The New Weight-Loss Drugs

Newer weight-loss drugs expedite sheading pounds, making you feel full faster so that you eat less. They can also change how your body metabolizes fat.

The standard weight-loss advice focuses on eating a healthy diet and exercising to gradually shed extra pounds. But for the nearly 42 percent of Americans who are obese, lifestyle changes might not be enough.

Weight-loss drugs expedite the process, making you feel full so that you eat less. They can also change the way your body metabolizes fat from food. These medications aren't for everyone, and they won't replace diet and exercise. If you're a good candidate, however, they might help you shed some of the pounds you've struggled to lose.

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What weight-loss drugs are available?

The U.S. Food & Drug Administration (FDA) has approved six weight-loss drugs (plus another for type 2 diabetes that can help with weight loss):

• Liraglutide (Saxenda). This daily injectable medication was originally approved as a diabetes drug under the brand name Victoza. It acts like the hormone glucagon-like peptide-1 (GLP1) (a receptor in your brain that helps your body produce insulin to lower blood sugar) to suppress your appetite and make you feel full. In studies, overweight or obese people who took Saxenda lost an average of 9 to 13 pounds more during a year than those who didn't take the drug.
• Naltrexone-bupropion (Contrave). Contrave combines naltrexone, which treats alcoholism and opioid addiction, with the antidepressant bupropion. You take the extended-release tablet twice a day. About half of people in studies lost at least 5 percent of their body weight on Contrave, keeping it off for more than a year.
• Orlistat (Alli, Xenical). This weight-loss drug is available in prescription (Xenical) and over-the-counter (Alli) strengths. It works in your intestines to reduce the amount of fat your body absorbs from food. Research has shown that the average weight loss after six months on Orlistat is more than 12 pounds.
• Phentermine-topiramate (Qsymia). Qsymia combines an anti-seizure drug (topiramate) with an appetite suppressant (phentermine) into one extended-release capsule. People who took Qsymia in studies lost an average of 5 percent to 7 percent of their body mass index (BMI).
• Semaglutide (Wegovy). Like Saxenda, this once-weekly injection acts like the GLP-1 receptor (for insulin production) in your brain. Semaglutide is also approved to treat type 2 diabetes under the brand names Ozempic and Rybelsus. In one study, more than 86 percent of participants lost 5 percent or more of their body weight on Wegovy, with 69 percent of them losing 10 percent or more of their body weight.
• Setmelanotide (Imcivree). This injectable medication is approved only for children and adults with rare genetic conditions like Bardet-Biedl syndrome.

Tirzepatide, sold as the type 2 diabetes medication Mounjaro, is another promising weight-loss drug. It works for diabetes, stimulating your pancreas to release insulin — the hormone that lowers blood sugar after a meal.

The FDA granted tirzepatide fast-track status for the treatment of adults who are obese or overweight with weight-related complications, after research showed that the drug helped some participants lose more than 20 percent of their body weight.

How can weight-loss drugs improve health?

These medications, when combined with healthy eating and exercise, increase weight loss. After one year on weight loss-drugs, people lose an average of 3 percent to 12 percent more than they would with lifestyle interventions alone.

Losing at least 5 percent of your body weight if you're overweight or obese can lower your blood sugar, blood pressure, and triglyceride levels, reducing your risks for chronic conditions such as type 2 diabetes and heart disease.  

What are the risks of weight-loss drugs?

The risks vary depending on the drug you take. The most common side effects reported with these medications are:

• Nausea and vomiting
• Diarrhea
• Constipation
• Belly pain
• Dry mouth
• Headache
• Trouble sleeping
• Fast heart rate

Some of the drugs may not be safe during pregnancy, or for people with conditions such as heart disease, high blood pressure, glaucoma, and thyroid disease. Your doctor should discuss the risks with you before prescribing a weight-loss drug.

Are these medications right for you?

Weight-loss drugs aren't for everyone. They're designed for people who:

• Have a BMI of 30 or higher
• Have a BMI of 25 to 29.9 and health complications such as diabetes or high blood pressure

Does insurance cover the cost?

Some insurance companies will pay for weight-loss drugs if your doctor deems them medically necessary. Check with your insurance plan to find out what it covers. They can be very expensive without health coverage.

What you can do

Medication isn't a quick fix for weight loss. If you're only a few pounds above your target weight, you're better off trying a diet and exercise plan first. If your doctor does prescribe a weight-loss drug, healthy eating and physical activity will help maximize its effectiveness.

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