Weight Loss Medications

Medications for weight loss are only one component of a comprehensive treatment plan that also includes nutritional, physical activity, and behavioral therapies.

Phentermine (Adipex, Ionamin, Suprenza)

  • Phentermine is available in daily doses of 37.5 mg, 30 mg,15 mg, and 8 mg (Lomaira).

  • Phentermine is FDA-approved for short term use – up to 12 weeks, and it is an adrenergic agonist that produces appetite suppression.

  • Do not use if you have heart disease, uncontrolled high blood pressure, hyperthyroidism, or glaucoma. Tell your doctor if you have severe anxiety or other mental health problems.

  • Side effects include: dry mouth, insomnia, dizziness, and irritability. Caution should be used with hypertension.

Orlistat

  • Orlistat is an oral medication that inhibits pancreatic and gastric lipase decreasing fat absorption in the gastrointestinal tract.

  • It is available to be taken with meals in doses of 120 mg (Xenical) and 60 mg (Alli) OTC.

  • Side effects include: flatulence with fatty discharge and fecal urgency after consumption of high-fat foods, side effects that lead to medication discontinuation.

  • Rare cases of severe liver injury have been reported. Avoid taking with cyclosporin.  

  • Take a multivitamin pill daily to make sure you get enough of certain vitamins that your body may not absorb from the food you eat.

Phentermine-Topiramate extended release (Qsymia)

  • This is the most effective weight loss drug available to date.

  • It combines an adrenergic agonist with a neurostabilizer.

  • Daily doses with four strengths start at 3.75/23mg to 15mg/92mg.

  • Adults with migraines and obesity are good candidates for this weight loss medication.

  • Side effects include: abnormal sensations, dizziness, taste alterations, insomnia, constipation, and dry mouth.

  • Contraindications include: uncontrolled hypertension and coronary artery disease, hyperthyroidism, glaucoma, and sensitivity to stimulants. Tell your doctor if you have had a heart attack or stroke, abnormal heart rhythm, kidney disease, or mood problems. If more than 5% weight loss is not achieved after 12 weeks of the maximum dose, the weight loss pill should be gradually discontinued.

  • MAY LEAD TO BIRTH DEFECTS. DO NOT TAKE QSYMIA IF YOU ARE PREGNANT OR PLANNING A PREGNANCY. Do not take if you are breastfeeding.

Bupropion/Naltrexone (Contrave)

  • Contrave combines a dopamine/norepinephrine reuptake inhibitor and an opioid receptor antagonist.

  • Start with a daily dose of 8/90 mg tablet to four tablets a day.

  • It controls cravings and addicted behaviors related to food.

  • Side effects include: constipation, headaches, insomnia, and dry mouth.

  • Contraindications include: uncontrolled hypertension, history of seizures, and opioid use and dependence.

  • Do not use if you have a history of anorexia or bulimia. Do not use if you are dependent on opioid pain medications  or withdrawing from drugs or alcohol. Do not use if you are taking bupropion (Wellbutrin, Zyban).

  • MAY INCREASE SUICIDAL THOUGHTS OR ACTIONS.

Liraglutide (Saxenda)

  • Saxenda is a glucagon-like peptide 1 (GLP-1) receptor approved for diabetes type 2 as Victoza and for weight loss injection as Saxenda.

  • Doses start at 0.6 mg to 3 mg a day. Liraglutide delays gastric emptying and causes satiety.

  • Good candidates are adults with diabetes and prediabetes.

  • Side effects include: nausea, vomiting, diarrhea, constipation, and abdominal pain.

  • It is contraindicated in patients with personal or family history of medullary thyroid carcinoma. May increase the chance of developing pancreatitis.  

  • Medications for weight loss are only one component of a comprehensive treatment plan that also includes nutritional, physical activity, and behavioral therapies.