AK TWISTED WELLNESS GUIDE: UNDERSTANDING WEIGHT LOSS MEDICATIONS

Contrary to what popular culture might teach you, you cannot identify obesity in yourself or others simply by observation–obesity is a chronic medical condition that affects millions of people worldwide. And while BMI is not the be-all and end-all assessment of obesity (it’s not without its problems), more than 73% of adults over the age of 20 have measurements in the overweight or obese range in the United States—that’s more than two out of every three adults. For some people, diet and exercise are not enough to lose weight and keep it off. Continue reading to learn more about weight loss medications that can help you lose weight and keep it off in a safe way.

WEIGHT LOSS: FAD DIETS STOP HERE

What are weight loss medications?

Historically, there are many different types of weight loss pills. And while there are still some weight loss pills on the market, it’s better to say weight loss medications or anti-obesity medications instead of pills, because the latest weight loss drugs that help people lose weight are not pills, but rather weekly or daily injections. These medications work in different ways, including:

Suppressing your appetite (decreasing your desire to eat)
Reducing how much fat you absorb from the foods you eat
Making you feel full faster

Weight loss medications are not for everyone–people who are pregnant, trying to become pregnant, or breastfeeding should not use weight loss medication (but more on who is eligible for weight loss pills later).

Who is eligible for weight loss medications?

Most weight management medications are meant for adults over 18 years old with the following:

Obesity with a BMI of 30 kg/m² or more
Overweight with a BMI of 27 kg/m² or more with a weight-related health problem, like high blood pressure, type 2 diabetes, or heart disease

The easiest way to determine your weight category is to measure your Body Mass Index (BMI).

If your BMI is higher than 25, you have an increased risk of several health conditions, including heart disease, stroke, diabetes, and severe COVID-19. Losing as little as 5–10% of the excess weight can significantly improve your health. Weight loss medications, in addition to diet, exercise, and lifestyle modifications, are appropriate for some people to help with their weight loss goals.

HOW WELL DO WEIGHT LOSS MEDICATIONS WORK?

Unfortunately, there is no magic pill to cure obesity. However, GLP-1 receptor agonists, a class of drugs used to treat diabetes and manage weight, are proven to be highly effective weight management medications. GLP-1 agonists include:

Tirzepatide (brand name Zepbound)
Semaglutide (brand names Ozempic and Wegovy)
Dulaglutide (brand name Trulicity)
Liraglutide (brand names Saxenda and Victoza)
Exenatide (brand names Bydureon and Byetta)
Lixisenatide (brand name Adlyxin)

In clinical trials, Wegovy (active ingredient semaglutide) helped adults with a BMI higher than 30 decrease their body weight by up to 15%. While weight loss results will vary based on the type of GLP-1 drug prescribed, dosage, and other lifestyle and health factors, they have been proven to be very effective at helping people lose weight and maintain weight loss.

HOW LONG DO I NEED TO TAKE WEIGHT LOSS MEDICATIONS?

How long you need to continue to take your weight loss medication depends on several factors and will vary from person to person. Depending on the side effects you experience and the success of your weight loss, your healthcare provider may need to adjust your dosage. Unfortunately, this means you might experience a trial-and-error period before seeing results.

If your weight loss is successful and you don’t experience negative side effects, your healthcare provider may recommend taking your weight loss medication long-term to help you keep the weight off. If you take your medication as prescribed and aren’t seeing results, your healthcare provider may prescribe you a different weight loss pill.

SHORT-TERM WEIGHT LOSS PILLS

The FDA has approved four medications for short-term use (up to 12 weeks) to help achieve weight loss:

Phentermine
Benzphetamine
Diethylpropion
Phendimetrazine

These drugs are all stimulants that decrease your appetite so that you eat less. Some of these medications are Schedule IV, meaning they have a higher potential for drug abuse. Potential side effects of these short-term weight loss pills include increased heart rate, high blood pressure, trouble sleeping (insomnia), dry mouth, constipation, and nervousness.

LONG-TERM WEIGHT LOSS PILLS AND MEDICATIONS

Given all of the risks of the short-term weight-loss drugs, most healthcare providers turn to treatments approved for longer time frames. There are currently five medications approved by the FDA for the long-term treatment of weight loss:

Phentermine/topiramate (Qsymia)
Liraglutide (Saxenda)
Semaglutide (Wegovy)
Naltrexone/bupropion (Contrave)
Orlistat (Xenical, Alli)

OTHER MEDICATIONS THAT MAY HELP WITH WEIGHT LOSS

The drugs mentioned above are the ones that carry FDA approval. However, other drugs may be used “off-label” to help with weight loss. Off-label simply means that a drug is being used for a condition that it was not originally approved to treat.

OTHER WEIGHT LOSS TREATMENTS

Other options are available if prescription weight loss medications aren’t right for you.

Plenity: An FDA-cleared weight management tool that can help you drop body weight.
Weight Loss Surgery: While surgery is the most invasive form of weight management, many of these procedures have been shown to help with weight loss.

WILL I GAIN WEIGHT BACK IF I STOP WEIGHT LOSS MEDICATION?

Unfortunately, weight loss medications only work as long as you take them—when you stop them, you will likely gain weight back. That’s why it is so important to incorporate diet and exercise changes into your daily routine.

DO WEIGHT LOSS PILLS REPLACE DIET AND EXERCISE?

As much as we may wish, weight loss pills and injectable weight loss drugs like Wegovy shouldn’t replace diet and exercise. Weight loss drugs should be part of a comprehensive treatment plan that includes lifestyle modifications, like diet and exercise, counseling, and behavioral interventions. Adding lifestyle changes may also help you minimize weight regain once you stop the weight loss pills.

Weight loss medications may be the added boost you need to help you lose weight. However, they’re not for everyone. Talk to your healthcare provider about prescription medications for weight management to determine if any are right for you.

DISCLAIMER

If you have any medical questions or concerns, please talk to your healthcare provider. The information provided here is for educational purposes only and should not be considered as medical advice. Always consult with a healthcare professional before starting any weight loss medication or treatment plan.

Sources:

Mayo Clinic. (2022). Obesity. https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742
Centers for Disease Control and Prevention. (2022). Adult Obesity Facts. https://www.cdc.gov/obesity/data/adult.html