Weight Loss Medication

They may be a game changer in treating obesity and improving your health

Are you eating right, exercising and getting plenty of sleep, but still struggling to shed a few pounds? The journey to weight loss can seem like a never-ending struggle. The answer could be as simple as adding medication to your diet and exercise plans.

New anti-obesity prescription weight-loss medications have created a marketing frenzy in recent years because of their success in helping people reduce body weight, especially those with obesity or weight-related health concerns.

“Obesity is a chronic, debilitating disease that can lead to serious health problems like diabetes, heart disease and sleep apnea,” says Ryan Horsley, DO, a bariatric and general surgeon at Geisinger. “Weight-loss medication can be an excellent tool to spur progress when used as part of a comprehensive plan. They’re especially helpful for people who haven’t seen results with diet and exercise alone.”

But before you call your doctor asking for a script, know that these drugs aren’t for everyone.

What FDA-approved weight-loss drugs are available?

Right now, there are many FDA-approved prescription medications for weight loss. Some work by reducing fat absorption, while others target appetite suppression or increase satiety — feeling full longer.

FDA-approved weight-loss drugs include:

Liraglutide (Saxenda^®)
Orlistat (Xenical^®)
Phentermine-topiramate (Qsymia^®)
Naltrexone-bupropion (Contrave^®)
Setmelanotide (IMCIVREE^®)
Semaglutide (Wegovy^® and Ozempic^®)
Tirzepatide (Zepbound^®)

Each of these medications can be highly effective in reducing weight, but newer ones like semaglutide and tirzepatide are what Dr. Horsley calls “a game changer” for cardiometabolic health.

“With the older medications, we typically saw about an 8% to 10% reduction in weight, but semaglutide averages about 16% weight loss in clinical trials and the newest FDA-approved drug, Zepbound^®, shows up to 21% reduction in weight,” he says. “For comparison, diet and exercise commonly max out at about 7%.”

Semaglutide is a once-weekly injectable that works by mimicking a naturally occurring hormone that regulates your appetite and helps you feel full. It’s available in 2 doses under 2 brand names: Wegovy^® and Ozempic^®. While Wegovy^® (the higher dose) is approved for obesity, Ozempic^® is specifically FDA-approved for type 2 diabetes.

Tirzepatide also is a once-weekly injectable, but it mimicks 2 hormones in the body to regulate your appetite and insulin response, and slow down digestion to help you feel full longer.

“These medications have made headlines and swept social media feeds due to their effectiveness,” says Dr. Horsley. “But it’s important to remember they’re meant to be used for medical — not cosmetic — reasons.”

Who are prescription weight-loss medications for?

Prescription weight-loss medications can be a beneficial option for you if you haven’t reached your weight-loss goals through diet and exercise alone.

However, there are certain criteria you need to meet before getting a prescription:

A body mass index (BMI) of 30+
Or a BMI of 27+ and at least one weight-related condition like sleep apnea, type 2 diabetes or high cholesterol

Your BMI is a screening tool used to determine your ideal weight. A BMI of 25 to 29 is considered overweight and anything above 30 is considered obese.

“There’s this common misconception that obesity is simply a lack of willpower, but that couldn’t be further from the truth,” explains Dr. Horsley. “Obesity is caused by biological, hormonal and metabolic factors outside our control, and it’s a chronic condition just like diabetes or high blood pressure.”

Excess weight can lead to type 2 diabetes, fatty liver, heart disease, arthritis, sleep apnea and COVID-19 complications, but even small changes can make a big difference in your health.

“You don’t need to lose a lot of weight to have an impact,” says Dr. Horsley. “Studies have shown taking off as little as 10% can significantly improve your health and reduce your risk of conditions like type 2 diabetes, fatty liver disease and cancer.”

What happens when you stop taking weight-loss drugs?

Once you stop, your appetite will increase as your body tries to get back to your previous weight.

“People typically regain the weight in about a year,” explains Dr. Horsley. “But that shouldn’t be seen as a personal failure. It’s the same as if someone with diabetes stops taking their insulin and their blood sugar rises.”

Because of this, weight-loss drugs are a long-term solution and not a quick fix. Incorporating healthy choices like eating well and exercising regularly can help set yourself up for success and limit weight gain after stopping these drugs.

Weight-loss drugs or bariatric surgery?

Weight-loss drugs and bariatric surgery are the most effective treatments for obesity, but the decision on which path to take depends on your health conditions and weight-loss goals.

Weight-loss drugs may be a good option for you if you’re moderately obese and haven’t achieved sufficient results through diet and exercise alone. They’re less invasive than surgical options and can help you lose weight more effectively than lifestyle changes alone. However, they require long-term use — possibly lifetime use — for sustained weight loss and come with side effects like nausea, diarrhea or constipation.

On the other hand, bariatric surgery is often recommended for people with higher BMIs (over 40) or those with a BMI above 35 and who have obesity-related health issues.

“Bariatric surgery can lead to more substantial and sustained weight loss — up to 40% of body weight — as well as remission in obesity-related conditions like type 2 diabetes, hypertension and sleep apnea,” says Dr. Horsley. “Surgery affects more of the gut hormones than the medications can, and research shows it’s a much more effective and permanent weight-loss solution.”

But like any surgical procedure, bariatric surgery carries certain risks. It’s important to have a thorough discussion with you doctor about whether weight-loss drugs or bariatric surgery is right for you.

Weight-loss medication: One piece of the puzzle

Weight-loss medications are best used as part of a comprehensive program tailored to your needs. This might include lifestyle changes, medication, bariatric surgery or a combination of all three.

“At Geisinger, our weight management team includes obesity medicine specialists, dietitians, bariatric surgeons, behavioral specialists and exercise physiologists,” says Dr. Horsley. “Together, we guide patients through each step of their personal weight-loss journey.”

If you’re having trouble losing weight on your own, talk to your doctor about your goals. They can help you determine the plan that best suits your needs.

“Treating obesity isn’t about trying to look a certain way,” explains Dr. Horsley. “It’s about doing what’s best for your health and managing your medical conditions. Weight-loss medications aren’t meant as a quick fix, but instead can kickstart your weight-loss journey to enhance the results and improve your health in the long run.”