Brenda Khan
Diet drugs, also known as weight loss drugs, are medications that can help people lose weight. They are often prescribed to people with obesity, which is defined as having a body mass index (BMI) of 30 or higher. These drugs can also be prescribed to people with a BMI of at least 27 who have weight-related health conditions such as diabetes or high blood pressure. While some diet drugs are approved by the FDA and are generally safe if taken as prescribed, others can have unpleasant gastrointestinal side effects and may cause addiction or abuse. The popularity of new drugs has led to some shortages, and they are often extremely expensive and not covered by insurance plans. It is important to discuss the use of diet drugs with a healthcare provider to ensure they are safe and right for the individual.
| Characteristics | Values |
|---|---|
| Safety | Long-term prescription appetite suppressants are generally safe if taken as prescribed. |
| Short-term prescription appetite suppressants require more caution due to possible severe side effects, addiction potential, and interaction with other medications. | |
| Some over-the-counter appetite suppressants have been linked to heart attacks, seizures, strokes, and death. | |
| Prescription weight loss drugs can be an effective treatment for obesity. | |
| FDA-approved anti-obesity medications are safe, evidence-based therapies that are most effective when used as part of a comprehensive treatment plan. | |
| Cost | Prescription weight loss drugs are often extremely expensive, and most insurance companies do not cover them. |
| Side effects | Gastrointestinal problems are the most common side effects of weight loss drugs. |
| Other side effects include nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, indigestion, dizziness, bloating, and gas. | |
| A small percentage of people taking Ozempic or Wegovy may suffer from a diabetes-related eye complication called retinopathy. | |
| Rare cases of severe liver injury have been reported in people taking orlistat. | |
| Effectiveness | Prescription weight loss drugs are a popular and effective treatment for obesity and health problems related to being overweight. |
| Weight loss drugs work best in the context of a healthy eating plan and exercise. | |
| Weight loss drugs can help with hunger, cravings, and metabolic preservation. | |
| Some weight loss drugs are designed for short-term use, while others are for long-term use. |
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What You'll Learn
Appetite suppressants
There are prescription and over-the-counter (OTC) appetite suppressants. Prescription appetite suppressants can be for long-term or short-term use. Long-term prescription appetite suppressants are generally safe if you take them as prescribed. However, short-term prescription appetite suppressants require more caution due to possible severe side effects and addiction potential. Some appetite suppressants can interact with medications, including antidepressants and anti-anxiety drugs (anxiolytics). Appetite suppressants can also worsen certain health conditions like high blood pressure, mood disorders, and glaucoma. Each appetite suppressant works differently, so they have different risks. Talk to your healthcare provider about all the benefits and risks of each medication if you’re thinking of starting an appetite suppressant.
The Food and Drug Administration (FDA) has approved these prescription appetite suppressants for long-term use: Liraglutide (Saxenda®), Semaglutide (Wegovy®), Naltrexone-bupropion (Contrave®), and Phentermine-topiramate (Qsymia®). Other FDA-approved prescription appetite suppressants are for short-term use only—typically up to 12 weeks (three months). These include Benzphetamine (Didrex®, Regimex®), Diethylpropion (Tenuate®, Tenuate Dospan®), Phendimetrazine (Prelu-2®), and Phentermine (Dipex-P®, Atti-Plex P®, Pro-Fast®).
Some OTC appetite suppressants or weight-loss supplements contain ephedra, ephedrine, or caffeine (stimulants). And some have been linked to reports of heart attack, seizure, stroke, and death. No over-the-counter appetite-suppressing drugs have been approved by the FDA. Despite no clear evidence that any of them are effective or safe for weight loss, supplements that claim to reduce appetite may include ingredients such as green tea extracts, yerba mate, guarana, and kola nuts.
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Side effects
While prescription weight loss drugs can be an effective treatment for obesity, they are not without their side effects. It is important to remember that obesity is a complex condition that requires a complex treatment plan, and medication is just one part of that. A healthy diet and physical activity are also key components of a weight loss journey.
Some of the most common side effects of prescription weight loss drugs are gastrointestinal problems. For example, Wegovy can slow down people's digestive systems, leading to nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, indigestion, dizziness, bloating, and gas. In rare cases, severe liver injury has been reported in people taking orlistat, although it is not certain that the drug is responsible for these problems.
Another potential side effect of weight loss drugs is the risk of addiction or abuse. Drugs like phentermine are amphetamines, and therefore have the potential for abuse and addiction. As a result, they are classified as "controlled substances" and require a special type of prescription.
Weight loss drugs can also negatively interact with other medications. For example, appetite suppressants can interact with antidepressants, anti-anxiety drugs, and medications for people with high blood pressure, mood disorders, and glaucoma. It is important to discuss all medications with a doctor to ensure they are safe for use.
Additionally, some over-the-counter weight loss supplements have been linked to reports of heart attack, seizure, stroke, and even death. It is important to be cautious when considering these types of supplements and to prioritize medications that are approved by the FDA.
