Losing excess weight can be difficult. And while eating healthy, a reduced calorie meal plan and getting regular physical activity remain the key foundational components of weight loss, there are often complexities that make lifestyle change alone especially challenging.
Prescription weight management medication may help ease those challenges.
How Do These Medications Work?
There are a number of weight loss medications on the market today, and each works a little differently, noted Katy Brown, DO, Samaritan Weight Management Institute.
“In general, these medications work in one of the following ways: to suppress appetite, decrease hunger, increase feelings of fullness, and decrease the tendency to turn to food due to emotions like boredom or stress,” she said.
However, medications aren’t very effective for weight loss unless combined with a lifestyle change program.
“Working in conjunction with good nutrition and regular exercise, weight-loss medication can lessen the barriers to making important lifestyle changes,” explained Dr. Brown.
What Kind of Results Can Be Achieved?
Choosing the right medication is a decision made in consultation with your doctor and will depend on medical history and health goals. If the medication helps you lose weight and keep it off and you experience few side effects, you may stay on it indefinitely.
“Since obesity is a chronic disease, most of these medications are used long term for weight management,” said Dr. Brown.
Prescription medications and their average weight loss include:
- Phentermine – 5% to 7% average weight loss at one year.
- Phentermine/Topiramate ER (Qsymia) – 8% to 10% average at one year.
- Bupropion/Naltrexone (Contrave) – 4% to 5% average at one year.
- Liraglutide (Saxenda) – 9% to 11% average at one year.
- Semaglutide (Wegovy) – 15% average at 16 months.
- Tirzepatide (Mounjaro) – varies with dosage from 15% to 21% average at 16 months.
While side effects vary by medication – some serious -- most are mild with common ones including nausea, diarrhea or constipation which can improve over time. In most cases, some weight gain occurs after stopping the drug.
While weight loss is important, Dr. Brown stresses that the overall goal of medication is to get an individual to a healthier place by reducing the burden of obesity-related diseases.
“We also can see reductions in body fat, improvements in blood sugar, blood pressure and cholesterol, as well as increased mental health wellness, confidence and overall well-being,” she explained.
Who Is a Good Candidate for the Medications?
Weight management medication is not for everyone. Considerations include:
- Body Mass Index. “Physicians consider prescribing these medications if body mass index is greater than 27 and there are health-related problems, such as high blood pressure or cholesterol, or if the BMI is greater than 30,” said Dr. Brown.
- Commitment. “Having the mindset and being ready to take the baby steps necessary to eat healthier and get regular exercise is critical to success,” noted Dr. Brown.
- Insurance Coverage. Weight management drugs are expensive and not covered on all health plans. “In the future, these medications will likely be better covered, but as of now, out-of-pocket expenses can be steep, ranging from $25 a month to $1,300 a month. So, be sure to check your particular health plan,” she said.
Better in Conjunction With Other Weight Loss Options
Often, medication is used in conjunction with other weight management options, such as a medical weight loss program or surgical procedures.
Medical Weight Loss Program
At Samaritan, Precision Wellness is a medically supervised, intensive group program in which participants learn the skills needed to make lasting lifestyle and behavioral health changes. It is possible to lose up to 15% to 20% of body weight by combining this program with medication.
Weight Loss Surgery
Gastric bypass or vertical sleeve gastrectomy offers a more aggressive weight loss option, and you can lose up to one-third your body weight by the first year. By altering the digestive system, bariatric surgery limits the amount of food you can eat and adjusts hormones so that you feel satisfied by eating less. Medication may be used before surgery to help you lose enough weight to be safe for surgery, or after a procedure to help maintain weight loss.
Obesity is a complex, chronic disease linked to serious health conditions such as Type 2 diabetes, stroke, high blood pressure, high cholesterol, osteoarthritis and more. But studies have shown that losing just a small amount of weight can have big impacts on health, Dr. Brown noted.
“We know that if a person can lose 5% to 10% of their body weight and maintain that weight loss, those medical conditions also improve. That is one other reason why weight management medication can help,” explained Dr. Brown.
Katy Brown, DO, sees patients at Samaritan Weight Management Institute and can be reached at 541-768-4280.