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Anti-Obesity Medications: Which is Right for Me?

There are a number of anti-obesity medications available. Learn more about how they work, potential side effects, average weight loss and more.

METFORMIN 

  • HOW IT WORKS: Helps metabolic issues. Decreases insulin response. Decreases appetite. 
  • POTENTIAL SIDE EFFECTS: Indigestion, nausea, diarrhea, headache, rash, metallic taste. 
  • THE GOOD: Helps reduce chance of diabetes. May help induce ovulation in PCOS. Appears to reduce risk of certain cancers. 
  • THE BAD: Amount of weight loss with this is small. WARNINGS Not approved for weight loss. Approved for diabetes. Contraindications: hepatic disease, CHF, alcohol abuse.
  • AVERAGE WEIGHT LOSS: Average weight loss is 3% of total body weight.

 

PHENTERMINE (ADIPEX) 

  • HOW IT WORKS: Suppresses appetite. Increases satiety. 
  • POTENTIAL SIDE EFFECTS: Nervousness, increased blood pressure, increased heart rate, dry mouth, constipation. 
  • THE GOOD: Affordable. Usually well tolerated. 
  • THE BAD: Controlled substance. FDA approved for only 3 months of use. However, it’s widely used long-term, and there is no evidence of harm using this long term. 
  • WARNINGS: Not to be used in combination with other stimulants or MAO inhibitors. Contraindications: heart disease, uncontrolled hypertension, hyperthyroidism, and glaucoma.
  • AVERAGE WEIGHT LOSS: Average weight loss is 5-8% of total body weight. 

 

PHENTERMINE/TOPIRAMATE ER (QSYMIA)

  • HOW IT WORKS: Decreased appetite and food intake. Taste changes. 
  • POTENTIAL SIDE EFFECTS: Feeling tired or fuzzy, numbness or tingling in hands, nervousness, depression, kidney stones, insomnia. 
  • THE GOOD: Carbonation can taste  at. Can help with quitting soda. 
  • THE BAD: Combination is more expensive, but may be able to take generics separately. 
  • WARNINGS: Kidney stones plus the same contraindications as phentermine. Women should not become pregnant while taking this. 
  • AVERAGE WEIGHT LOSS: Average weight loss is 10% of total body weight. 

 

NALTREXONE/BUPROPION (CONTRAVE)

  • HOW IT WORKS: Opioid antagonist and decreased norepinephrine and dopamine uptake. Works best on cravings and thoughts about food. Reduces hunger. 
  • POTENTIAL SIDE EFFECTS: Nausea, anxiety, increase in blood pressure. Dry mouth, constipation, diarrhea. 
  • THE GOOD: Noncontrolled substance. Works great on cravings. Also helps with smoking cessation. Might be good option if trying to cut back on alcohol.
  • THE BAD: Brand name can be expensive, but active the ingredients can be prescribed separately to save on cost. Can increase blood pressure.
  • WARNINGS: Do not use with opioids, benzodiazepines, antiepileptic drugs or bupropion containing products. Contraindications: uncontrolled hypertension, history of seizures, angle-closure glaucoma, anorexia nervosa or bulimia. 
  • AVERAGE WEIGHT LOSS: Average weight loss is 6-8% of total body weight. 

 

ORFORGLIPRON (FOUNDAYO)

  • HOW IT WORKS: Oral GLP-1 agonist. Increases feeling of fullness and slows stomach emptying. Improves blood sugar metabolism 
  • POTENTIAL SIDE EFFECTS: Nausea, constipation, diarrhea, vomiting, indigestion, abdominal pain, belching, heartburn, gas, headache. 
  • THE GOOD: A GLP-1 agonist that can be taken orally. Can be taken with or without food. 
  • THE BAD: Lower average weight loss than other GLP-1 receptor agonists, but higher average weight loss than most oral medications. 
  • WARNINGS: Do not use it if you or a family member has had medullary thyroid cancer or MEN2 syndrome. Diarrhea and vomiting can lead to dehydration, leading to kidney problems. Risk of severe stomach problems, pancreatitis, or gallbladder problems. 
  • AVERAGE WEIGHT LOSS: Average weight loss: 11% of body weight. 

 

SEMAGLUTIDE INJECTION (WEGOVY AND WEGOVY HD INJECTION) 

  • HOW IT WORKS: GLP-1 agonist. Slows stomach emptying and increases feeling of fullness. Improves blood sugar metabolism. 
  • POTENTIAL SIDE EFFECTS: Low blood sugar, nausea vomiting, diarrhea, constipation, GERD, headaches, dizziness, fatigue. 
  • THE GOOD: Convenient weekly injection. FDA-approved for cardiovascular risk reduction in adults with overweight and obesity and to treat metabolic dysfunction-associated steatohepatitis (MASH). 
  • THE BAD: Very expensive. Potential cost savings available at wegovy.com. 
  • WARNINGS: Do not use it if you or a family member has had medullary thyroid cancer or MEN2 syndrome. Diarrhea and vomiting can lead to dehydration, leading to kidney problems. Risk of severe stomach problems, pancreatitis, or gallbladder problems. 
  • AVERAGE WEIGHT LOSS: Average weight loss to 15% (Wegovy injection) and 19% (Wegovy HD). 

 

SEMAGLUTIDE (WEGOVY PILL) 

  • HOW IT WORKS: Oral Glp-1 agonist. Slows stomach emptying and increases feeling of fullness. Improves blood sugar metabolism. 
  • POTENTIAL SIDE EFFECTS: Nausea, vomiting, diarrhea, constipation, bloating, heartburn, headaches, dizziness, fatigue 
  • THE GOOD: Similar ef cacy to Wegovy injection. FDA-approved for cardiovascular risk reduction in adults with overweight and obesity and to treat metabolic dysfunction-associated steatohepatitis (MASH). 
  • THE BAD: Must be taken  rst thing in the morning on an empty stomach with 4 oz water. Unable to take any additional medications, eat, or drink additional  uids for 30 minutes after. Potential cost savings available at wegovy.com. 
  • WARNINGS: Do not use it if you or a family member has had medullary thyroid cancer or MEN2 syndrome. Diarrhea and vomiting can lead to dehydration, leading to kidney problems. Risk of severe stomach problems, pancreatitis, or gallbladder problems. Do not use if breastfeeding. 
  • AVERAGE WEIGHT LOSS: Average weight loss of 14% of total body weight. 

 

TIRZEPATIDE INJECTION (ZEPBOUND) 

  • HOW IT WORKS: GLP-1 and GIP receptor agonists. Increase feeling of fullness and slows stomach emptying. Improves blood sugar metabolism.
  • POTENTIAL SIDE EFFECTS: Low blood sugar, nausea, vomiting, diarrhea, constipation, GERD, headache, dizziness, fatigue. 
  • THE GOOD: Highly effective. Convenient weekly injection. FDA indicated for sleep apnea. 
  • THE BAD: Very expensive. Potential cost savings available at zepbound.lily.com/savings. 
  • WARNINGS: Do not use it if you or a family member has had medullary thyroid cancer or MEN2 syndrome. Diarrhea and vomiting can lead to dehydration, leading to kidney problems. Risk of severe stomach problems, pancreatitis, or gallbladder problems. 
  • AVERAGE WEIGHT LOSS: Average weight loss of 22.5% of total body weight.