A Comprehensive Guide to the 8 FDA-Approved Drugs for Weight Management in 2024

Most individuals struggling with obesity understand that weight loss is a challenging journey that often requires more than just diet and exercise. In some cases, healthcare providers may recommend FDA-approved weight loss medications to help. In this comprehensive guide, we will investigate into the details of the eight FDA-approved drugs for weight management, discussing their effectiveness, dosing, potential side effects, and considerations for use. Whether you have a BMI of 30 or above, or a BMI of 27 with additional medical conditions, this guide will provide valuable information on these medications to support your weight loss journey.

Key Takeaways:

• Weight Loss Medications: There are eight FDA-approved weight loss medications available for individuals with a BMI of at least 30 or 27 with additional medical conditions like high blood pressure or type 2 diabetes.
• Effectiveness and Considerations: Each medication, such as Xenical, Alli, Contrave, Saxenda, Qsymia, Imcivree, Wegovy, and Zepbound, has its own effectiveness, dosing, side effects, and contraindications that should be discussed with a healthcare provider.
• Lifestyle Changes: While these medications can aid in weight loss, they are not quick fixes, and it’s crucial to continue maintaining a healthy diet and exercise routine for long-term success in managing obesity.

Overview of FDA-Approved Weight Management Drugs

Criteria for FDA Approval

Approval for FDA-approved weight management drugs is based on specific criteria. Individuals with a body mass index (BMI) of at least 30, or a BMI of 27 with an additional medical condition such as high blood pressure, type 2 diabetes, or high cholesterol, may be eligible for these medications. This article explores eight current FDA-approved weight loss drugs on the market, each tailored to meet different weight management needs.

Profile of the 8 Leading Drugs

Clearly, FDA-approved weight management drugs offer a range of options for individuals seeking to lose weight. From Xenical and Alli, containing the active ingredient orlistat, to Contrave, a combination of bupropion and naltrexone, and Saxenda, a GLP-1 receptor agonist, each drug works uniquely to aid in weight loss. Another leading option is Imcivree, recommended for individuals with specific genetic dispositions who experience obesity. Understanding the profile of each drug can help individuals make informed decisions about their weight management journey.

Xenical (Orlistat)

Xenical (orlistat) can help you lose weight and keep it off. It belongs to a class of medications called lipase inhibitors.

Orlistat reduces the amount of fat absorbed in the gut after eating. When taking it, no more than 30% of your calories should come from fat. Because of how it works, orlistat is often a better choice for people who tend to eat fatty foods.

Alli (Orlistat)

Like Xenical, Alli contains the active ingredient orlistat. This version is available over the counter (OTC) and comes in a 60 mg capsule.

Alli works the same way as Xenical, by reducing the amount of fat absorbed in your gut. It is only for adults 18 or older.

Because Alli has the same active ingredient as Xenical, it has similar side effects and safety considerations to account for. However, Alli tends to be better tolerated than Xenical because it is a lower dose.

Contrave (Bupropion-Naltrexone)

Contrave is a combination medication that consists of bupropion, an antidepressant, and naltrexone, an opioid antagonist. The two work together to help you lose weight along with a low-calorie diet and appropriate exercise.

Contrave is usually taken differently every week for the first month. Follow the dosing schedule prescribed by your healthcare provider. Do not take it with high-fat meals.

Saxenda (Liraglutide)

Saxenda (liraglutide) belongs to a class of medications known as glucagon-like-peptide receptor agonists (GLP-1), which work by stimulating the GLP-1 receptor in the brain. This can help to regulate appetite.

Saxenda is a medication injected subcutaneously (under the skin).

You’ll usually take your dose once daily, with or without meals. When first starting treatment, your healthcare provider will have you start at a lower dose and then gradually increase it over the coming weeks.

Qsymia (Phentermine-Topiramate)

Qsymia is combination medication made up of phentermine, a medication similar to amphetamines, and topiramate, an anti-seizure medication. It works in the brain to reduce your appetite.

Usually, Qsymia is taken once daily in the morning because it can cause insomnia.

Children 12 years and older can take Qysmia if they have a BMI considered to be in the 95th percentile. Talk to your healthcare provider about your child’s BMI to determine if Qsymia is right for them. 

Imcivree (Setmelanotide)

Imcivree belongs to a class of medications called melanocortin receptor agonists, which can affect fat formation in the body. 

Imcivree is injected under the skin. It helps control your hunger and appetite if you have certain genetic dispositions that include:

• Bardet-Biedl syndrome
• Gene deficiencies such as pro-opiomelanocortin (POMC), proprotein convertase subtilisin/kexin type 1 (PCSK1), or leptin receptor deficiency (LEPR)

Wegovy (Semaglutide)

Like Saxenda, Wegovy is a GLP-1 receptor agonist. It stimulates the GLP-1 receptor in the brain, making you feel full.

