Dante Carrillo
Diet pills, also known as weight management medications or appetite suppressants, are prescription drugs that can help with weight loss for people struggling with obesity or overweight. Healthcare providers recommend these pills to patients with a body mass index (BMI) of 30 or higher, or a BMI greater than 27 with other weight-related health issues such as high blood pressure or type 2 diabetes. While some diet pills are administered as injections, there are several FDA-approved prescription appetite suppressants available in pill form, each with its own unique mechanism of action and potential side effects.
| Characteristics | Values |
|---|---|
| How they work | Diet pills work by blocking or increasing specific hormones, neurotransmitters and/or peptides to reduce appetite. |
| Who they are for | Diet pills are for people with obesity or a body mass index (BMI) of 30 or higher. They are also for those with a BMI of 27 or higher who have weight-related health problems such as high blood pressure or type 2 diabetes. |
| Types | Prescription appetite suppressants, weight loss injections, and weight loss pills. |
| Prescription appetite suppressants | Liraglutide (Saxenda), Semaglutide (Wegovy), Naltrexone-bupropion (Contrave), Phentermine-topiramate (Qsymia), Benzphetamine (Didrex, Regimex), Diethylpropion (Tenuate, Tenuate Dospan), Phendimetrazine (Prelu-2), Phentermine (Dipex-P, Atti-Plex P, Pro-Fast). |
| Weight loss injections | Liraglutide, Wegovy, Ozempic, Mounjaro, Zepbound. |
| Weight loss pills | Contrave, Qsymia. |
| Side effects | Mild side effects include nausea, diarrhea, constipation, vomiting, headache, decreased appetite, dyspepsia, fatigue, dizziness, abdominal pain, bloating, and gas. In rare cases, serious side effects can occur. |
| Precautions | Diet pills should be used in conjunction with a healthy eating plan and regular physical activity. They should only be taken under the supervision of a healthcare provider. They should not be taken during pregnancy or when planning a pregnancy. |
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What You'll Learn
Prescription appetite suppressants
There are several prescription appetite suppressants available, including both short-term and long-term options. Short-term prescription appetite suppressants, such as benzphetamine (Didrex®, Regimex®), diethylpropion (Tenuate®, Tenuate Dospan®), phendimetrazine (Prelu-2®), and phentermine (Adipex-P®, Lomaira®), (Dipex-P®, Atti-Plex P®, Pro-Fast®), are typically prescribed for up to 12 weeks and are considered controlled substances due to their potential for addiction and abuse. Phentermine, for example, is an amphetamine that comes in various forms, including tablets, capsules, and extended-release capsules, and is typically taken once a day before or after breakfast. It is important to note that phentermine should not be taken by individuals with a history of heart disease, stroke, congestive heart failure, or uncontrolled high blood pressure.
On the other hand, long-term prescription appetite suppressants like liraglutide (Saxenda®), semaglutide (Wegovy®), naltrexone-bupropion (Contrave®), and phentermine-topiramate (Qsymia®) are approved for long-term use. Liraglutide and semaglutide are injectable medications, while naltrexone-bupropion and phentermine-topiramate are pills. Wegovy, for example, is a brand name for semaglutide, a GLP-1 receptor agonist that works by lowering your appetite and making you feel full. It is administered as a weekly injection and has shown impressive weight loss results in clinical trials.
It is important to note that prescription appetite suppressants should be used in conjunction with a reduced-calorie eating plan and regular physical activity to achieve optimal weight loss results. Additionally, they may have side effects, so it is crucial to discuss potential risks and benefits with a healthcare provider before starting any medication.
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Liraglutide (Saxenda)
Liraglutide, also known by the brand name Saxenda®, is a prescription weight-loss medication. It is a daily injectable medicine used to help adults and children aged 12-17 years old with obesity or being overweight to lose weight and keep the weight off. Saxenda® is also approved for Type 2 Diabetes under the brand name Victoza.
Saxenda® should be used in conjunction with a reduced-calorie diet and increased physical activity. It is not recommended for those who already take liraglutide or other medications called glucagon-like peptide 1 receptor agonists (GLP-1 receptor agonists). It is also not advised for those with a history of medullary thyroid cancer or diabetic ketoacidosis. Additionally, pregnant women and those who are breastfeeding or planning to breastfeed should not use this medication.
Liraglutide works by acting on hormones that send signals from the gut to the brain, making patients feel full quicker and reducing hunger signals. The dosage typically starts at 0.6 mg and can go up to 3 mg per day. Some patients may lose 5-10% of their body weight, especially with the higher dosage. It is injected once daily under the skin of the stomach, thighs, or upper arm, and users should rotate the injection area each time.
Side effects of liraglutide may include nausea, diarrhoea, constipation, vomiting, headache, decreased appetite, dyspepsia, fatigue, dizziness, abdominal pain, increased lipase, and renal insufficiency. It is important to note that in animal studies, liraglutide caused thyroid tumours or thyroid cancer, but it is unknown if these effects would occur in humans using regular doses.
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Semaglutide (Wegovy)
Semaglutide, also known by its brand name Wegovy, is a prescription medicine used for weight loss and weight management. It is administered as an injection and was approved by the FDA in 2021 for use in adults and children aged 12 years or older with obesity or being overweight with associated medical problems.
