Milly Gaines
Doctors may prescribe weight loss medication to patients who are overweight or obese, typically defined as having a body mass index (BMI) of 30 or higher. Medication may also be prescribed for those with a BMI of 27 or greater if they have weight-related health problems such as high blood pressure or type 2 diabetes. Before prescribing medication, doctors will take into account the patient's medical history, including any allergies or other medications they are taking, and will discuss the medication's cost and side effects. Weight loss medication is intended to be used in conjunction with a healthy diet and exercise program, and patients should be aware that long-term use may be necessary to maintain results.
| Characteristics | Values |
|---|---|
| Who can prescribe diet pills? | Primary care doctor, obesity medicine specialist, endocrinologist, or cardiologist |
| Who are they for? | Adults with a BMI of 27 or greater, and weight-related health problems such as high blood pressure or type 2 diabetes |
| What are the side effects? | Nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, diarrhea, and rare cases of severe liver injury |
| What are the risks? | Harmful interactions with other medications, suicidal thoughts or actions, and potential harm to a fetus |
| What are the benefits? | Weight loss of 5-21% of body weight, with some people losing as much as 20% |
| What is the cost? | Around $800 for a 1-month supply of Xenical, but generic versions of orlistat are cheaper |
| Are they covered by insurance? | Some insurance plans cover weight loss medications, especially if they are prescribed to treat another health condition |
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What You'll Learn
Who can prescribe weight loss medication
Weight loss medication is typically prescribed by a health care professional or a doctor. This could be your primary care physician, or they may refer you to a doctor who specialises in obesity medicine.
If you are an adult with a body mass index (BMI) of 27 or greater, and you have weight-related health problems such as high blood pressure or type 2 diabetes, your doctor may prescribe weight loss medication. Weight management medications are meant to help people who have health problems related to being overweight.
However, weight loss medication is not suitable for everyone with a high BMI. A health care professional may first recommend a lifestyle program that changes your behaviours and improves your eating and physical activity habits.
Some insurance plans cover weight loss medications, but most do not. They are more likely to be covered if you need the drugs for an added purpose, like reducing your risk of heart disease. Medicare Part D may cover weight loss drugs if they're prescribed to treat another health condition like diabetes.
If you are prescribed a weight-loss medication, a board-certified provider will continue to evaluate you and may slowly adjust the dose every four weeks to find the right dose. Once the correct dose has been determined, it is recommended to schedule a visit once every three months.
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Effectiveness, risks and benefits
Prescription weight loss medications are intended to be used in conjunction with a healthy eating plan and regular exercise. Doctors may prescribe weight loss medications to adults with a body mass index (BMI) of 27 or greater, who also have weight-related health problems, such as high blood pressure or type 2 diabetes. Weight loss medications are not suitable for everyone, and doctors will consider a patient's current health issues, other medications, family medical history, and the medication's cost and side effects.
The average weight loss from medication varies from 5% to 21%, with some people losing more and some less. Weight loss medications can cause mild and temporary side effects, such as nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, and diarrhoea. In rare cases, more severe side effects have been reported, such as liver injury. Weight loss medications may also have harmful interactions with other medications, and they are not recommended for pregnant or breastfeeding people.
Some weight loss medications suppress appetite, while others make it harder for the body to absorb fat. For example, orlistat (Xenical) blocks the enzyme that breaks down fats consumed through food, inhibiting the absorption of dietary fats. Bupropion (Wellbutrin) is another example of a weight loss medication that is also used to treat depression.
Prescription weight loss medications can be an effective treatment for obesity and related health problems. They can help people lose a significant amount of weight and lower their risk of developing other diseases. However, it is important to be aware of the potential risks and side effects and to discuss these with a doctor before starting medication.
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Side effects
Diet pills, or appetite suppressants, are a type of weight-loss medication for people with obesity (a body mass index, or BMI, over 30). They 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.
There are several prescription diet pills that have been approved by the FDA for long-term use, including:
- Orlistat (Xenical, Alli)
- Phentermine-topiramate (Qsymia)
- Naltrexone-bupropion (Contrave)
- Liraglutide (Saxenda)
- Semaglutide (Wegovy)
- Tirzepatide (Zepbound)
- Setmelanotide (IMCIVREE)
There are also several short-term prescription appetite suppressants, including:
- Benzphetamine (Didrex, Regimex)
- Diethylpropion (Tenuate, Tenuate Dospan)
- Phendimetrazine (Prelu-2)
- Phentermine (Dipex-P, Atti-Plex P, Pro-Fast)
These short-term appetite suppressants are controlled substances, which means they have addiction potential and can be dangerous if not used as prescribed.
The side effects of prescription diet pills vary depending on the specific medication. Most side effects are mild and temporary, but serious side effects can occur in rare cases. It is important to follow the instructions provided by your doctor when taking any medication, including diet pills.
