Can My Doctor Prescribe Weight Loss Pills – FDA-approved weight loss pills | phentermine | Qsymia | Saxenda | Contrave | fullness | Orlistat | Wegovy | security information | What is the best weight loss pill?
Just over 42% of American adults are obese (defined as having a body mass index over 30) – and that number is expected to grow to 50% by 2030. Because of the countless conditions of health that all those extra pounds can cause, many wonder: Can losing weight be as simple as taking a pill?
Can My Doctor Prescribe Weight Loss Pills
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Prescription weight loss pills are not a magic bullet. But when used in conjunction with a healthy diet, restricting calorie intake and exercise, they can help some people in their weight loss journey. On average, after one year of use, people who take prescription weight loss medications lose 3% to 12% more body weight than people who use diet and exercise alone. This may not sound so impressive, but that difference can be enough to help reduce the risk of heart attack, stroke and diabetes.
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“We live in what we now call an obesogenic environment,” says Juliana Simonetti, MD, co-director of the Comprehensive Weight Management Program at the University of Utah. “Physiologically speaking, we are built to conserve calories so we can survive things like famine and war. We also eat a lot of calorie-dense foods and have 24/7 access to food. All of these things promote increased weight. Weight loss medications can help overcome some of that physiology and control our appetites so we can lose weight.”
Prescription weight loss medications work in different ways. Some work by targeting areas of the brain that regulate appetite. By altering certain brain chemicals, these drugs act as an appetite suppressant and/or increase feelings of fullness. Some drugs use a different route, helping to interfere with your body’s absorption of fat. Because obesity can be a chronic health problem, many of these drugs are meant to be used long-term, even after you’ve reached your ideal weight—assuming you respond to the medication in the first place.
“A common analogy is blood pressure medication,” says Aleem Kanji, MD, a board-certified endocrinologist and obesity medicine specialist with Ethos Endocrinology in Houston, Texas. “Most people expect high blood pressure to return if the medication is stopped. Obesity is the same. It is a chronic disease that requires chronic therapy.”
But not everyone is a candidate for weight loss drugs. The use of prescription weight loss medications is typically reserved for people who:
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A BMI of 25-30 puts a person in the overweight category. A BMI over 30 is considered obese. Your primary care doctor may prescribe a weight loss medication, as can an obesity medicine doctor or an endocrinologist, who treats weight health conditions such as diabetes. Currently, there are only a few weight loss medications approved by the Food and Drug Administration (FDA). The most commonly used include the following.
Phentermine is the most commonly prescribed weight loss medication in this country. It helps suppress your appetite and makes you feel fuller longer. Phentermine is a stimulant drug like amphetamine that can affect your heart. As such, it is generally used for the short term (usually 12 weeks at a time).
In a study looking at almost 800 people with a BMI of more than 25, 45.6% of people were able to lose 5% or more of their initial body weight after 12 weeks of using phentermine.
Qsymia combines a low dose of phentermine with topiramate, a drug used to treat seizures and migraines. “Phentermine helps suppress appetite and topiramate seems to reduce cravings,” says Dr. Simonetti. “Because we use a low dose of phentermine, Qsymia can be used for a long period of time and typically produces good results.”
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Qsymia can cause some of the same side effects as other medications that contain phentermine, as well as possible additional side effects due to topiramate. One of the biggest dangers of Qsymia is its link to birth defects. It is imperative that you talk to your doctor about pregnancy prevention if you want to try Qsymia and to take monthly pregnancy tests if you are at risk for pregnancy. And while Qsymia can have other serious side effects, including suicidal thoughts, increased irritability, worsening depression/anxiety, and heart and eye problems, the most common include:
Higher doses produce more weight loss). In one study, people who took the average dose of Qsymia (7.5/46 mg) lost 7.8% of their body weight and those who took the highest dose (15/92 mg) lost almost 10 %.
