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In recent years, the search for effective weight-loss medications has made big strides. Since the first weight-loss drugs hit the market in the 1940s, scientific research has vastly improved. Today’s treatments are safer, more effective ways to manage weight. But weight-loss medications aren’t a one-size-fits-all solution. They’re best for people with specific health concerns related to obesity. Curious about what is available today, the best possible treatments, and potential risks? Here is a guide from PatientsLikeMe.
A History of Weight-Loss Medications
Scientists first developed weight-loss medications in the 1940s. They mostly used amphetamines to suppress appetite. They were effective in the short term. However, they caused serious side effects and were eventually taken off the market all together. In 1962, stricter regulations by the U.S. Food and Drug Administration (FDA) required that all medications demonstrate both safety and effectiveness.
Since then, scientists have worked on developing safer drugs that target weight gain more effectively and with fewer risks. Today, FDA-approved anti-obesity medications are designed to be used in combination with lifestyle changes like a healthy diet and regular physical activity. This makes them an important tool for those with obesity-related health issues.
Who Can Benefit?
Not everyone with extra weight needs medication to help them lose it. These drugs are best for people with a body mass index (BMI) of 30 or more. It can also help people with a BMI of 27 or more if they have obesity-related health problems like type 2 diabetes or high blood pressure. For these people, weight-loss medications can help prevent further complications. It gives a more targeted approach when lifestyle changes alone aren’t enough. Doctors generally prescribe weight-loss drugs as part of a broader weight-loss plan. This includes changes to your diet, exercise, and behavioral support.
Today's Medications
These days, FDA-approved medications for long-term weight management target different aspects of appetite control and metabolism. The FDA has approved six medicines for long-term use:
- Orlistat
- Phentermine-topiramate
- Naltrexone-bupropion
- Liraglutide
- Semaglutide
- Tirzepatide
One other medication has been approved by the FDA, but is limited to people who have been diagnosed with one of four rare genetic disorders. Doctors have to confirm these disorders with genetic testing before it can be prescribed. The drug is:
- Setmelanotide
Here is an overview of each drug, how they work, and why you might need to avoid them.
| Medication | Approved For | How it Works | Dose Timing | Reasons to Avoid |
| Orlistat (Xenical) | Adults and children ages 12 years and older. | Reduces the amount of fat your body absorbs from food. | Pill, taken by mouth 3 times per day. | If you have problems absorbing nutrients from the food you eat, or if you have cholestasis. |
| Phentermine-topiramate (Qsymia) | Adults and children ages 12 years and older. | This is a mix of two medications. One lessens your appetite and the other treats migraines and seizures. May make you less hungry or feel full sooner. | Pill, taken by mouth once per day. | If you have glaucoma, hyperthyroidism, or have taken certain antidepressants called MAOIs in the past 14 days. |
| Naltrexone-bupropion (Contrave) | Adults | This is a mix of two medications. One is used to treat alcohol and rug dependance, the other treats depression and helps people quit smoking. May make you less hungry or feel full sooner. | Pill, taken by mouth 1 to 2 times per day. | If you have uncontrolled high blood pressure, seizures, anorexia or bulimia, frequently use opioids or medications with bupropion, take antidepressants called MAOIs, or abruptly stopped drinking alcohol or certain drugs like benzodiazepines or barbiturates. |
| Liraglutide (Saxenda) | Adults and children ages 12 years and older. | This drug mimics a hormone called glucagon-like peptide-1 (GLP-1). It helps regulate appetite and food intake. A variation of this drug (Victoza) is also approved to treat Type 2 Diabetes. | Injection, given once daily. | If you have a personal or family history of a thyroid cancer called MTC or multiple endocrine neoplasia syndrome type 2. |
| Semaglutide (Wegovy) | Adults and children ages 12 years and older. | This drug mimics a hormone called glucagon-like peptide-1 (GLP-1). It helps regulate appetite and food intake. Two variations of this drug (Ozempic and Rybelsus) are also approved to treat Type 2 Diabetes. | Injection, given once weekly. | If you have a personal or family history of a thyroid cancer called MTC or multiple endocrine neoplasia syndrome type 2. |
| Tirzepatide (Zepbound) | Adults | This drug mimics two hormones, glucose-dependent insulinotropic polypetide (GIP) and glucagon-like peptide-1 (GLP-1). These help regulate appetite and food intake. A variation of this drug (Mounjaro) is also approved to treat Type 2 Diabetes. | Injection, given once weekly. | If you have a personal or family history of a thyroid cancer called MTC or multiple endocrine neoplasia syndrome type 2. |
| Setmelanotide (IMCIVREE) | People ages 6 and up with one of four genetic conditions confirmed by testing. | This drug activates pathways in the brain to promote weight loss by lowering appetite and food intake while increasing the number of calories the body uses. | Injection, given once daily. |
Obesity is linked to multiple health risks. These include heart disease, type 2 diabetes, high blood pressure, and certain cancers. These risks increase significantly with the presence of central obesity (fat around the abdominal area). By lowering body weight by just 5-10%, you can improve heart health, increase insulin sensitivity, and even have better respiratory health in people with sleep apnea and asthma.
Risks and Considerations
Weight-loss medications aren’t for everyone. They can interact with other drugs, including some over-the-counter medications, and may not be safe for pregnant or breastfeeding women. Always talk to a doctor before starting any weight-loss medication. They can help answer questions about potential side effects and interactions with other drugs.
The Future of Weight-Loss Treatments
The development of weight-loss medications has grown alongside our understanding of obesity as a complex chronic condition, similar to hypertension or diabetes. Today’s weight-loss treatments help with sustained, long-term management of weight. With these promising new options, researchers continue to make advancements.
Weight-loss medications offer new hope for people who need more support beyond just diet and exercise. While these medications can be effective, they work best when combined with a comprehensive health plan, including lifestyle adjustments and support from healthcare professionals.
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