Some common side effects of orlistat include:
- Mild and temporary side effects when taken with a high-fat diet, which may worsen if high-fat foods are consumed
- Interference with the absorption of vitamins A, D, E, and K, requiring the additional intake of a daily multivitamin
- Rare cases of severe liver injury have been reported, although it is not certain that orlistat was the cause
Some common side effects of Wegovy include:
- Mild and temporary side effects
- Less common but more serious possible side effects include allergic reactions, problems with the gallbladder, kidneys, or pancreas, blurred vision, increased heart rate, and suicidal thoughts
- Studies have shown that semaglutide, the active ingredient in Wegovy, can cause a rare kind of thyroid tumor in animals, but it is not known if it can cause thyroid cancer in people
Some common side effects of short-term prescription appetite suppressants include:
- Rapid or irregular heartbeat (tachycardia or arrhythmia)
- Mood changes, such as depression or anxiety
- Cognitive (mental) changes like agitation, delirium, or psychosis
- Nausea and vomiting
- Diarrhea or constipation
- Abdominal pain
It is important to note that appetite suppressants can also interact with other medications, such as antidepressants and anti-anxiety drugs. They can also worsen certain health conditions like high blood pressure, mood disorders, and glaucoma.
Additionally, people taking certain weight-loss medications have reported having suicidal thoughts or actions, and further research is being conducted by the FDA to determine if this is caused by the medication. Weight-loss medications are not recommended for pregnant or breastfeeding individuals, as they may harm the fetus.
Before taking any prescription diet pills, it is important to discuss your medical history and any medications or supplements you are currently taking with your doctor to ensure that the medication is safe and appropriate for you.
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Cost
The cost of prescription diet pills is a crucial factor when considering this treatment option. The price of these medications can vary significantly, and it's important to evaluate the financial implications before starting a weight-loss medication regimen.
One popular prescription weight-loss pill is Qsymia (phentermine and topiramate extended-release capsules). While Qsymia has shown promising results, it is a cash-only program, and insurance claims will not be processed. Additionally, there is a $45 charge for the consultation with a doctor. This cost must be considered before beginning treatment with Qsymia.
Another option, Wegovy, is a brand name for semaglutide, a GLP-1 receptor agonist administered as an injection. The list price for Wegovy is $1,349 for a 4-week supply, which is significantly more expensive than some other options. However, the manufacturer, Novo Nordisk, offers a savings program to assist with out-of-pocket costs, which can help make this treatment more affordable.
The cost of prescription appetite suppressants, such as Benzphetamine (Didrex®, Regimex®), Diethylpropion (Tenuate®, Tenuate Dospan®), and Phendimetrazine (Prelu-2®), should also be considered. These medications are typically prescribed for short-term use of up to 12 weeks and may have severe side effects and addiction potential. As such, they may not be a long-term cost-effective solution and could lead to further health complications.
Orlistat, a lipase inhibitor, is another weight-loss medication option. The prescription form, Xenical, costs around $800 for a 1-month supply, while the over-the-counter version, Alli, costs less than $60 for a month. This significant price difference should be considered when choosing between prescription and over-the-counter options.
In conclusion, the cost of prescription diet pills varies widely, and it is essential to discuss financial considerations with a healthcare professional. The effectiveness, safety, and affordability of these medications should all be taken into account when making a decision about weight-loss treatment.
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Lifestyle changes
Healthy Eating
A healthy eating plan is fundamental to achieving and sustaining weight loss. Eating a variety of nutrient-rich foods provides your body with the essential vitamins, minerals, and energy it needs to function optimally. This supports your overall health and helps in the weight loss process. Focus on achievable weight loss goals rather than drastic changes, such as deprivation diets. Instead, opt for a balanced diet with a variety of nutrient-rich foods.
Mindful Eating
Being mindful of your eating habits can also help. Take time to savour each bite of your food, focusing on its texture and taste. Ask yourself if you feel satisfied and want more. This helps you eat more mindfully and feel more satisfied with smaller portions.
Regular Physical Activity
Incorporating regular physical activity into your routine is another essential aspect of lifestyle changes. This can include activities such as walking, jogging, swimming, or any form of exercise that suits your interests and fitness level.
Behavioural Changes
Behavioural changes can also contribute to weight loss. This may include addressing eating triggers, improving sleep habits, and making small positive changes, such as drinking more water or increasing your daily steps. These small steps can lead to significant and lasting results over time.
Bariatric Surgery
In some cases, individuals may opt for bariatric surgery as a tool to assist in weight loss. The two main types are gastric bypass and sleeve gastrectomy, which reduce the size of the stomach, leading to reduced food consumption. However, it is important to note that surgery is not a quick fix, and individuals must commit to significant lifestyle changes post-surgery, including dietary modifications and regular physical activity.
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Frequently asked questions
Doctors will consider your current health issues, other medications, family medical history, and cost and side effects. They will also assess your BMI, with most medications prescribed for a BMI of 30 or greater, or a BMI of 27 or greater if the patient has weight-related health conditions.
Side effects of diet pills can include nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, and diarrhea. Some people taking weight-loss medications have also reported having suicidal thoughts or actions.
Commonly prescribed weight loss medications include Wegovy, Ozempic, Rybelsus, liraglutide (Saxenda), naltrexone-bupropion (Contrave), phentermine-topiramate (Qsymia), and orlistat (Xenical).
Yes, you will need a prescription from a doctor to obtain weight loss medication. This can be from your primary care doctor, obesity medicine specialist, endocrinologist, or cardiologist.
Some insurance plans cover weight loss medications, but most do not. They are more likely to be covered if you need the drugs for an added purpose, such as reducing your risk of heart disease.
