What are the medications for weight loss?

From the Guidelines

Weight Loss Medications Weight loss medications, such as orlistat (120mg orally three times a day) and liraglutide (3mg subcutaneously once daily), are approved for use in conjunction with a reduced-calorie diet and increased physical activity for weight loss in obese individuals 1.

• Phentermine-topiramate (3.75-15mg/23-92mg orally once daily) and naltrexone-bupropion (8-32mg/180-360mg orally twice daily) are also available options, with treatment durations typically ranging from 12 to 52 weeks 1.
• The dosage and duration of treatment should be individualized based on patient response and tolerability, with regular monitoring of weight, vital signs, and adverse effects 1.
• Other medications, such as lorcaserin (10mg orally twice daily) and liraglutide (3mg subcutaneously once daily), may also be considered for weight loss in obese individuals 1.
• It is essential to note that weight loss medications should be used in conjunction with lifestyle modifications, such as a reduced-calorie diet and increased physical activity, to achieve and maintain significant weight loss 1.
• The choice of medication should be based on the patient's individual needs and medical history, as well as the potential side effects and benefits of each medication 1.

From the FDA Drug Label

Phentermine Hydrochloride, USP 15 mg and 30 mg is indicated as a short-term (a few weeks) adjunct in a regimen of weight reduction based on exercise, behavioral modification and caloric restriction in the management of exogenous obesity for patients with an initial body mass index greater than or equal to 30 kg/m 2, or greater than or equal to 27 kg/m 2 in the presence of other risk factors (e.g., controlled hypertension, diabetes, hyperlipidemia).

The medication for weight loss is Phentermine.

• Indications: Short-term adjunct in a regimen of weight reduction for patients with exogenous obesity and a BMI ≥ 30 kg/m² or ≥ 27 kg/m² with other risk factors.
• Dosage: 15 mg to 30 mg daily, taken at approximately 2 hours after breakfast. 2

From the Research

Medications for Weight Loss

The following medications have been studied for their effectiveness in weight loss:

• Liraglutide: a glucagon-like peptide-1 receptor agonist that has been shown to induce significant weight loss in obese individuals without type 2 diabetes 3, 4, 5, 6
• Orlistat: a gastrointestinal lipase inhibitor that has been shown to produce greater and more frequent significant weight loss than placebo during 1 year of treatment 3, 7, 6
• Phentermine-topiramate: an appetite suppressant that has been shown to be associated with the highest odds of achieving at least 5% weight loss at 52 weeks 6
• Naltrexone-bupropion: an opioid receptor antagonist and norepinephrine-dopamine reuptake inhibitor that has been shown to be effective in weight loss, but also associated with a higher risk of adverse event-related treatment discontinuation 6
• Lorcaserin: a serotonin receptor agonist that has been shown to be effective in weight loss, but with a lower odds of achieving at least 5% weight loss compared to other medications 6
• Semaglutide: a glucagon-like peptide-1 receptor agonist that is being investigated in phase III trials for obesity management 5

Mechanism of Action

The mechanism of action of these medications varies:

• Liraglutide and semaglutide work by activating the glucagon-like peptide-1 receptor, which helps to reduce appetite and increase feelings of fullness 4, 5
• Orlistat works by inhibiting the absorption of dietary fat in the gut, which helps to reduce calorie intake 7
• Phentermine-topiramate works by suppressing appetite and increasing feelings of fullness 6
• Naltrexone-bupropion works by blocking the opioid receptor and increasing the levels of norepinephrine and dopamine in the brain, which helps to reduce appetite and increase feelings of fullness 6
• Lorcaserin works by activating the serotonin receptor, which helps to reduce appetite and increase feelings of fullness 6

Efficacy and Safety

The efficacy and safety of these medications have been studied in several clinical trials:

• Liraglutide has been shown to be effective in inducing significant weight loss and improving certain obesity-related risk factors, but has also been associated with a higher risk of nausea and vomiting 3, 4
• Orlistat has been shown to be effective in producing greater and more frequent significant weight loss than placebo, but has also been associated with a higher risk of gastrointestinal adverse events 7, 6
• Phentermine-topiramate has been shown to be effective in inducing significant weight loss, but has also been associated with a higher risk of adverse event-related treatment discontinuation 6
• Naltrexone-bupropion has been shown to be effective in inducing significant weight loss, but has also been associated with a higher risk of adverse event-related treatment discontinuation 6
• Lorcaserin has been shown to be effective in inducing significant weight loss, but with a lower odds of achieving at least 5% weight loss compared to other medications 6