Are Weight Loss Drugs Effective?

The Food and Drug Administration (FDA) has approved several medications for weight loss, including overweight and obesity. These medications require a doctor's prescription and should be taken only under medical supervision. These include:

• GLP-1 agonists, including liraglutide (Saxenda), semaglutide (Vegovi), and tirazepate (Zepbound)
• ​Orlistat (Xenical)
• ​Phentermine/topiramate (Qsymia)
• Naltrexone/bupropion (Contraway)
• ​Setmelanotide (Emsivri)
• ​Appetite suppressants, including phentermine (Adipex-P or Lomira)

These medications should be combined with a balanced weight loss diet, as taking medications alone will not be enough to achieve weight loss. They also have several potential side effects, some of which can be serious.

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Weight loss medications can be an effective tool to aid in weight management. Most medications work by reducing your food intake, reducing fat absorption, or increasing metabolism, resulting in weight loss over time.

In most cases, these prescription medications usually result in only about 5-10% weight loss. Keep in mind that along with using these medicines, it is also important to make changes in your diet and other lifestyle. Making diet and lifestyle changes will help you increase the effectiveness of weight loss medications.

Advantages

• It is effective for weight loss when used along with dietary changes and regular physical activity.
• ​FDA approved for weight management
• ​May provide other health benefits, including improved blood sugar, blood pressure or cholesterol levels.
• ​Many medications are available through telehealth platforms

Disadvantages

• Not suitable for everyone
• Medicines can be expensive
• May have some serious side effects
• ​Weight gain is possible after stopping the medicine

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GLP-1
​GLP-1 drugs work by reducing the feeling of emptying of the stomach, increasing the feeling of fullness, and reducing the secretion of glucagon, a hormone involved in controlling appetite. Several studies have shown that GLP-1 agonists may be beneficial for weight management.

For example, a study with 1,961 adults found that taking 2.4 mg of semaglutide per week along with lifestyle changes reduced body weight by about 15% after 68 weeks.

More recently, a 2023 Phase 3 clinical trial of 2,539 adults found that people taking tirazepide lost more than 20% of their weight over the course of 72 weeks.

Side effects: Common side effects include nausea, vomiting, diarrhea, dizziness, headache, increased heart rate, infection, and indigestion.

Serious side effects include kidney problems, thyroid C-cell tumors, gallstone disease, low blood sugar, and suicidal thoughts. To avoid these side effects, definitely talk to your doctor. More research is also needed on the long-term effects of these drugs, as they may lead to weight gain over time.

GLP-1 agonist medication should be avoided by people with serious gastrointestinal conditions such as syndrome type 2, thyroid cancer, pancreatitis, gastroparesis, and inflammatory bowel disease.

Orlistat (Xenical)
Orlistat is an oral medication available as Xenical. It can also be purchased over the counter under the brand name Eli. Orlistat works by blocking the activity of certain enzymes used to break down fat in the digestive tract, which helps reduce the amount of calories you absorb.

According to a 2011 study of 80 people with obesity, those who took orlistat lost an average of 4.65 kg after 6 months. They also experienced significant reductions in body mass index (BMI), belly fat, and total and LDL (bad) cholesterol levels.

Side effects: Taking orlistat may cause digestive problems such as gas formation, frequent bowel movements, etc. It can also lead to nutrient deficiencies, including fat-soluble vitamins A, D, E, or K. A low-fat diet should usually be taken while taking this medication to help reduce adverse side effects.

Phentermine/topiramate (Qsymia)
Phentermine/topiramate is an oral medication that requires a doctor's prescription and is sold under the brand name Qsymia. This medication contains phentermine, a central nervous system stimulant and appetite suppressant with a mechanism similar to that of amphetamine. It also contains topiramate, an anticonvulsant that helps reduce appetite and increase satiety (feeling full) to promote weight loss.

A research review concluded that phentermine/topiramate resulted in an average weight loss of 7.7 kg and significantly reduced belly fat, blood pressure, blood sugar and cholesterol levels.

Another review comparing the effectiveness of several weight loss medications found that overweight or obese people who took phentermine/topiramate lost an average of 8.8 kg after 1 year.

Side effects: Possible side effects may include nausea, vomiting, diarrhea, and stomach cramps. This medicine should not be taken in heart disease, high blood pressure, hyperthyroidism, glaucoma, diabetes, or pregnancy.

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Most weight loss medications are approved for adults who are obese or overweight and have at least one weight-related condition, such as:

• Diabetes type 2
• ​High blood pressure
• High cholesterol

These medications are designed for people who are not able to lose weight through other methods, including diet or lifestyle changes. Although they should not be considered a quick fix, these medications can aid in weight management when taken along with regular physical activity and a nutritious diet.

When To See A Doctor
If you have tried everything to lose weight but nothing has come to an end and now you are planning to take medicines for weight loss then definitely visit a doctor. Because these pills can have serious side effects and are not safe for everyone, it is important not to take any weight loss medications or supplements without consulting a professional first.

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There is strong evidence as to whether medications are useful for weight loss. These medications may also provide other health benefits by promoting weight loss, keep in mind that these medications are not suitable for everyone and may cause weight gain again when you stop taking them. A doctor or other trusted health care professional can help you determine what is and what is not right for you. Finally, it is important to remember that these products should not be considered a “quick fix” for weight loss. Obesity is a chronic condition, and medications can be just one part of a treatment plan to help lose and maintain weight.

Instead, they should be used only as directed and combined with a balanced diet, healthy lifestyle, and regular physical activity for best results.