Prescription Medications To Treat Overweight Obesity

What is the difference between obesity and overweight?
To define obesity and overweight, health care professionals use the Body Mass Index (BMI). This is a measure of your body mass in relation to height.

Overweight people are those with a BMI of between 25- 30. A BMI greater than 30 is considered obesity. To determine if you are obese, overweight or suffering from severe obesity, calculate your BMI. Your individual risk of developing health problems due to your weight can be assessed by your doctor.

A healthy eating plan and regular exercise can help you lose weight. Your doctor may recommend medication if these lifestyle changes don’t work.

What is the prevalence of obesity and overweight?
More than 4 out 10 Americans are obese, and almost 1 in 10 Americans suffer from severe obesity.

What are the benefits of weight management drugs?
Prescription medication to treat obesity and overweight work in different ways. Some medications can make you feel fuller or less hungry. Some medications can make it more difficult for your body absorb fat from the foods you eat.

Who could benefit from weight management medication?
People with obesity or overweight are eligible for weight management medication. BMI is a measure of how likely you are to benefit from weight management medication. If you are an adult, your doctor may recommend a medication to help with obesity or overweight.

High BMI people may not be able to use weight management drugs. A lifestyle program can help you lose weight if you’re overweight or obese. Lifestyle programs can also help with other factors that contribute to weight gain, such as food triggers or not getting enough sleep.

Are children and teenagers allowed to take weight-management medications?
The majority of weight management drugs approved by the U.S. Food and Drug Administration are only for adults. The FDA approved two prescription medications for children 12 years and older, namely liraglutide (3Saxenda) and orlistat (2Xenical). The FDA has approved setmelanotide,4 a prescription medication for children 6 years old and older with rare genetic disorders that cause obesity.

Are medications able to replace exercise and healthy eating habits?
Weight loss medications don’t replace healthy eating habits and physical activity. Research shows that weight management medications work best when used in conjunction with a lifestyle program. Talk to your doctor about lifestyle programs for weight management that will work for you.

Prescription medications for weight management don’t replace healthy eating habits and physical activity.
Prescription medications can help people lose weight or maintain their weight when combined with lifestyle changes such as healthier eating habits and more physical activity. People who use prescription medication as part of a lifestyle plan lose an average of 3% to 12 percent more weight after one year than those who don’t take medications.

Research has shown that prescription weight management medication can help people lose up to 10% of their initial weight.5,6 The results vary depending on the medication and the person.

A weight loss of 5%-10% of your body weight can improve your health and lower blood sugar, blood pressure, cholesterol, and triglyceride levels. Weight loss can also help with other health issues such as joint pain or sleep apnea that are related to obesity and overweight. The majority of weight loss occurs within six months after the medication is started.

What are your concerns regarding prescription medication for weight loss?
Experts worry that prescription medication that treats obesity and overweight may have side effects that outweigh their benefits. You should never use a weight management drug to improve your appearance. Some weight management drugs were associated with serious health issues in the past and were therefore removed from U.S. market.

Side effects can vary depending on the medication you are taking and how your body reacts to it. Most side effects are minor and will disappear if you continue taking the medication. Rarely can serious side effects occur.

Tips to take weight management medication
* Always follow your doctor’s advice regarding weight management medication.
* Only purchase your medication from a licensed online pharmacy.
* Weight management medication should only be used to support healthy eating habits and exercise.
Before you take any medication, be aware of the side effects and warnings.
* Ask your doctor if you have not lost weight in 12 weeks of taking the full amount of your medication.
When considering weight management medication, it is important to talk with your doctor about any other medications, including vitamins and supplements.
* Do not take weight-management medications while pregnant or planning to become pregnant.

What weight-management medication could work for me?
Your health care provider and you will decide if you want to take a medication that treats obesity or overweight. You should consider the following important factors

* The likely benefits of weight loss
* Possible side effects of the medication
* Your current health problems and any other medications
* Your family’s medical history
* Cost

What length of time will I have to use weight management medication?
The length of time you’ll need to take weight-management medication will depend on how successful the drug is in helping you lose weight and keep it off, and whether or not you have any side effects.

