From the Guidelines
The most affordable medication for weight loss in non-diabetic patients is generally phentermine, which costs approximately $10-40 per month depending on the pharmacy and insurance coverage. According to a study published in the Annals of Internal Medicine 1, phentermine is one of the options for adjunctive drug therapy for weight loss, with a pooled weight loss of 3.6 kg at 6 months. Phentermine is typically prescribed at doses of 15-37.5 mg taken once daily in the morning before breakfast or 1-2 hours after breakfast. It's approved for short-term use (usually up to 12 weeks) as part of a comprehensive weight loss program that includes diet and exercise. Some key points to consider when prescribing phentermine include:
- Common side effects such as dry mouth, insomnia, constipation, and increased heart rate or blood pressure
- Contraindications in patients with cardiovascular disease, hyperthyroidism, glaucoma, history of drug abuse, or during pregnancy
- The importance of lifestyle modifications as the foundation of any weight loss program, with medication considered an adjunct to these efforts rather than a replacement. While other medications such as sibutramine, orlistat, diethylpropion, fluoxetine, and bupropion are also available for weight loss, phentermine is generally the most affordable option, with a cost-effective profile that makes it a viable choice for patients without diabetes 1.
From the Research
Medication Options for Weight Loss
The most affordable medication for weight loss for a patient without diabetes is orlistat, as it is a cost-effective option for patients with obesity, particularly those without type 2 diabetes 2, 3.
Key Points About Orlistat
- Orlistat is an inhibitor of gastrointestinal lipases, preventing the absorption of dietary fat 2, 3.
- It reduces weight in obese adults and adolescents with or without comorbidities, including hypercholesterolaemia and hypertension 2, 3.
- Orlistat is generally well tolerated, with gastrointestinal adverse events being most commonly reported 2, 3.
Comparison with Other Medications
- Other medications such as fluoxetine and sibutramine can also achieve statistically significant weight loss, but the magnitude of weight loss is modest, and long-term health benefits remain unclear 4.
- A review of the latest pharmacological options for obesity management lists orlistat as one of the seven FDA-approved anti-obesity medications, along with phentermine, phentermine/topiramate ER, naltrexone SR/bupropion SR, liraglutide 3.0 mg, semaglutide 2.4 mg, and tirzepatide 5.
Considerations for Patients Without Diabetes
- Orlistat is an attractive option for the treatment of patients with obesity, especially those without type 2 diabetes, as it is cost-effective and improves metabolic risk factors 2, 3.
- Patients without diabetes can benefit from orlistat as part of a weight management strategy, in conjunction with a hypocaloric diet and moderate exercise 3.