Since weight management is essential to overall health and well-being, many adults aim to reduce weight to improve their blood pressure, blood glucose, and cholesterol levels. Healthy weight loss can also prevent chronic conditions like obesity, which is why research in the journal Obesities found that 91.7% of adult participants had tried to lose weight. Among those who attempted to lose weight prior to the study, only 72% were successful during at least one attempt.

The success of the most effective weight loss program can be attributed to the strategies adopted by the participants. Some created an exercise plan consisting of cardio and weight training, while others went on a diet to adjust their calorie intake. A previous post entitled ‘Does the Keto Diet Work? A Comprehensive Look at the Benefits and Risks’ discusses how the low-carbohydrate, high-fat keto diet can aid in reducing body fat by stimulating metabolism, thus making it effective for weight loss.

Besides diet and exercise, individuals attempting to lose weight can also consider pairing these lifestyle changes with prescription medications for higher chances of success. Below are the current weight loss medications approved by the FDA, with information on their mechanisms of action, effectiveness, and side effects so you can decide whether or not they’re suitable for you.

Which weight loss drugs are approved by the FDA?

As of 2023, the Food and Drug Administration’s (FDA) list of approved chronic weight management medications includes six drugs: orlistat (Xenical), phentermine/topiramate (Qsymia), naltrexone/bupropion (Contrave), setmelanotide (Imcivree), liraglutide (Saxenda), semaglutide (Wegovy), and tirzepatide (Zepbound). Zepbound is the latest drug approved by the FDA, as it contains the active ingredient tirzepatide, also found in Mounjaro, a drug used to improve blood glucose among overweight or obese individuals with type 2 diabetes mellitus. While all these medications require a prescription and must be used under medical supervision, they vary in how they help you reduce your weight healthily and sustainably, as discussed in the next section.

How do different types of weight loss drugs work?

GLP-1 agonists

Zepbound, the most recent FDA-approved weight loss drug, is classified as a glucagon‐like peptide‐1 or GLP-1 agonist. It belongs to the same class of weight loss drugs as Saxenda and Wegovy, which are both injectables that differ in terms of dosage and frequency of administration but have the same mechanism of action. The daily injectable Saxenda or liraglutide was first approved in 2014 for obesity treatment and has a maximum dose of 3.0mg, while the weekly injection Wegovy or semaglutide was approved in 2021 and can be gradually increased to 2.4mg. As GLP-1 agonists, these drugs impact the brain’s receptors that signal satiety, making you feel less hungry and controlling your cravings to reduce your overall calorie intake.

Appetite suppressants

Meanwhile, appetite suppressants like phentermine found in the drug Qysmia can influence weight loss by stimulating the brain’s receptors that regulate appetite, increase energy, and improve overall mood. Although bupropion is technically an appetite depressant, it can benefit weight loss efforts when combined with the opioid agonist naltrexone under the trade name Contrave. It suppresses appetite and increases the levels of dopamine and noradrenaline, both neurotransmitters linked to the development and progression of obesity.

Lipase inhibitors

While both GLP-1 agonists and appetite suppressants aid in weight loss by preventing overeating and unnecessary snacking, the lipase inhibitor orlistat’s anti-obesity properties work by decreasing the amount of dietary fat absorbed in the intestines by as much as 30. Additionally, orlistat, marketed under the brand names Xenical and Alli, has other health benefits independent of weight loss. In a clinical trial involving patients with a body mass index (BMI) of over 27, orlistat was found to significantly decrease serum total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels, thus playing a crucial role in reducing the risk of heart disease and hypertension as obesity-related conditions.

How effective are weight loss drugs?

Although they differ in mechanisms of action, these FDA-approved chronic weight management medications have been scientifically proven to contribute to long-term weight loss. An article in The World Journal of Men’s Health reviewed this new class of anti-obesity drugs and found that they help achieve weight loss when combined with behavior-based interventions like weight management programs and consultations.

Using anti-obesity drugs can result in a loss of total body weight ranging from 2.9% to 6.8%, namely phentermine/topiramate (6.8%), liraglutide (5.4%), naltrexone/bupropion (4.0%), and orlistat (2.9%). The study period was over 12 months, which means results may vary depending on how long physicians suggest you take the weight loss drug. Nonetheless, losing 3% to 5% of total body weight and keeping it off is clinically significant enough to benefit other health aspects like blood pressure and blood glucose levels.

What are the potential side effects of weight loss drugs?

Like any other medication, you may experience some side effects when using weight loss drugs. Mild symptoms include nausea and vomiting, tiredness, headaches, and diarrhea, but these side effects typically lessen over time. While serious side effects like depression and increased heart rate may occur, they are extremely rare. Overall, individuals taking weight loss medications must be in constant communication with their physician to minimize side effects and determine the best treatment option.

Are weight loss drugs suitable for everyone?

Considering the side effects of weight loss drugs, the FDA has approved their use for adults only. Specifically, adults must first meet clinical requirements before receiving a prescription, such as having a BMI equal to or greater than 30 or a BMI of at least 27 with one or more obesity-related conditions like diabetes or hypertension. Health experts also recommend taking these medications in conjunction with lifestyle modifications like diet and exercise for more significant and sustainable weight loss.

In summary, FDA-approved weight loss drugs work by regulating appetite, hunger, and cravings, as well as stimulating fat metabolism. These drugs must be prescribed by health professionals and incorporated with lifestyle changes at the same time for long-term and clinically significant results.

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