Obesity is a chronic condition classified by having a body mass index (BMI) higher than 30. Sometimes, it can include having a waistline greater than 40 or 35 inches, based on whether you’re assigned male or female at birth, respectively. Your doctor may develop a diet and exercise plan to help reverse obesity, but some doctors may also prescribe medication to help you along your journey.
Types of prescription medications for obesity
The Food and Drug Administration (FDA) has approved several medications for weight management. They fall into two primary categories: appetite suppressants and nutrient absorption inhibitors. Each works differently to help manage or reverse obesity.
- Appetite suppressants:
- Liraglutide (Saxenda), setmelanotide (Imcivree), phentermine-topiramate (Qsymia), and semaglutide (Wegovy) target areas of the brain that regulate hunger. Tirzepatide (Zepbound) is a similar drug that’s linked to a higher increase in weight loss than some of its competitors.
- Glucagon-like peptide-1 (GLP-1) receptor agonists (tirzepatide, liraglutide, and semaglutide) also influence glucose metabolism, making them particularly beneficial for people with type 2 diabetes.
- Nutrient absorption inhibitors:
- Orlistat (Xenical) works in the gastrointestinal tract to help prevent the absorption of dietary fat. It blocks the enzyme lipase and reduces the number of calories your body absorbs from fat.
- Combination medications:
- Naltrexone/bupropion (Contrave) combines different mechanisms of action to suppress appetite and manage cravings. This dual approach can help with following a nutrient-dense diet.
Benefits and risks of obesity medications
When combined with lifestyle habits such as healthy eating and increased physical activity, prescription medication helps people lose body fat and achieve a lower weight. Research suggests that many people who use weight management medication may lose 5% to 10% of their body weight within the first year. This can help lower blood sugar and triglyceride levels and improve joint pain and sleep apnea.
However, taking obesity medication may come with some risks. Studies suggest the most common side effects may include nausea, diarrhea, constipation, insomnia, and headaches. Serious side effects, though rare, can include heart or kidney problems. It’s important to discuss potential risks with your doctor.
When to start and stop obesity medications
The best way to know if it’s the right time to start obesity medication is by asking your doctor. They’ll look at your BMI, health history, weight goals, and weight journey before helping you make a decision.
Typically, doctors will want to ensure you’re routinely eating balanced meals and getting some form of exercise before prescribing medication to aid with weight management. These medications are usually prescribed when lifestyle changes alone have not resulted in notable weight changes or when weight-related health conditions make it necessary for additional management.
Once started, obesity medications are typically part of a long-term treatment plan, and your doctor may advise you to stay on them indefinitely. However, they may advise you to discontinue the treatment if there is no noticeable weight loss (at least 5%) within 3 months or if you experience severe side effects. If this happens, your doctor may try a different medication, change your treatment plan, or suggest other weight-loss methods.
How long does it take for obesity medications to work
The exact timeline of how soon you should expect to see results from your medication will vary depending on the prescription, dosage, and your body’s response to the drug.
However, GLP-1 receptor agonists can lead to significant body fat loss within 6 months to 1 year.
How to choose the right obesity medication
Selecting the best medication for weight management involves a thorough conversation with your medical team. They’ll have the best suggestions based on your medical history, weight goals, interactions with other medications you may be taking, and potential side effects. Some factors to keep in mind while discussing a possible plan with your doctor include:
- financial cost
- potential benefits and side effects
- preferred method (oral pill or injection)
- frequency of the medication (daily or once weekly)
Once you’ve settled on a treatment with your doctor, they may recommend starting with a trial period. They may also suggest regular follow-ups to monitor your response to the medication and ensure its effectiveness and safety.
Prescription medications may help with weight management if lifestyle changes have not made a difference. Talk with your doctor if you have questions about obesity medications and think they may be helpful for you.