aren't the only option. Several other FDA-approved medications can assist in weight management. It's crucial to understand that most of these medications primarily work by suppressing appetite; they don't magically boost metabolism or directly burn fat.
Let's explore some of these options, including the increasingly popular GLP-1 and GLP-1/GIP receptor agonists.
1. GLP-1 and GLP-1/GIP Receptor Agonists:
How they work: These medications mimic the action of naturally occurring hormones that regulate appetite and blood sugar. They slow gastric emptying, increase insulin release, and decrease glucagon secretion. Tirzepatide also acts on the GIP receptor, further enhancing its effects.
Common side effects: Nausea, vomiting, diarrhea, constipation, abdominal pain, injection site reactions. These side effects are often mild and temporary.
Contraindications: History of pancreatitis, certain endocrine tumors (MEN 2), and personal or family history of medullary thyroid carcinoma.
Estimated cost (GoodRx): These medications are generally the most expensive weight loss options.
Average weight loss: Liraglutide (Saxenda) around 5-10% of body weight; Semaglutide (Wegovy) around 15-20% of body weight; Tirzepatide (Zepbound/Mounjaro) up to 20% or more of body weight.
How it works: Phentermine is a stimulant that suppresses appetite.
Common side effects: Increased heart rate, anxiety, insomnia, dry mouth, constipation.
Contraindications: History of heart disease, uncontrolled high blood pressure, hyperthyroidism, glaucoma, anxiety disorders, and drug abuse.
Estimated cost (GoodRx): Varies widely; generally inexpensive.
Average weight loss: Around 5-10% of body weight.
3. Qsymia (phentermine/topiramate):
How it works: This combination medication combines phentermine with topiramate (an anti-seizure medication that also suppresses appetite).
Common side effects: Similar to phentermine, plus potential cognitive effects, tingling, and changes in taste.
Contraindications: Similar to phentermine, plus pregnancy, glaucoma, and history of kidney stones.
Estimated cost (GoodRx): More expensive than phentermine alone, but at the time of this writing Qsymia is available for $98/month through Qsymia Engage program.
Average weight loss: Around 10% of body weight.
4. Contrave (naltrexone/bupropion):
How it works: This combination medication combines naltrexone (used to treat opioid and alcohol addiction) and bupropion (an antidepressant). It works on different pathways in the brain to reduce appetite and cravings.
Common side effects: Nausea, constipation, headache, dizziness, insomnia, increased blood pressure.
Contraindications: Uncontrolled high blood pressure, seizures, history of eating disorders, opioid use, and certain mental health conditions.
Estimated cost (GoodRx): Moderately expensive, but at the time of this writing is available for $99/month through CurAccess Patient Support Program.
Average weight loss: Around 5-10% of body weight
5. Orlistat (Alli, Xenical):
How it works: Orlistat works by blocking the absorption of fat from the diet.
Common side effects: Oily stools, gas, abdominal cramps, frequent bowel movements, and difficulty absorbing certain vitamins.
Contraindications: Chronic malabsorption syndromes, cholestasis (reduced bile flow).
Estimated cost (GoodRx): Available over-the-counter (Alli) and by prescription (Xenical). The prescription version contains a higher dose of the medicine, is more expensive, and rarely covered by insurance.
Average weight loss: Around 3% of body weight.
Important Note: The information presented here is intended for general knowledge purposes only; it is not comprehensive and should not replace professional medical advice. It is essential to consult your doctor to discuss your specific needs and determine if weight loss medication is suitable for you. They can evaluate your health history, discuss potential risks and benefits, and assist you in selecting the most appropriate option. They can also oversee your progress and modify your treatment plan as necessary. Keep in mind that weight loss medications are most effective when paired with healthy lifestyle changes, such as a balanced diet and regular exercise.
If you'd like to discuss your personal situation and receive individualized advice, schedule an appointment with the Institute for Diabetes, Endocrinology, Adiposity, and Longevity today.
Till next time,
Dr. Koren
DISCLAIMER: The content on this webpage is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified healthcare provider. Never disregard professional medical advice or delay in seeking it because of something you have read or watched on this website. The mention of any product, treatment, or organization on this website does not indicate the author's endorsement. The product names referenced here are trademarks owned by their respective manufacturers. The author disclaims any legal liability for personal injury or any other damage or loss resulting directly or indirectly from the use or misuse of this website's contents.
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