10 Things to Know About Weight Loss Medications

In this article:

• The FDA has approved several prescription medications for weight loss. They include Orlistat (Xenical, Alli), bupropion-naltrexone (Contrave), and phentermine-topiramate (Qsymia), as well as GLP-1 receptor agonists (RAs) like semaglutide (Wegovy) and liraglutide.
• The medications differ in how they work, their possible side effects, and how to take them.
• Whether you’re on prescription medications for weight loss or not, long-term weight management depends on eating behaviors and other behaviors like being physically active, getting enough sleep, and managing your stress in healthy ways.
• Talk to your healthcare provider if you’re interested in weight loss medications or if you have any questions or concerns about them.
• Lark can support your goals and help you stay motivated as you make progress towards your health and weight loss goals with or without medications as you log food, get tips for eating healthier, and make small changes that can turn into healthy habits.

Prescription weight loss medications can help patients lose more weight than lifestyle changes alone. GLP-1 medications like semaglutide (Wegovy), tirzepatide (Mounjaro), and liraglutide (Saxenda) have been in the news recently for their impressive weight loss results, but the FDA has also approved other medications for long-term use for weight loss. Orlistat (Xenical, Alli), bupropion-naltrexone (Contrave), and phentermine-topiramate (Qsymia) are examples.

Whether you’re using them or considering it, here’s some information about different types of weight loss medications, how they work, their pros and cons, and how to get the most from them. Talk to your doctor before starting any new medication or changing your use of existing prescription medications.

1. Weight loss medications work in different ways

The FDA has approved a variety of medications for weight loss and they work in different ways.

• Bupropion-naltrexone (Contrave): This medication has bupropion, an antidepressant, and naltrexone, which is used for addiction treatment. The medication affects areas of the brain related to reward and appetite to help reduce hunger and cravings.‍
• Orlistat (Xenical/Alli): This medication acts in the intestines to reduce 25-30% of dietary fat absorption, which causes fewer calories to be absorbed.
• Phentermine-topiramate (Qsymia): This medication has phentermine, which suppresses appetite, and topiramate, a medication used for epilepsy and migraines that promotes feelings of fullness and reduces cravings.
• GLP-1 RAs (Wegovy, Mounjaro, Saxenda): These medications act like a hormone called glucagon-like peptide-1 (GLP-1). They increase insulin secretion to help control blood sugar, reduce glucagon release, slow gastric emptying, and increase feelings of fullness, leading to reduced food intake and weight loss.

2. Weight loss medications aren’t new

People have used phentermine for weight loss since the 1950s, and the FDA approved orlistat for weight loss in 1999. The FDA approved a GLP-1 medication for diabetes in 2005, and approved the first GLP-1 for weight loss in 2014. Wegovy was approved in 2021 for weight loss. The FDA hasn’t yet approved Mounjaro for weight loss, but may do so soon.

3. Effectiveness varies by medication and patient

Studies are ongoing regarding how much weight patients typically lose on various weight loss medications. Contrave and Qsymia are likely to help patients lose 5-10% of body weight, and orlistat may help patients lose an extra 5-7 lbs compared to diet alone. Many patients on GLP-1 medications have lost 10-15% of their body weight.

Your own results using weight loss medications will depend on which medication you’re taking and many additional factors such as:

• How closely you follow instructions for taking the medication
• Which dietary and other lifestyle choices you make
• Your initial weight
• Your body’s response to the medication and lifestyle changes

Ask your healthcare provider how you can support your weight loss efforts.

4. You may experience side effects

All approved weight loss medications commonly cause side effects. They can range from mild to serious. Ask your healthcare provider what to expect from the medication that you’re on.

Here are some common side effects.

• Bupropion-naltrexone (Contrave): This medication can cause nausea, constipation, headaches, dizziness, and higher blood pressure. It can also alter mood.
• Orlistat (Xenical/Alli): This medication can cause oily stools, gas, and diarrhea, as well as reduced absorption of the fat-soluble vitamins A, D, E, K.
• Phentermine-topiramate (Qsymia): This medication can lead to dry mouth, constipation, insomnia, dizziness, and tingling in the hands and feet. It also has serious risks like increased heart rate and mood or cognitive changes, as well as birth defects.
• GLP-1 RAs (Wegovy, Mounjaro, Saxenda): These medications can lead to nausea, vomiting, diarrhea, constipation, abdominal pain, and reduced appetite/increased fullness.

Ask your provider how you can minimize side effects. Strategies may include changing the timing of when you take your medications relative to when you eat meals. Here are some other common strategies.

• Drinking plenty of water
• Limiting fat consumption
• Eating slowly
• Keeping portion sizes small
• Starting at a small dose and increasing your dose gradually until it reaches a full dose

Also ask your healthcare provider and pharmacist which side effects may require medical attention, and know whom to contact if you have questions or need help.

