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Weight loss medications can be used together with a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of:
- 30 kg/m2 or greater (obese) or
- 27 kg/m2 or greater (overweight) in the presence of at least one weight-related medical condition such as high blood pressure, type 2 diabetes, or high cholesterol
Treatments designed to induce weight loss focus on reducing energy intake (by decreasing food absorption or by decreasing appetite), increasing energy expenditure or a combination of both effects.
Phentermine has been available since the 1960s with a worldwide exposure of more than 50 million prescriptions. Adverse effects were minor such as dry mouth or insomnia. The weight loss can be 10-30 pounds.
Phentermine and Topiramate combination (Qsymia)
Qsymia is a combination of phentermine and topiramate in an extended-release capsule. In the clinical trials the weight loss is up to 10% of body weight. Possible side effects of Qsymia include: Mood changes and trouble sleeping. Qsymia may cause depression or mood problems.
Bupropion and Naltrexone combination (Contrave)
Contrave contains a combination of bupropion and naltrexone. Bupropion is an antidepressant medicine. Naltrexone blocks the effects of narcotic medicines and alcohol. The weight loss in clinical trial is up to 10% body weight. The most common side effects of Contrave include: gastrointestinal side effects, headache and dry mouth.
Liraglutide is a GLP-1 receptor agonist that, at higher doses, is used to treat obesity. It works by mimicking a hormone that naturally decreases appetite and slows digestion. Common side effects include nausea, stomach upset and diarrhea. In a clinical trial, 60% of patients lost at least 5% of their body weight (average of 12 lbs) and ~30% of patients lost more than 10% of their body weight (average of 23 lbs).
Orlistat (Xenical, Alli)
Orlistat acts locally to potently inhibit pancreatic and gastric lipase and thus the hydrolysis of triglycerides. As a result, only approximately two-thirds of dietary triglyceride intake is absorbed by the small intestine. Orlistat has been shown to be modestly efficacious (120 mg three-times daily) in several long-term randomized clinical trials where it induced weight loss of approximately 5–10 pounds more than diet and exercise alone. The most common side effects are diarrhea, flatulence, bloating, abdominal pain and dyspepsia.
For a physician referral, please call (800) UCLA-MD1 (825-2631).
*Weight loss results can vary depending on the individual. There is no guarantee of specific results. Read full disclaimer.