Losing weight is a goal many of us aspire to, and there is some debate about the best ways to do it. Changing to a healthier diet and getting more exercise provides health benefits beyond just weight reduction, and these changes should be the foundation of any weight loss plan.
Medications are available to assist patients with weight loss, but should be used along with diet and exercise. Perhaps the greatest value medications can provide is the initial loss of a few pounds which can serve as motivation to continue the weight loss plan.
Here are the currently available prescription medications approved for weight loss:
- Phentermine, diethylpropion, benzphetamine, phendimetrazine, and methamphetamine* are stimulant medications that help decrease appetite. These should only be used short term (a few weeks) and may cause an increase in heart rate or blood pressure, so they are not a good choice for some patients.
- Lorcaserin (Belviq) acts on serotonin receptors to promote satiety, or feeling full. Lorcaserin is approved for chronic weight management and can be used long term, unlike some other weight loss medications.
- Liraglutide (Saxenda) is a daily injection and contains a higher dose of the same medication in Victoza, a diabetes medication. Saxenda can be used in non-diabetic patients also, and is approved for long term use.
- Orlistat (Xenical) is a pill taken with each meal, to reduce the amount of fat that is absorbed from food. This medication can cause some unpleasant side effects like oily stools due to the increased amount of fat that stays in the digestive tract. Orlistat is also available without a prescription, sold under the name Alli.
- Phentermine/topiramate (Qsymia) is a combination of 2 medications, a stimulant (phentermine) and topiramate. Topiramate is also used as an anticonvulsant and mood stabilizer. Its effects for weight loss are due to actions on neurotransmitters that help produce satiety and decrease appetite. Unlike phentermine alone, this combination is approved for long term use.
- Bupropion/naltrexone (Contrave) is a combination of an antidepressant (bupropion) and a medication that blocks opioid receptors (naltrexone). This combination helps with weight loss by increasing dopamine activity to reduce appetite, and by regulating the reward system in the brain that helps to control cravings and overeating behavior. This medication is also approved for long term use. Since it blocks opioid receptors, it will make some pain medications less effective.
Remember that medications work best when combined with diet and exercise.
*prohibited in some states