Your doctor may recommend that you continue taking the medication as long as you are able to lose enough weight to improve your overall health. Your health care professional may advise you to stop taking the medication if you don’t lose at least 5 percent of your initial weight within 12 weeks. Your doctor may also recommend you stop taking the medication.

* Change your treatment plan or try a different weight-management medication
* Have you ever tried a different lifestyle, exercise, or diet?
* Change any other medications that may be causing weight gain
* Refer you to a surgeon who specializes in bariatric surgery to determine if weight loss (bariatric) might be an option.

Obesity is a chronic condition that can be difficult to overcome. You may have to maintain your healthy eating habits and exercise routines for many years or even a lifetime.

What if I stop taking weight-management medication?
After you stop taking weight-management medication, you will likely gain some weight. You can lose weight by developing and maintaining healthy eating habits, and exercising more.

Federal guidelines for physical activity (PDF, 14.5MB) recommend that you do at least 150 minutes of moderate-intensity aerobic exercise per week and at least 2 days of muscle-strengthening activity per week. To reach your weight loss goal, you may need to engage in moderate intensity activity for more than 300 minutes per week.

Is insurance available to cover weight management medications?
Some insurance policies cover medication that treats obesity and overweight. To find out if your policy covers these medications, contact your insurance provider.

What are the best medications to treat obesity and overweight?
Below is a list of FDA approved prescription drugs for weight loss. The FDA has approved five of these drugs–orlistat (Xenical, Alli), phentermine-topiramate (Qsymia), naltrexone-bupropion (Contrave), liraglutide (Saxenda), and semaglutide (Wegovy)–for long-term use. Setmelanotide, (IMCIVREE), was approved for people with three rare genetic conditions. This must be confirmed through genetic testing. These medications can be continued as long as they are effective and you do not experience any side effects.

FDA approves some weight-management medications that curb appetite for short-term use, up to 12 weeks. While some doctors may prescribe them for longer periods of time, there are not many studies that have examined their safety and effectiveness for long-term use.

If you’re pregnant, don’t take weight management medication. These medications may cause harm to the fetus if you’re pregnant.

Prescription medication approved for treating obesity and overweight
Weight Management Medication Approved for How It Works Warnings orlistat

Available in lower doses without prescription (Alli).

Children and adults 12 years and older. Works in the gut to reduce fat absorption from food * diarrhea
* Gas
* Leakage of oily stool
* stomach pain

* Very rare cases of severe liver injury have been reported
* Do not take cyclosporine with you
To ensure your body gets enough vitamins from the food you eat, take a multivitamin tablet daily

phentermine-topiramate (Qsymia) Adults * A mix of two medications: phentermine, which lessens your appetite, and topiramate, which is used to treat seizures or migraine headaches
* Can make you feel fuller or less hungry.

* Constipation
* dizziness
* Dry mouth
* Taste changes, especially when carbonated beverages are involved
* Tingling sensations in your feet and hands
* trouble sleeping

* Avoid use if you have hyperthyroidism or glaucoma.
* Inform your doctor if you have ever suffered from a heart attack, stroke, heart rhythm abnormality, kidney disease or mood problem.
* Do not take if breastfeeding

Naltrexone-bupropion Adults * A combination of two medications: bupropion, used to treat depression and help people quit smoking, and naltrexone which is used for drug dependence and alcohol abuse.
* Can make you feel fuller or less hungry sooner

* Constipation
* diarrhea
* dizziness
* Dry mouth
* Headache
* Increased blood pressure
* Increased heart rate
* insomnia
* liver damage
* nausea
* vomiting

* Avoid use if you have high blood pressure or seizures that are not under control, or a history bulimia or anorexia.
* Do not use if your opioid dependence or withdrawal from drugs or alcohol are a factor.
* Do not use if taking bupropion (Wellbutrin or Zyban).
* MAY INCREASE Suicidal Thoughts or ACTIONS

liraglutide (Saxenda)

Inject daily

Children and adults 12 years old and older * Mimics a hormone called “glucagon-like Peptide-1” (GLP-1), which targets brain areas that regulate appetite, food intake, and other aspects of the brain
* This drug was FDA-approved for type 2 diabetes treatment at a lower dosage under Victoza.

