Your guide to anti-obesity weight loss drugs
Medication can work when other weight-loss strategies don’t. Here’s what’s new, what’s ahead and what you should know about the pharmaceutical approach to obesity.
People around the world spend billions of dollars on weight loss solutions each year. Fad diets, extreme fitness plans and apps upon apps — all promising to melt off the pounds. But the hard reality is this: There are no quick fixes when it comes to reaching your healthy weight.
One of the main reasons is that obesity isn’t cosmetic. And it’s not a matter of willpower or discipline. Like diabetes or high blood pressure, it’s a chronic disease.
When you have obesity, your metabolism and hunger and fullness signals don’t work the way they should. Having excess weight doesn’t mean you’ll have poor health. Yet it’s important to know that obesity is linked with other conditions, including heart disease, cancer, sleep apnea and Type 2 diabetes.
For many people with obesity, lifestyle changes can only go so far, says Mir Ali, MD. He’s a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California.
The good news: Weight-loss medications can help you get closer to your health goals. Many work to reduce your appetite and food cravings. But a new class of medications can target metabolism changes, too. Here’s what you need to know.
(Weight-loss medications can be pricey. Be sure to download our free mobile app to find the best price for your prescriptions at a pharmacy near you.)
What’s new with weight-loss medications?
The newest weight-loss medication is called semaglutide, sold under the brand name Wegovy®. It was recently approved by the U.S. Food and Drug Administration (FDA) for people with a body mass index (BMI) of 27 or more and at least one weight-related coexisting condition, or those with a BMI of 30 or more. It’s the first weight management treatment to be approved since 2014.
In a study published in The New England Journal of Medicine, participants took semaglutide once a week. Along with lifestyle changes, these people saw sustained and meaningful weight loss. At the end of 68 weeks, those on the medication lost on average nearly 34 pounds, while those in the placebo group lost an average of 6 pounds.
Many weight-loss medications only reduce appetite. But semaglutide is an injection that also helps regulate blood sugar. While this leads to less hunger and food cravings, it also improves how the body’s metabolism works, says Dr. Ali.
“Much like other types of weight-loss medication, semaglutide is often used for patients who don’t quite meet the requirements for bariatric surgery or want to try a medication-managed strategy first before trying surgery,” Dr. Ali says. (You can read more about other obesity treatments here.)
Other FDA-approved weight-loss medications
While semaglutide might be the new kid on the block when it comes to weight-loss medications, it’s joining a list of well-known options. Here’s a look at other FDA-approved treatments, along with what makes each unique:
- Orlistat (Xenical®, Alli®): It lowers the amount of dietary fat absorbed in your intestines. When you take the pill with a meal, about 25% of the fat you consume isn’t broken down and is eliminated through bowel movements. Together with healthy eating and physical activity, orlistat has been shown to help people lose about 6 more pounds per year than lifestyle changes alone, according to the Mayo Clinic.
- Phentermine-topiramate (Qsymia®): This pill combines an appetite suppressant with an epilepsy and migraine medication that’s been shown to promote weight loss. According to a review in American Family Physician, people taking the maximum dose lost an average of 11% of their body weight after 1 year. Those on a lower dose lost an average of 7% of their body weight.
- Naltrexone-bupropion (Contrave®): This pill combines an antidepressant that decreases appetite with a medication that’s usually given to block the effects of opioids or alcohol. According to commentary in the journal Pharmacy and Therapeutics, the combination works by making you feel full longer so you eat less. After 12 weeks, you should drop at least 5% of your body weight, the experts note.
- Liraglutide (Saxenda®): This medication also works by increasing feelings of fullness and decreasing hunger. And it is given as an injection. According to a review in American Family Physician, it produces a clinically significant and sustained weight loss. But nausea and vomiting are common side effects, and about 10% of patients will stop treatment as a result.
- Setmelanotide (Imcivree™): This medication is only for those with specific genetic conditions related to obesity. The FDA notes that it works by activating areas in the brain that regulate appetite and fullness, and it also increases the number of calories the body burns at rest.
There are other medications in the pipeline for FDA approval, notably tirzepatide and bimagrumab. Both are still in the testing phase, and it may be years before they are available on the market.
Why so many options? Because like any treatment that addresses a complex condition, what works for one person may not work for another, says Dr. Ali. Also, some people may experience side effects and need to switch to a different, similar medication.
The body may also adjust to these medications over time, Dr. Ali adds. You may hit a plateau (even when you’re taking the medication as prescribed) and temporarily stop losing weight. In that case, your doctor might suggest a different medication for better results.
The bottom line
Even weight-loss medications aren’t magic pills. “Keep in mind that these drugs are a tool, not a solution in itself,” says Dr. Ali. “You may still need significant lifestyle changes to maximize your success.”
And before you start on a new medication, you may want to look at the ones you’re currently taking. There are a number of common medications that have weight gain as a side effect, says Beth Bryan, PharmD, a Tennessee-based pharmacist. (Find out more here.) This means your weight-loss medication might not be as effective as it could be.
You can get ahead of this with a medication review. It allows a pharmacist or other medical professional to look at everything you’re taking, including any over-the-counter remedies, herbal blends, vitamins and other supplements. That's a good way to identify medication-related reasons you may be struggling to lose weight.
Another thing to bring to your pharmacist: our free prescription discount card. Simply present it at checkout — you could save up to 80% on your medications.
Overview of FDA-approved medications: National Institute of Diabetes and Digestive and Kidney Diseases
The approval of semaglutide: U.S. Food and Drug Administration
Study on semaglutide for obesity: The New England Journal of Medicine (2021). “Once-weekly semaglutide in adults with overweight or obesity”
Background on the weight-loss medication Alli: Mayo Clinic
Review on Qsymia: American Family Physician (2014). “Phentermine/topiramate (Qsymia) for chronic weight management”
Commentary on Contrave: Pharmacy and Therapeutics (2016). “Naltrexone/bupropion ER (Contrave): Newly approved treatment option for chronic weight management in obesity adults”
Review on Saxenda: American Family Physician (2016). “Liraglutide (Saxenda) for weight loss”
How Imcivree works: U.S. Food and Drug Administration