The active ingredient in Saxenda is a glucagon-like peptide-1 (GLP-1) receptor agonist, a class of drugs used to treat type 2 diabetes and maintain blood sugar levels. GLP-1 is a hormone your body makes naturally that is released in response to food and helps regulate appetite. Saxenda mimics the action of GLP-1 in your body, but it lasts much longer than natural GLP-1. As such, it can help suppress hunger longer and slow down the movement of food emptied from your stomach. Both factors can help you eat less in general and lose weight.
“I have patients who tell me that they never left food on their plates before, but with Saxenda, they eat less and get full quickly,” comments Dr. Simonetti. At the end of 2020, Saxenda was approved for use in adolescents.
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Saxenda is a daily injectable with the dose increasing from 0.6 mg in the first week to 3.0 mg in the fifth week. While Saxenda can cause some serious side effects, such as inflammation of the pancreas (called pancreatitis), gallbladder problems, and mood changes, the most common side effects include:
A study after more than 500 people found that 50.5% of those taking liraglutide were able to lose at least 5% of their body weight during the study period versus 21.8% who took a placebo. Even more impressive, 26.1% of the drug group were able to lose 10% of their body weight, compared to only 6.3% in the placebo group.
Saxenda carries a black box warning (the FDA’s strongest warning to consumers and health care providers about very serious side effects) due to the fact that animal studies have linked liraglutide and drugs such as to certain thyroid tumors and thyroid cancer. It is important that you do not use Saxenda if you have had these conditions or have a family history of them. Saxenda is not suitable for pregnant or breastfeeding women. Talk to your doctor if you are taking medicines that act as GLP-1 receptor agonists. Because Saxenda can slow stomach emptying, it’s also important to ask your doctor how it might affect other prescription and over-the-counter medications you’re taking.
Contrave combines naltrexone (used to treat substance abuse) and bupropion (an antidepressant that is marketed under the brand name Wellbutrin). It is thought to work on the brain to regulate appetite and cravings.
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Contrave can potentially produce serious side effects, such as suicidal thoughts and seizures, but the most common side effects are:
A study examined how Contrave contributed to weight loss when used in conjunction with behavioral therapy (sessions with registered dietitians, exercise specialists and psychologists). Compared to those who received a placebo and therapy, 1.5 times more people in the Contrave/therapy group were able to lose at least 5% of their body weight compared to those in the placebo group.
Plenity is technically a medical device, not a medication. It is a capsule containing superabsorbent hydrogel particles. When the capsule is swallowed, the particles are released, helping to fill up to a quarter of the stomach (when a person is fully hydrated). With a stomach at least partially full, you are apt to eat less.
Take three Plenity capsules with 16 ounces of water before lunch and dinner. The particles absorb water and mix with food in the stomach, helping you feel fuller so you eat less.
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A study showed that 59% of those taking Plenity lost 5% or more of their body weight and 27% lost more than 10% of their weight. It is compared to 42% and 15%, respectively, in the placebo group.
A Plenty is not approved for use in those under the age of 22. Do not even take it if you are allergic to citric acid, cellulose, gelatin and other ingredients of the gel.
Orlistat is a lipase inhibitor, which means it blocks the enzyme that helps absorb some of the fats in the foods you eat. Meaning, less of the fat you consume turns into fat cells to become stubborn belly fat. Orlistat comes in two different strengths – a 60mg strength sold as Alli and a prescription strength (120mg) marketed as Xenical.
Xencal is taken by mouth three times a day, with or within an hour of a meal containing fat.
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Xenical is not as effective as some other weight loss prescriptions. A study comparing orlistat with liraglutide found that those using the latter were able to lose more than twice the weight of those taking orlistat.
Xenical can affect the absorption not only of fat, but also of vitamins from the foods you eat. Be sure to talk to your doctor about taking a multivitamin supplement.
Wegovy is the newest FDA approved weight loss medication and works much like Saxenda, mimicking the action of hormones.
