Losing weight may be difficult for people with obesity because of cues that take place within the body, which they cannot control without medication. Weight loss isn’t as simple as calories in versus calories out. Hormones in the brain and the gut “talk” back and forth to control hunger cues.

Doctors treat obesity like other chronic diseases, such as high blood pressure or high cholesterol. They may prescribe medication to help manage obesity, just like they help patients control their blood pressure or cholesterol with medication.

Who is eligible for weight loss medications?

We consider a person’s body mass index (BMI), which compares their height and weight and can determine if they are overweight or obese. A BMI between 25 and 29.9 is overweight. A BMI of 30 or higher is considered obese.

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Weight loss medication may be prescribed to individuals with a BMI of 30 or higher, or to individuals with a BMI of 27 or higher with obesity-related medical conditions like diabetes, high cholesterol or high blood pressure, to name just a few.

If someone’s BMI is in the right range and they’re interested in taking medication, we can talk about options.

How do Ozempic and other injectable medications work?

Ozempic (semaglutide) has been in the news recently. It’s indicated for people with type 2 diabetes, but it can lead to weight loss even in people without diabetes.

Similarly, Wegovy (also semaglutide) is FDA-approved for weight loss in non-diabetics.

Both drugs are GLP-1 receptor agonists, which increase insulin secretion, decrease glucagon secretion, delay stomach emptying and signal fullness to the brain. They’re injected weekly.

Another GLP-1 receptor agonist FDA-approved for weight loss is Saxenda (liraglutide) – it’s injected daily.

There are currently shortages of many of these injectable medications.

What oral weight loss medications are out there?

Oral medications that we prescribe include: phentermine (Adipex, Suprenza, Lomaira); phentermine-topiramate (Qsymia); and naltrexone-bupropion (Contrave), among others. Each medication has its own mechanism of action to decrease appetite and food cravings, promoting weight loss.

If your health insurance won’t cover weight loss drugs, we may prescribe medications off-label as well.

Is medication enough to help with weight loss? 

When it comes to the treatment of obesity and weight loss, there are no magic pills. You should use medication as a tool to help manage your weight, along with diet and exercise. We like to help you make positive changes like these to encourage weight loss.

When we prescribe medication for you, we also discuss several factors relating to weight, not just medication:

  • We discuss your diet and exercise habits in depth.
  • We screen for eating disorders as well, including binge-eating disorder and night-eating syndrome.
  • We recommend that you see a registered dietitian to establish healthier eating habits.
  • And we work with you to eliminate unhealthy habits by adopting new, small, doable habits and lifestyle changes. For example, to encourage you to start walking more regularly, we may ask you to commit to taking two 20-minute walks per week to just start the healthy habit.

Although it doesn’t sound like a lot at first, small changes help you establish positive habits that can be expanded on in the future.