If you have been reading my blogs you know that I prefer prescription drugs over supplements because prescription drugs are standardized and tested to be safe and effective. Supplements are not. The downside to prescription weight loss drugs is that you need permission from your doctor and your insurance may or may not pay for them. Be prepared to pay cash for them and get a price quote. Insurance will most likely pay for antidepressants and diabetic medications that double as weight loss medications. See the list below.
The diabetic medications exenatide and liraglutide have been tested in diabetics and non-diabetics according to this review of several studies published by Vilsboll T, Christensen M, Junker AE, et al. Effects of glucagon-like peptide-1 receptor agonists on weight loss: Systematic review and meta-analyses of randomized controlled trials. BMJ 2012; 344:d7771. However, these diabetic medicines work slowly and consistently over time. If your doctor prescribes a diabetic medication, you might want to ask her if you can try these first because some diabetic medications cause weight gain. Stay tuned for the blog on drugs that make you gain weight.
Antidepressants have the pleasant side effect of elevating your mood as well as helping you lose weight. But not all antidepressants cause weight loss, some cause weight gain. Doctors a lot of times will let you try various antidepressants to see which ones resolve your symptoms, so it’s good to know which ones cause weight gain. I will include those medications in the future blog on drugs that make you fat and alternatives to ask your doctor about.
My number one recommendation for prescription weight loss is Bupropion. Originally marketed as an antidepressant, it’s used to treat any sort of addictive behavior like smoking, bulimia, and cocaine dependence. It’s important to do your research before asking your doctor for a prescription. In addition to checking the cash price, I’d also print out the prescribing information for your doctor in case she asks for it. I also recommend you read the patient information on the website MedlinePlus. I like this website for patient information because they do not have tricky advertisements disguised as news information.
After doing the necessary research I’d gently bring up the subject and say something like….”Dr., as you know I’ve been struggling with my weight/elevated blood sugar/elevated blood pressure/sleep apnea, and I was wondering if one of the following drugs might help me in my efforts to lose weight.” Then I would produce the following list of medications. The average weight loss of these medications was formulated based on the article by LeBlanc ES, O’Connor E, Whitlock EP, et al. Effectiveness of primary care-relevant treatments for obesity in adults: A systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med 2011; 155:434. which reviewed 6498 abstracts and 648 articles.
If your doctor does not prescribe medications listed below, ask her if you can take a dietary supplement listed in a previous blog of mine called Dietary Supplements That Make You healthier Than Ever. But whatever you do, don’t give up the good fight to stay healthy and fit. There is help.
The following are a list of prescription weight-loss drugs, the average amount of weight loss during the study, and important information regarding that drug.
- Orlistat (Alli) ≥1 year was 5.3 kg (11lbs 10oz) Prevents the absorption of fat. FYI: wear a diaper due to uncontrollable fatty diarrhea. Take three times per day, taken with a meal; you can skip a dose if you skip a meal or if the meal contains no fat.
- Fluoxetine (Prozac) at 24 weeks there was a 4.8 kg (10 lbs 9oz) weight loss. Originally an antidepressant.
- Bupropion (Wellbutrin)***my #1 recommendation. At 24 weeks there was 8.0 kg (17lbs 10oz) weight loss. Originally an antidepressant helps with food cravings and also used to quit smoking.
- Bupropion and Naltrexone combined (Contrave) at ≥1 year there was an 8.7 kg (19 lbs 2 oz) weight loss. Each ingredient sold separately. Can cause constipation even though it is NOT a stimulant.
- Exenatide (Byetta) At 24 weeks there was 2.9 kg (6 lbs 6 oz) A diabetic medication. Requires injection, frequent GI side effects, long-term safety not established, expensive.
- Liraglutide (Victoza) At 24 weeks there was a 2.8 kg (6 lbs 2 oz) A diabetic medication. Requires injection, frequent GI side effects, long-term safety not established, expensive
- Metformin (Glucophage) At 1 year there was an average weight loss of 2.8 kg (6 lbs 2 oz) originally a diabetic medication, GI side effects, contraindicated with renal insufficiency, can throw off your body chemistry.
- Lorcaserin (Belviq) 1 year -5.8 kg (12 lbs 12 oz) increases happy hormones in the brain, does not take with stimulants or antidepressants. do not take if have kidney problems.
- Phentermine (Adipex, Qsymia) at 13 weeks there was a 6.4 kg (14lbs 1 oz) weight loss: stimulant, increase in blood pressure, heart rate, dry mouth, constipation, insomnia…this is true for all stimulants. see below. It is also a controlled substance.
- Diethylpropion (Tenuate) at 18 weeks there was a 6.5 kg (14 lbs 5 oz) weight loss. It is a stimulant, controlled substance.
- Mazindol (Sanorex, Mazanor) at 11 weeks there was 5.7 kg (12.9 lbs oz) weight loss. It is a stimulant and controlled substance.
- Phen/Topiramate (sold separately Adipex and Topamax) ≥1 year -10.2 kg (22 lbs 7 oz) phen is a stimulant, topiramate originally used for seizures and headaches, do not stop suddenly or you can get a seizure. causes birth defects,