5. They require dietary changes for success

Medications can help with weight loss, but the amount of weight you lose largely depends on your behaviors and habits. A calorie deficit, or negative calorie balance, is necessary for long-term weight loss. That means you consume fewer calories than you expend, or burn.

Here are some common dietary changes that can help with weight loss.

• Choosing water and other low-calorie or calorie-free beverages instead of beverages with sugar
• Consuming plenty of lean protein like fish, beans, egg whites, reduced-fat dairy products, and skinless chicken
• Serving smaller portions of calorie-dense foods
• Choosing less processed foods compared to fast foods, fatty foods, and fried foods
• Eating slowly and only when you are hungry

Being physically active, getting enough sleep, and managing stress also help with weight management.

6. Weight loss medications work best if you take them as prescribed

Ask your healthcare provider or pharmacist for detailed instructions on how to take your medication. Make sure you understand which times and days to take them and how much to take each time. Some medicines like many GLP-1 medications are injectables; be sure you understand how to inject them.

Here are some tips for taking medications properly.

• Set a timer on your phone to help you remember when to take them
• Know how to contact your doctor, nurse, or pharmacist if you have questions about your medication
• Ask what happens if you miss a dose
• Reduce chances of having side effects by eating according to the instructions you receive
• Plan to take them with you if you’re planning to be away from home when it’s time to take them
• Always be sure you have plenty of doses at home and any other equipment you need like syringes
• Set reminders in the Lark app

Let your doctor know if you’re having trouble taking your medications as prescribed. You may need more guidance on taking them, or a different medication may work better for you.

7. Decide with your doctor if you’re a good candidate for weight loss medications

Healthcare providers and insurers may require you to meet certain requirements before prescribing or paying for weight loss medications. Usually, there are two main requirements.

• You have tried making lifestyle changes like changing how you eat and increasing physical activity, but they didn’t lead to lasting weight loss
• You have a body mass index (BMI) of at least 30, which is classified as obese, or you have a BMI of at least 27 and have at least one obesity-related comorbidity like diabetes or hypertension

As you and your provider discuss medication options, keep in mind that you’ll still need to make lifestyle changes to be successful while on medications. In addition, it’s important to recognize that starting to use weight loss medication doesn’t mean you’re a failure. It means that first-line weight loss treatments didn’t work for you or that your provider agrees that you can benefit from medication as well as lifestyle changes. Lark can also help on your journey!

8. Prices vary widely

Costs can be major factors in your decision whether to use weight loss medications and which ones to consider. The cost of GLP-1 medications like Wegovy has made headlines, with monthly costs of around $1,100 or more. On the other hand, medications like Qsymia, Orlistat (Xenical), and Contrave can be $20-$100 monthly.

Health insurers may cover certain weight loss medications. Some patients don’t get their medications paid for by insurance and need to decide whether to pay for their medications out of pocket or to skip them.

Here are some tips for getting the lowest possible prices on your medications.

• See if you qualify for Lark and join at no extra cost to you.
• Ask your healthcare provider about generic options
• Compare prices at different online and in-person pharmacies, as prices can vary widely
• Ask providers and pharmacists about prescription discount programs
• Ask if it’s less expensive per dose if you opt for a 90-day instead of a 30-day supply
• Ask about manufacturer coupons or check for them on manufacturers’ websites

Many weight loss medications turn out to be cost-saving in the long run due to a lower risk for conditions like diabetes or other weight-related chronic conditions

9. Your own choices determine weight loss

Prescription weight loss medications may support your weight loss efforts by decreasing hunger, reducing cravings, increasing metabolism, or balancing hormones, but weight loss requires that you have a calorie deficit. It’s important to eat according to the instructions your provider gives you.

Here are some examples of other factors that affect weight loss and your ability to maintain weight loss long-term.

• Being physically active
• Maintaining muscle mass by eating sufficient amounts of protein and by performing muscle-strengthening exercises
• Getting enough sleep
• Working out ways to incorporate healthy eating into your daily life.

10. Weight loss medications are your personal business

Your weight loss journey is your own. You can do it your way. You have a say in your menu, your exercise program, and your medications.

Along with that, you get to decide whether or not to tell people you’re on weight loss medications. As with any other medication or medical issues, weight loss medications and your weight are your private business.

How Lark Can Help

Weight loss medications can help some people lose more weight, and you’re more likely to find success if you make small, sustainable lifestyle changes at the same time. Lark can help you make positive choices on a daily basis. Your Lark coach is available 24/7 for encouragement, coaching, and tracking. Lark can help you engage in healthy behaviors and establish habits that fit into your lifestyle so you can lose weight and keep it off with or without GLP-1 medications.

Click here to see if you may be eligible to join Lark today!

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