Semaglutide/Wegovy is a GLP-1 receptor agonist, a man-made version of the naturally occurring hormone GLP-1 in the body. By activating the GLP-1 receptors in the brain, it lowers appetite and slows the rate at which the stomach empties, making people feel fuller for longer and eat less, leading to weight loss. It is intended to be used indefinitely, in conjunction with a calorie-controlled diet and increased physical activity.
The drug is not suitable for everyone. It should not be used if there is a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Additionally, people with a history of depression, suicidal thoughts, or mental health issues, as well as those with kidney or pancreas problems, should not use this medication. It is important to consult a healthcare provider before taking Semaglutide/Wegovy, as there are potential side effects, including gastrointestinal symptoms, headache, dizziness, and fatigue.
Semaglutide is also marketed under the name Ozempic, which is approved for use in people with Type 2 diabetes. Ozempic has the same active ingredient as Wegovy but is prescribed under a different name with a slightly different dosage and indication.
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Naltrexone-bupropion (Contrave)
Naltrexone-bupropion, also known by its brand name Contrave, is an FDA-approved prescription weight-loss pill. It is a 2-in-1 oral medication that combines naltrexone, an opioid antagonist, and bupropion, an aminoketone antidepressant. Contrave is designed to assist certain adults in losing weight when accompanied by a reduced-calorie diet and proper exercise. It is important to note that this medication is only available with a doctor's prescription.
The standard dosing regimen for Contrave involves starting with one tablet taken orally in the morning during the first week. In the second week, an additional tablet is introduced to be taken in the evening. This gradual increase continues weekly until the recommended dose of two tablets twice daily is achieved by the fourth week. Each tablet contains 8 mg of naltrexone and 90 mg of bupropion, resulting in a total daily dose of 32 mg of naltrexone and 360 mg of bupropion.
It is crucial to be aware of potential side effects and contraindications before taking Contrave. The medication is not suitable for individuals with uncontrolled high blood pressure, a history of seizures, concurrent use of specific medications containing bupropion, a history of eating disorders such as anorexia or bulimia, or dependence on opioid pain medications. Additionally, those who consume excessive amounts of alcohol or abruptly stop drinking should refrain from using Contrave.
One of the most significant risks associated with Contrave is the potential for seizures, especially in individuals taking higher doses, with certain medical conditions, or when combined with particular medications. Bupropion, one of the ingredients in Contrave, has been associated with an increased risk of suicidal thoughts or actions in some individuals, particularly children, teenagers, and young adults. Therefore, it is essential to closely monitor any changes in mood, behaviour, thoughts, or feelings while taking this medication.
Furthermore, Contrave interacts with opioids, and individuals taking it should refrain from using any type of opioid, including street drugs, prescription pain medications, and opioid-containing cough, cold, or diarrhoea medicines. Combining Contrave with opioids can lead to serious adverse effects, including accidental overdose, serious injury, or even death. It is imperative to consult a healthcare provider before taking Contrave to ensure it is safe and appropriate for your specific circumstances.
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Phentermine-topiramate (Qsymia)
Phentermine-topiramate, also known by its brand name Qsymia, is a prescription medicine that combines phentermine and topiramate extended-release. It is approved for use in adults and children aged 12 and older who are considered obese, or for some adults who are overweight and have weight-related medical issues. Qsymia is designed to help with weight loss and is typically taken as a once-daily tablet. It is important to note that Qsymia should be used in conjunction with a reduced-calorie diet and increased physical activity for optimal results.
Phentermine, a sympathomimetic, works in the brain to reduce appetite. On the other hand, topiramate is an antiepileptic or anti-seizure medication, and its exact mechanism of weight loss is not fully understood. However, it is believed to decrease appetite and increase feelings of fullness. While Qsymia can aid in weight loss, it is not without potential side effects and risks.
One of the primary concerns with Qsymia is the risk of birth defects if taken during pregnancy. It is crucial that individuals who can become pregnant follow specific directions, including taking a pregnancy test before starting the medication and during treatment. Additionally, reliable birth control methods must be used if one engages in sexual activity while taking Qsymia. Studies have also indicated that topiramate, one of the ingredients in Qsymia, may increase the risk of suicidal thoughts or actions, depression, and anxiety.
Other possible side effects of Qsymia include a "'pins-and-needles'" sensation, dry mouth, constipation, dizziness, changes in taste or loss of taste, trouble sleeping (insomnia), and numbness or tingling in the hands, arms, feet, or face (paraesthesia). In some cases, Qsymia may also cause more severe issues such as a severe rash with blisters and peeling skin, particularly in sensitive areas like the mouth, nose, eyes, and genitals (Stevens-Johnson Syndrome). This could also manifest as Toxic Epidermal Necrolysis, a life-threatening condition.
It is important to consult a healthcare professional before taking Qsymia, especially if one has a history of depression or suicide attempts. Additionally, those with heart conditions should exercise caution and discuss the potential risks and benefits with their doctor, as Qsymia has been shown to increase heart rate.
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Frequently asked questions
Contrave, Qsymia, and phentermine (Adipex-P) are some popular weight-loss pills.
Contrave is a combination of two drugs: naltrexone and bupropion.
Qsymia combines phentermine with the seizure/migraine drug topiramate.
Side effects of diet pills vary depending on the medication. Some common side effects include nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, and diarrhea.