* nausea
* diarrhea
* Constipation
* Abdominal pain
* Headache
* Increased heart rate

* Increased chance of developing pancreatitis
* In animals, has been shown to cause a rare form of thyroid cancer

Semaglutide (Wegovy7)7

Inject weekly

Adults * Models a hormone called “glucagon-like Peptide-1” (GLP-1) which targets brain areas that regulate appetite, food intake and other aspects of the brain
* FDA approved this drug under different names and dosages to treat type 2 Diabetes. It can be used as an injectable medication (Ozempic), or as an oral tablet (Rybelsus).

* nausea
* diarrhea
* vomiting
* Constipation
* Abdominal (or stomach) pain
* Headache
* Fatigue

* Do not use in combination with other semaglutide-containing products, other GLP-1 receptor agonists, or other products intended for weight loss, including prescription drugs, over-the-counter drugs, or herbal products
* Increased chance of developing pancreatitis
* In animals, has been shown to cause a rare form of thyroid cancer

Setmelanotide, IMCIVREE

Only available by injection

Three rare genetic conditions can lead to obesity in people aged 6 and over. * May decrease appetite and increase feelings of fullness
* May increase resting metabolism (how your body burns calories).
* It can help someone lose weight but it cannot treat genetic defects

* injection site reaction
* skin darkening
* nausea
* Disruption in sexual arousal
* Suicidal ideation and depression
* Risk of serious adverse reactions in neonates or infants born with low birth weight due to benzyl alcohol preserver

Only for those with these rare genetic diseases.
* proopiomelanocortin (POMC) deficiency
* proprotein convertase subtilisin/kexin type 1 (PCSK1) deficiency
* Leptin receptor (LEPR), deficiency

Avoid using this product if you are pregnant or nursing.
* Phentermine (or other medications that reduce your desire to eat)
* benzphetamine
* diethylpropion
* phendimetrazine

Adults * This increases chemicals in the brain to make it feel fuller or less hungry
* Please note: FDA approval is only for short-term use – up to 12 weeks

* Dry mouth
* Constipation
* Trouble sleeping
* dizziness
* Feeling nervous
* Feeling restless
* Headache
* Increased blood pressure
* Increased heart rate

* Avoid use if you have uncontrolled high blood pressure, heart disease, hyperthyroidism or glaucoma
* Talk to your doctor if you are experiencing severe anxiety or any other mental health issues

How can health care professionals use prescription drugs “off-label”, to treat obesity and overweight?
Sometimes, health care professionals may use medication in a different way than what the FDA has approved. This is called “off-label use”. Your doctor may recommend an off-label medication for treating obesity and overweight.

* A drug that is approved to treat a medical condition.
* Two or more drugs simultaneously
* A drug that is approved for a longer period of time than the FDA has approved

Asking your doctor if a medication is being prescribed for obesity treatment is a good idea. Learn everything you can about a medication before you take it.

Are there any other options for weight loss?
Researchers are currently looking at new medications and combinations of drugs in both animals and humans. Researchers are currently trying to find safer and more effective ways to help obese people lose weight and keep it off for a long period of time.

Future drugs could use new strategies such as

* Regulating multiple gut hormones at once
* Targeting specific genes that cause obesity
* Allowing people to lose body weight without losing muscle while they are trying to lose weight
* Changing the bacteria in your gut to control weight

Clinical trials for prescription meds to treat obesity and excess weight
Clinical trials are conducted and supported by the NIDDK for many conditions and diseases, including obesity and overweight. These trials aim to improve the quality of life and prevent, detect or treat diseases.

What clinical trials are there for prescription drugs to treat obesity and overweight?
Medical research includes clinical trials and other types of clinical study. They involve people just like you. Participating in a clinical trial is a way for researchers and health care professionals to learn more about diseases and improve the care of patients in the future.

Prescription medications are being studied to treat obesity and overweight.

* The FDA-approved medication Liraglutide (Saxenda and Victoza), has an effect on weight loss and gastric functions in overweight or obese people.
* Teens and young adults who do not lose the weight they desire or are still obese after weight-loss surgery.
* Patients with obesity or binge-eating disorders
* Women who are obese or have polycystic-ovary syndrome (or both)

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