People who have long struggled with obesity are turning to prescription medications to help them control their appetite and melt away dozens or more extra pounds. But anyone considering weight-loss medications should understand the basics of how they work as well as the pros and cons, says Denise Pate, MD, an internist and medical director at Medical Offices of Manhattan.
The Obesity issue
About two-thirds of Americans are overweight or obese, according to the Centers for Disease Control and Prevention (CDC). And the obesity rate has steadily climbed over the past several decades, with 40% of Americans now classified as obese, with a body mass index (BMI) of 30 or higher.
“Weight-loss medications are meant to help those with obesity or it they are overweight, especially if they have related health problems such as diabetes, high blood pressure, or high cholesterol,” according to Dr. Pate. “But it’s also important that they’ve first attempted to lose weight through lifestyle behaviors such as physical activity and eating healthy foods.”
“Medications can’t replace exercise or diet measures as a way to lose weight,” says Dr. Pate. “Research demonstrates that weight-management drugs work best when combined with all the other things people should do to take care of their health, regardless of size.”
What are my choices?
The U.S. Food and Drug Administration has approved about a dozen weight-loss medications for use in adults and, in some cases, children as young as 12. These include Wegovy (semaglutide), Saxenda (liraglutide), Mounjaro (tirzepatide), Xenical (orlistat), Contrave (naltrexone HCl and buproprion) and Adipex or Suprenza (phentermine).
Risks and benefits
Prescription weight-loss drugs are also different in other ways. Some medications are meant to be used for short periods, others longer. And all come with side effects that vary widely—ranging from headache, nausea, vomiting, diarrhea, constipation, and dizziness to dry mouth, insomnia, and heart palpitations. Serious side effects can also happen, including pancreatitis, gallbladder disease, kidney problems, and hypertension.
“Nobody should take a weight-loss medication thinking that it’s free of possible complications,” Dr. Pate says. “It’s a serious decision that can have serious consequences on the body.”
That said, weight-loss medications can offer significant benefits—which is what most people focus on. When combined with healthy eating and physical activity, many people taking them can lose 10% or more of their body weight, Dr. Pate notes.
That said, weight-loss medications can offer significant benefits—which is what most people focus on. When combined with healthy eating and physical activity, many people taking them can lose 10% or more of their body weight, Dr. Pate notes.
“The health benefits can be incredible, lowering people’s blood sugar, cholesterol and blood pressure levels,” she says. “Significant weight loss can also help ease joint pain and improve or eliminate sleep apnea symptoms, really improving someone’s overall quality of life.”
Anyone who’s interested in taking prescription weight-loss drugs should speak to their doctor about the risks and benefits, she says. “This is not a decision to take lightly, but for the right person, these medications can be a game-changer,” she says.