Wegovy may be prescribed to children 12 and older with a BMI in the 95th percentile (considered obese).¹

Wegovy is given under the skin once weekly, at the same time every week, with or without meals. 

Zepbound (tirzepatide)

Zepbound is a dual-acting glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist. Zepbound activates these hormones, making you feel full.

Zepbound is a medication injected subcutaneously and is approved for adults with obesity.

The recommended maintenance dosage of Zepbound is 5-15 mg, injected once weekly

Detailed Analysis of Each Drug

Mechanism of Action and Usage

One of the FDA-approved drugs for weight management is Xenical (Orlistat). Xenical belongs to a class of medications called lipase inhibitors and works by reducing the amount of fat absorbed in the gut after eating. It is recommended for individuals with a BMI of at least 30 or a BMI of 27 with an additional medical condition such as high blood pressure or type 2 diabetes.

Efficacy and Clinical Trials Outcomes

On the efficacy front, clinical trials have shown that Xenical users can expect to lose at least 5% of their body weight in one year. Additionally, studies have indicated that individuals using Xenical may experience reductions in BMI, waist circumference, cholesterol, and LDL levels. While Xenical has shown modest weight loss results, other medications such as liraglutide have shown more significant weight loss outcomes in certain studies.

A large trial evaluating liraglutide demonstrated significant weight loss in individuals who were overweight or had obesity, with 63% of participants losing at least 5% of their body weight and 33% losing at least 10%. Furthermore, other FDA-approved drugs like Contrave and Wegovy have also shown promising weight loss results in clinical trials, making them viable options for individuals struggling with obesity.

Potential Side Effects and Considerations

Common Adverse Effects

On rare occasions, some common adverse effects that individuals may experience while taking FDA-approved weight management drugs include nausea, vomiting, diarrhea, constipation, abdominal pain, headache, dizziness, and changes in taste. It is important to monitor any side effects and consult with your healthcare provider if they persist or worsen.

Drug Interactions and Contraindications

On top of common side effects, it is crucial to be aware of possible drug interactions and contraindications while taking weight management medications. For example, Xenical may interact with medications like cyclosporine and anticoagulants. Contrave is not recommended for use in individuals with uncontrolled high blood pressure or seizure disorders. Consult with your healthcare provider before starting any weight loss medication to ensure compatibility with existing medications and medical conditions.

Common contraindications across these medications include pregnancy, allergies to specific ingredients, and existing medical conditions such as hyperthyroidism or glaucoma. Understanding these contraindications is crucial to ensure the safe and effective use of FDA-approved weight management drugs.

Lifestyle Modifications and Supportive Therapies

The Role of Diet and Exercise

Exercise plays a crucial role in weight management, along with a balanced diet. Making time for regular physical activity can help in achieving weight loss goals more effectively. Combined with dietary changes, exercise can improve overall health and increase weight loss outcomes. According to clinical trials, lifestyle interventions including exercise have shown significant weight loss results in individuals with obesity.

Psychological and Behavioral Support for Weight Loss

Supportive therapies that address the psychological and behavioral aspects of weight management can be beneficial in long-term success. Weight loss journeys can be challenging, and having support from professionals can help individuals navigate through obstacles and stay motivated. Counseling, cognitive-behavioral therapy, and support groups are some of the options available to address emotional eating, stress management, and other behavioral patterns contributing to weight gain.

This additional support can complement the effects of FDA-approved weight loss medications and further enhance the overall success of a weight management plan.

Conclusion

Now armed with knowledge about the eight FDA-approved drugs for weight management, individuals struggling with obesity have a range of options to consider in consultation with their healthcare providers. From lipase inhibitors like Xenical and Alli to GLP-1 receptor agonists like Saxenda and Wegovy, each medication offers unique benefits and considerations. It’s important to remember that these drugs are not quick fixes but tools to support a comprehensive approach to weight loss that includes healthy eating habits and regular exercise. Consulting with a healthcare provider to determine the best option based on individual health goals and medical history is crucial for safe and effective weight management.

FAQ

Q: Can I take more than one weight loss medication at the same time?

A: It is not recommended to take more than one weight loss medication simultaneously without consulting your healthcare provider. Doing so may exacerbate potential side effects of the medication.

Q: What kind of medications are available for weight loss if I’m pregnant?

A: Weight loss medications should not be taken during pregnancy as they may pose risks to the fetus. It is important to prioritize the health and safety of both the mother and the baby during pregnancy.

Q: If I’m not overweight but want to lose weight, can I use these medications?

A: These FDA-approved weight management drugs are typically indicated for individuals with a BMI of at least 30, or a BMI of 27 with additional medical conditions. If you do not meet these criteria, it is advisable to discuss weight loss options with your healthcare provider to determine the most appropriate approach for your situation.