Weight Loss Medications
Learn about the weight loss medications we use to help you achieve long-term success.When used in combination with our medical weight loss programs, FDA approved weight loss medications can be useful not only with increasing both speed and amount of weight loss, but also with reducing the sensation of hunger. Weight loss medications are not a substitute for a good diet and exercise program – they are designed to work hand in hand with a behavioral program.
Which Weight Loss Medication Works Best For You?*
GLP-1 Injectable Weight Loss Medications
Wegovy® (Semaglutide / marketed as Ozempic® and Rybelsus® for diabetes)
Wegovy is a once-weekly injectable medication approved for the treatment of obesity. It is a synthetic analog of a hormone your gut produces in response to meals that tells your brain you shouldn’t be hungry anymore. The main side effect is nausea, which generally goes away as your body gets used to the medication. The drug can’t be used if you have a history of or are at risk for medullary thyroid carcinoma or acute pancreatitis. The same molecule, Semaglutide, has been available for treating type 2 diabetes since 2016 (brand name Ozempic); however, the dose used for weight control is significantly higher. It is approved for chronic use for appropriate individuals, including teens down to age 12 with obesity.
Zepbound® (tirzepatide / marketed as Mounjaro® for diabetes)
Zepbound is a once-weekly injectable medication that the FDA has approved for chronic weight management. The mechanism of action is similar to Wegovy in that it is a gut hormone analogue. Wegovy is a GLP-1 analogue, while Zepbound is a dual-hormone analogue, having activity at both GIP (glucose-dependent insulinotropic peptide) and GLP-1 (glucagon-like peptide 1).
Prescription Weight Loss Medications
Phentermine, Tenuate (Adipex, Bontril, Tenuate)
These medications benefit from nearly 60 years of clinical experience (Phentermine was approved in 1959), are low cost, and are very effective. We generally use them first-line for these reasons. They have a mild stimulant effect (not too unlike caffeine), so unless directed otherwise, take them first thing in the morning. Side effects may include dry mouth, constipation, heart rate or blood pressure elevation, agitation, and insomnia. Most side effects are minor and resolve as your body gets used to the new medication; however, if you experience severe side effects, please discontinue your medication immediately and let us know. We typically avoid this class of medications in people with pre-existing heart disease or uncontrolled high blood pressure.
We recommend avoiding other stimulants (caffeine, Sudafed) while taking an appetite suppressant medication.
Contrave® (bupropion er / naltrexone)
Contrave is a combination of 2 medications – bupropion and naltrexone. It works in two separate areas of the brain to control hunger and reduce cravings. Side effects may include suicidal thoughts and other neuropsychiatric reactions, nausea, vomiting, headache, and insomnia. Most side effects are mild and go away quickly.
It can’t be used if you are on narcotic pain medications. It also can’t be used if you have a history of seizures or risk factors for seizures (including anorexia, bulimia, or heavy alcohol use). It can interact with narcotic pain medications (such as oxycodone/hydrocodone / etc.) It has been approved for chronic use for appropriate adults aged 18 and up.
Qsymia® (phentermine / topiramate er)
Qsymia is a combination of 2 medications – phentermine and topiramate. The phentermine is at a lower dose than we typically use with the older forms of phentermine, and the topiramate is time-released. This gives very good appetite control – the phentermine through the first half of the day, then the topiramate during the second half of the day.
Side effects can include numbness or tingling in the hands, arms, feet, or face (paranesthesia); dizziness; changes in the way foods taste or loss of taste (dysgeusia); trouble sleeping (insomnia); constipation; and dry mouth. This drug can cause birth defects if a woman becomes pregnant while taking it; therefore, if you are of childbearing potential, special counseling is needed to determine if this is a safe choice. It is approved for chronic use for appropriate individuals, including teens down to age 12 with obesity.
Controlling the diet can be challenging for many patients, losing or maintaining weight loss. After weight loss, people often find themselves constantly deliberating on what they should and shouldn’t eat, and after trying to restrict calories all day, overeating at night. Weight loss medications can assist with keeping your appetite at bay and improve your ability to stick to your healthy food plan.
*Weight Loss medications are not appropriate for all individuals and will be prescribed only if deemed an appropriate treatment option by your provider.