10 best drugs for weight loss (including Ozempic)
In this article we will describe the 10 best drugs for weight loss. Not all are available in the UK.
There is not really a ‘best one’. It is more about finding the right one for you, after discussion with your doctor. It is not wise to self-prescribe from the internet.
Though GLP-1 agonists, including Semaglutide, are currently the most well known and commonly prescribed weight loss drugs. So we will start off with that drug.
1. Semaglutide (doctors’ name; trade names = Wegovy, Ozempic)
Wegovy is a trade (brand) name for semaglutide, a GLP-1 receptor agonist. It is administered as an injection and used in adults and children aged 12 years or more with obesity (BMI ≥30 for adults, BMI ≥ 95th percentile for age and sex for children); or some adults with excess weight (BMI ≥27) (overweight) who also have weight-related medical problems.
The dose must be increased gradually over 16 to 20 weeks to arrive at the 2.4 mg dosage. This progression can help to alleviate side effects, which include gastrointestinal symptoms, headache, dizziness, and fatigue.
Ozempic is the same medication but is approved to treat type 2 diabetes.
2. Tirzepatide (Zepbound, Mounjaro)
Tirzepatide was previously approved to treat type 2 diabetes as Mounjaro. As Zepbound, it is approved to treat obesity in adults with a BMI of 30 or greater.
It is both a GLP-1 and a GIP receptor agonist and, like semaglutide, works by reducing appetite; and is meant to be used in combination with diet and exercise to lose weight. It is also administered as an injection.
3. Liraglutide (Saxenda)
Liraglutide is a daily injectable medication that acts on hormones from the gut that send signals to the brain to make the patient feel full quicker and decrease hunger signals. Doses start at 0.6 mg to 3 mg a day. Some patients may lose 5-10% of body weight, especially with higher liraglutide doses.
Side effects include nausea, diarrhoea, constipation, vomiting, headache, decreased appetite, dyspepsia, fatigue, dizziness, abdominal pain, increased lipase, and can worsen kidney function in a small number of patients (it may benefit more).
4. Phentermine (Adipex, Suprenza)
Phentermine is the oldest and most widely used weight loss medication. It was originally used as a short-term medication to jump-start weight loss; but now newer medical guidelines have added it to long-term therapy. Some patients may lose about 5% of their body weight by taking it.
In the US, phentermine is almost exclusively available in the HCl formulation – available in 15 mg and 30 mg strength. Side effects include headache, overstimulation, high blood pressure, insomnia, rapid or irregular heart rate, and tremor.
Interactions may occur during or within 14 days following the use of monoamine oxidase (MAO) inhibitors, sympathomimetics, alcohol, adrenergic neuron-blocking drugs, and possibly some anaesthetic agents.
5. Phentermine-topiramate (Qsymia)
Topiramate can be combined with phentermine to decrease appetite and cravings. Having the combination of two drugs increases efficacy.
Adults with migraines and obesity are good candidates for this weight-loss medication. Some patients may lose an average of 5-10% of body weight.
If more than 5% weight loss is not achieved after 12 weeks of the maximum dose, the drug should be gradually discontinued.
Daily doses with four strengths start at 3.75 mg/23 mg to 15 mg/92 mg. Side effects include abnormal sensations, dizziness, altered taste, insomnia, constipation, and dry mouth.
6. Naltrexone-bupropion (Contrave)
Naltrexone-bupropion combines an opioid receptor antagonist with an antidepressant; to affect the pleasure-reward areas of the brain and thereby decrease cravings and appetite. Some patients lose 5-10% of body weight.
Start with a daily dose of one 8/90 mg tablet and gradually increase to four tablets a day. The most common side effects include nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, and diarrhoea.
This medication should not be prescribed to a patient who has a seizure disorder or who takes opioids for chronic pain.
7. Setmelanotide (Imcivree)
Setmelanotide is a melanocortin-4 receptor agonist indicated for chronic weight management in adult and children 6 years of age and older with obesity due to one of several specific rare genetic disorders.
These include variants in POMC, PCSK1, or LEPR genes that are interpreted as pathological, likely to be pathological, or a variant of uncertain significance (VUS).
8. Orlistat (Xenical and Alli)
Orlistat is a lipase inhibitor that comes in a capsule and works by blocking the enzyme that breaks down fats consumed through food. In this way, it inhibits the absorption of dietary fats.
Undigested fat is then passed through the body. It is intended for use in conjunction with a reduced-calorie diet and is also indicated to reduce the risk of weight regain.
Some patients may lose about 5% of their body weight. Dosage is one 120 mg capsule three times a day with each main meal containing fat (during or up to 1 hour after the meal).
An over-the-counter (OTC) formulation is available at 60 mg capsule with each meal containing fat. The most common adverse reactions to orlistat are oily discharge from the rectum, flatus with discharge, increased defecation, and faecal incontinence.
9. Other drugs
These include benzphetamine (Didrex, Regimex), diethylpropion, methamphetamine (Desoxyn), dulaglutide (Trulicity), exenetide (Bydureon BCise, Byetta)
10. Hydrogel (Plenity)
This is a medical device and not a medication; used for people with a BMI of 24 to 40. The treatment has experienced increased media attention since the rise of GLP-1 receptor agonists.
It consists of a capsule that releases a biodegradable, super-absorbent hydrogel into the stomach. The gel helps to increase satiety, enabling the person to eat less. The average weight loss is 9%.
Summary
We have described the 10 best drugs for weight loss. We hope it has been helpful.
