In: Nursing
Eating less and moving more are the basics of weight loss that lasts. For some people, prescription weight loss drugs may help.
Doctors usually prescribe them only if your BMI is 30 or higher, or if it's at least 27 and you have a condition that may be related to your weight, like type 2 diabetes or high blood pressure.
Here's what we should know about the most common prescription weight loss drugs: liraglutide (Saxenda), naltrexone-bupropion (Contrave), orlistat (Alli, Xenical), phentermine (Adipex-P, Ionamin, Pro-Fast), and phentermine-topiramate (Qsymia).
Before we get a weight loss drug prescription, tell our doctor about your medical history. That includes any allergies or other conditions you have; medicines or supplements we take (even if they're herbal or natural); and whether we're pregnant, breastfeeding, or planning to get pregnant soon.
weight loss medicines
How it works: Blocks your body from absorbing about a third of the fat we eat.
Side effects include abdominal cramping, passing gas, leaking oily stool, having more bowel movements, and not being able to control bowel movements.
These side effects are generally mild and temporary. But they may get worse if you eat high-fat foods.
Also, take a multivitamin at least 2 hours before or after taking orlistat, because the drug temporarily makes it harder for your body to absorb vitamins A, D, E, and K.
How it works: Contrave is a combination of two FDA-approved drugs, naltrexone and bupropion, in an extended-release formula. Naltrexone is approved to treat alcohol and opioid dependence. Bupropion is approved to treat depression, seasonal affective disorder, and help people stop smoking.
Side effects: The most common side effects include nausea, constipation, headache, vomiting, dizziness, insomnia, and dry mouth. Contrave has a boxed warning about the increased risk of suicidal thoughts and behaviors associated with bupropion. The warning also notes that serious neuropsychiatric issues linked to bupropion have been reported. Contrave can cause seizures and must not be used in patients who have seizure disorders. The drug can also increase blood pressure and heart rate.
How it works: Liraglutide is a higher dose of the type 2 diabetes drug Victoza. It mimics an intestinal hormone that tells the brain your stomach is full.
Side effects: Nausea, vomiting, diarrhea, constipation, low blood pressure, and increased appetite. Serious side effects can include raised heart rate, pancreatitis, gallbladder disease, kidney problems, and suicidal thoughts. Liraglutide has been shown in studies to cause thyroid tumors in animals, but it is not yet known if it can cause thyroid cancer in humans.
How it works: Curbs our appetite.
Side effects can be serious, such as raising your blood pressure or causing heart palpitations, restlessness, dizziness, tremor, insomnia, shortness of breath, chest pain, and trouble doing activities you've been able to do.Less serious side effects include dry mouth, unpleasant taste, diarrhea, constipation, and vomiting.
We should not take phentermine if you have a history of heart disease, stroke, congestive heart failure, or uncontrolled high blood pressure. We also shouldn't take it if we have glaucoma, hyperthyroidism, or a history of drug abuse, or if we are pregnant or nursing.
How it works: Curbs your appetite.
Qsymia combines phentermine with the seizure/migraine drug topiramate. Topiramate causes weight loss in several ways, including helping you feel full, making foods taste less appealing, and burning more calories.
Side effects: The most common side effects are tingling hands and feet, dizziness, altered sense of taste, insomnia, constipation, and dry mouth.