Weight-loss medications: What you need to know

By Joe Tintera, RDN

Weight loss can feel like climbing a mountain — challenging and overwhelming. But what if there’s a way to make that climb a bit more manageable? Enter weight-loss medications, otherwise known as anti-obesity medications or incretin-based therapies. These tools can be used to help optimize weight-loss efforts.

Let’s dive in and explore how these medications work, who might benefit and if they’re right for you.

What are weight-loss medications?

Weight-loss medications are prescription drugs designed to help people with weight management. They aren’t magic pills, but they can assist in reducing hunger, increasing feelings of fullness and blocking fat absorption. Imagine having a helpful sidekick in your weight-loss journey; that’s what these medications aim to be.

Who can benefit from weight-loss medications?

Not everyone needs or can use weight-loss medications. Generally they’re recommended for adults who have a body mass index (BMI) of 30 or higher, or a BMI of 27 or higher with weight-related health issues like diabetes or high blood pressure. So, if you’ve been struggling to lose weight with diet and exercise alone, you may be a candidate.

How do weight-loss medications work?

Think of them as tools in a toolbox. Each one has a different function and therefore works in various ways.

Mimicking gut hormones: These medications help by mimicking the function of naturally occurring gut hormones. Some, like semaglutide (Wegovy) and tirzepatide (Zepbound), mimic the hormones in your body that help to regulate appetite, food intake and blood sugars.

Semaglutide mimics glucagon-like peptide 1 (GLP-1), which in turn increases insulin production following a meal, thus lowering appetite and promoting satiety or fullness.

Tirzepatide works similarly, but it mimics two hormones, GLP-1 and glucose-dependent insulinotropic polypeptide (GIP). This in turn increases the body’s production of insulin and helps reduce blood sugars while slowing down the release of food from the stomach, promoting extended satiety.

Due to their potential positive impact on blood sugar control, semaglutide and tirzepatide are often used in the treatment of diabetes.

Appetite suppressants: Some medications serve simply as appetite suppressants. Some, like naltrexone-bupropion (Contrave), work by acting on various central nervous system pathways, which in turn reduces cravings and appetite throughout the day, leading to reduced caloric intake.

Another example, phentermine-topiramate (Qsymia), is a central nervous stimulant that stimulates the release of neurotransmitters, such as dopamine, epinephrine and norepinephrine, which in turn leads to appetite suppression and increased breakdown of stored fat.

Fat inhibitors: These medications block the absorption of dietary fat consumed, thus reducing overall caloric intake. One example is orlistat (Xenical or Alli), which blocks the work of a naturally occurring digestive enzyme responsible for breaking down dietary fats, known as lipase. By blocking the breakdown of dietary fat, your body is not able to absorb it appropriately, thus reducing the absorption of fat and caloric intake, leading to potential weight loss.

The pros and cons of weight-loss medications

Like any tool, weight-loss medications come with their own set of benefits and drawbacks.

Pros

• Weight-loss support: When combined with a healthy diet and exercise, these medications can help you lose more weight than diet and exercise alone.
• Health improvements: Weight loss can lead to better control of blood sugar, improved cholesterol levels and even less joint pain.
• Boosted motivation: Seeing results from medications can give your confidence a much-needed lift, making you more likely to stick with your weight-loss journey.

Cons

• Side effects: Just like any prescription, weight-loss medications can come with side effects, from mild stomach issues to more serious conditions.
• Cost: Some weight-loss medications can be pricey, and not all insurance plans cover them. This can be a significant factor for many.

Real-world feedback

People who use these medications have varied experiences. Some folks rave about their effectiveness, sharing stories of how they lost significant weight and improved their health. Others mention the hurdles, like side effects or the struggle to maintain weight loss after stopping the meds. It’s like trying to find the right key for a lock; sometimes, it takes a few tries before you find what works for you.

Is weight-loss medication right for you?

Weight-loss medications can be a valuable addition to your weight-loss toolkit, especially if you’ve tried other options without success. However, they’re not for everyone and should be considered carefully. Always chat with a doctor or other health care provider to explore the best options for your unique situation.

Remember, the most important part of any weight-loss journey is finding what works for you and sticking with it. So, whether it’s medication, diet and/or exercise, take the first step and move toward a healthier you.