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Drug interactions
Diet and lifestyle can have a significant impact on drugs. A drug interaction is a situation in which a substance affects the activity of a drug, i.e., the effects are increased or decreased, or they produce a new effect that neither the drug nor the substance produces on its own. Drug interactions can be between two or more drugs or between a drug and a food, beverage, or supplement.
People with certain medical conditions should be aware of potential drug interactions. For example, if someone has high blood pressure, taking a nasal decongestant may increase their risk of stroke or heart attack. Similarly, some HIV medicines may make hormonal birth control less effective.
Grapefruit juice has a high interaction with almost all types of drugs. The juice modifies the body's way of metabolizing the medication, affecting the liver's ability to work the drug through a person's system. Furanocoumarins and active bioflavonoids present in grapefruit juice are also inhibitors of OATP and when ingested concomitantly, can reduce the oral bioavailability of the OATP substrate, fexofenadine.
A lack of interaction may be due to insufficient concentrations of causative ingredients at the enzyme or transporter active site, metabolism of causative ingredients to inactive products, or transport of causative ingredients out of target cells.
The FDA has approved several drugs for weight management, including orlistat (Xenical, Alli), phentermine-topiramate (Qsymia), naltrexone-bupropion (Contrave), liraglutide (Saxenda), semaglutide (Wegovy), and tirzepatide (Zepbound). However, it is important to note that weight management medications are not for everyone with a high BMI, and they should not be taken during pregnancy or if planning a pregnancy.
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Weight loss drugs and diabetes
Weight loss drugs are generally safe if taken as prescribed. However, it is important to consult a doctor or a healthcare provider before taking any weight loss drugs as they can have side effects and may interact with other medications. This is especially important for people with diabetes, as some weight loss drugs can cause a diabetes eye complication called retinopathy.
There are several weight loss drugs available that can also help manage diabetes. For example, Ozempic (semaglutide) and Wegovy are medications that can cause significant weight loss and are approved for people with Type 2 diabetes. Mounjaro (tirzepatide) is another medication that works similarly to GLP-1 agonists but with an added boost. It acts like GLP-1 and another hormone called glucose-dependent insulinotropic polypeptide (GIP), providing better blood glucose-lowering effects. Trulicity (dulaglutide) and Jardiance (empagliflozin) are other diabetes medications that may cause weight loss, although not as much.
GLP-1 agonists are a group of medications that are growing in popularity for diabetes and weight loss. They can lead to significant weight loss and are FDA-approved for Type 2 diabetes. However, they are not interchangeable with the versions used to treat Type 2 diabetes. When used for weight loss, they are administered at higher doses.
It is important to note that these medications are intended for people who are overweight or obese with health problems related to excess weight. They are not meant for individuals who are mildly overweight and simply looking to lose a few pounds. Additionally, these medications are extremely expensive, and most insurance companies do not cover them for weight loss purposes.
Before considering weight loss drugs, it is recommended to discuss the options with a healthcare provider and specialists who can provide a full health picture and ensure safe use. This is especially important for individuals with diabetes, as proper use of medications and regular follow-ups with an ophthalmologist are crucial.
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FDA-approved weight loss drugs
The U.S. Food and Drug Administration (FDA) has approved several weight management medications for adults and children. It is important to note that weight management medications are not for everyone with a high BMI, and lifestyle changes such as improving eating and physical activity habits are also important.
For children aged 12 and older, the FDA has approved orlistat (Xenical), liraglutide (Saxenda), phentermine-topiramate (Qsymia), and semaglutide (Wegovy). Setmelanotide (IMCIVREE) is approved for children aged 6 and older with rare genetic disorders causing obesity.
For adults, the FDA has approved Zepbound (tirzepatide) for chronic weight management in those with obesity or who are overweight with at least one weight-related condition. This medication is to be used in conjunction with a reduced-calorie diet and increased physical activity. Wegovy is another FDA-approved medication for adults with obesity or those who are overweight and have health problems related to excess weight.
It is important to discuss weight loss drugs with a healthcare provider to understand the potential benefits and risks. Prescription appetite suppressants, for example, can help with weight loss but may have side effects and interact with other medications. They should be used with caution, especially in the short term due to the risk of severe side effects and addiction.
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Frequently asked questions
Diet drugs are generally safe if you take them as prescribed. However, it is important to consult your doctor before taking any diet drugs to ensure they are right for you. Some diet drugs are only suitable for people with a body mass index (BMI) of 27 or higher and who have weight-related health conditions, such as diabetes or high blood pressure.
Side effects depend on the specific drug. Short-term prescription appetite suppressants may have severe side effects and addiction potential. They can also interact with other medications, such as antidepressants and anti-anxiety drugs. Some over-the-counter appetite suppressants have been linked to heart attacks, seizures, strokes, and even death. Common side effects of other diet drugs include gastrointestinal problems, such as nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, indigestion, dizziness, bloating, and gas.
Yes, a treatment plan for obesity can include a healthy diet, exercise, and/or surgery. Even with a healthy diet and exercise, medications can still help with hunger, cravings, and metabolic preservation.
Speak to your doctor about your options and whether diet drugs are suitable for you. You can also take part in clinical trials to gain early access to new treatments and help doctors learn more about weight loss.
