Navigating Weight Loss Medication: Exploring Options for Patients

By Allen L. Silvey, Jr., DO

For individuals struggling with weight management, exploring weight loss medication options can be a valuable tool in their journey towards achieving a healthier weight. Weight loss medications, when used in conjunction with a balanced diet, regular exercise, and lifestyle modifications, can assist in reaching weight loss goals. In this article, we will discuss some common weight loss medication options, their mechanisms of action, potential side effects, and considerations for patients.

1. Orlistat (Xenical, Alli):

Orlistat is a medication that works by blocking the absorption of dietary fats in the intestines. It is available in prescription strength (Xenical) or over-the-counter (Alli) forms. Orlistat can be effective in promoting weight loss, but it is important to follow a low-fat diet to minimize potential side effects such as gastrointestinal discomfort and loose stools.

2. Phentermine (Adipex-P, Lomaira):

Phentermine is an appetite suppressant that acts on the central nervous system, reducing hunger and increasing feelings of fullness. It is available in tablet or capsule form and is usually prescribed for short-term use. Phentermine may cause side effects such as increased blood pressure, insomnia, dry mouth, and irritability. Due to its stimulant effects, it is generally not recommended for individuals with a history of heart disease, high blood pressure, or hyperthyroidism.

3. Liraglutide (Saxenda):

Liraglutide is an injectable medication originally approved for the treatment of type 2 diabetes. It also has been approved for chronic weight management. Liraglutide works by mimicking the effects of a hormone called GLP-1, which helps regulate appetite and blood sugar levels. Common side effects include nausea, vomiting, diarrhea, and constipation. Liraglutide is usually prescribed for individuals with a body mass index (BMI) of 30 or greater, or for those with a BMI of 27 or greater with obesity-related comorbidities.

4. Bupropion and Naltrexone (Contrave):

Contrave is a combination medication that consists of bupropion, an antidepressant, and naltrexone, a medication used to treat alcohol and opioid dependence. It works by reducing appetite and cravings. Side effects may include nausea, constipation, headache, and insomnia. Contrave is typically prescribed for individuals with a BMI of 30 or greater, or for those with a BMI of 27 or greater with obesity-related comorbidities.

5. Wegovy (Semaglutide):

Wegovy, approved by the FDA in 2021, is an injectable medication that harnesses the power of semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist. Semaglutide works by mimicking the effects of GLP-1, a hormone that regulates appetite, slows down digestion, and increases feelings of fullness. By activating GLP-1 receptors, Wegovy helps individuals eat less and feel satisfied with smaller portions. Studies have shown that Wegovy can lead to significant weight loss when combined with a reduced-calorie diet and increased physical activity. Some patients have experienced an average weight loss of 15-20% of their initial body weight over a one-year period. However, it is essential to note that individual results may vary.

6. Mounjaro (Eptinezumab):

Mounjaro, originally developed as a preventive treatment for migraines, has shown some potential in aiding weight loss. Eptinezumab, the active ingredient in Mounjaro, is a monoclonal antibody that targets calcitonin gene-related peptide (CGRP), a neuropeptide involved in migraines. It is believed that CGRP may also play a role in regulating appetite and body weight. While the exact mechanism of action for weight loss with Mounjaro is not fully understood, early studies have suggested that it may lead to modest weight loss in some individuals. Further research is needed to better understand the efficacy and safety of Mounjaro specifically for weight management.

Weight loss medications can be a useful tool for individuals struggling with weight management, but they are not a magic solution. They should be used in conjunction with lifestyle modifications, including a healthy diet and regular exercise. It is important to discuss the benefits, potential risks, and side effects of weight loss medications with a healthcare professional. Remember, personalized guidance and ongoing monitoring are essential for safe and effective weight loss medication use.

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