Comparing Weight Loss Drugs in 2024

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Currently, there are nine FDA-approved medications specifically designed to tackle obesity. On top of these, there’s a handful of other medications often used off-label for shedding pounds. We’ll delve into each of these options to give you a clear picture of the choices available for weight loss.

Approved for short-term use

Let’s kick off with the weight loss meds approved for short-term use. When we say short-term, we’re talking about a duration of no more than three months as per official guidelines. However, it’s important to note that just because they’re labeled for short-term use doesn’t mean they stop working after three months. Many people continue to benefit from these drugs beyond that timeframe. The reason behind the short-term recommendation is primarily rooted in safety concerns. Without sufficient long-term data, it’s hard to guarantee the safety of prolonged use of these medications and avoid potential serious issues down the line.

Phentermine

Phentermine is one of the first short-term weight loss meds approved by the FDA. It’s been around for a while and is still widely used today. Phentermine basically revs up your sympathetic nervous system, which in turn curbs your appetite significantly. Those on phentermine can typically shed about 4.4% of their body weight, which is an extra bonus on top of any other weight loss efforts you’re making.

Diethylpropion

Similar to phentermine, diethylpropion also gives your sympathetic nervous system a nudge and is okayed for short-term use in tackling obesity. It operates by tweaking how norepinephrine works in your body. Users of diethylpropion typically see a weight loss of around 6.6% of their body weight.

Approved long-term use

Let’s dive into weight loss medications approved for long-term use. These are the ones you can stick with for a year or even longer. But remember, just because they’re approved for long-term use doesn’t mean you’ll keep shedding pounds endlessly. It also doesn’t necessarily mean they’re more effective than short-term meds. The main thing here is that studies have shown they’re safe to take over an extended period, and some folks do see some weight loss when they stick with them for a year or more.

Plenity

Plenity is one of the few medications approved for overweight adults, regardless of whether they have other health issues. Unlike other drugs mainly recommended for those with a higher BMI or specific health conditions like diabetes, Plenity is a game-changer. It’s a hydrogel matrix that swells up with water in your stomach, filling about a quarter of its volume. This gives you that satisfying feeling of fullness, much like how soluble fibers work for weight loss. Since it works mechanically and not chemically, Plenity is classified as a device rather than a drug. This means it’s safer for a wider range of overweight individuals. However, compared to other obesity meds, Plenity tends to be less effective, delivering only a modest 2.0% body weight loss.

Orlistat

Orlistat helps with weight loss by blocking lipases, enzymes that break down fat in your gut, thus reducing fat absorption. At its maximum recommended dose, Orlistat can slash fat absorption by about 30%. Notably, you can snag Orlistat over the counter without a prescription in the US, under the brand name Alli. But here’s the thing: it works best when teamed up with a low-fat diet. Straying from this diet might render the medication ineffective or cause some rather messy side effects. Users of Orlistat can expect an additional 3.8% body weight loss when sticking to a low-fat diet.

Contrave

Contrave is a combo pill that blends bupropion and naltrexone. Bupropion tinkers with dopamine and norepinephrine levels by blocking their reabsorption. Meanwhile, naltrexone, an opioid receptor antagonist, teams up with bupropion to squash those inhibitory feedback loops. The result? Reduced cravings, less food intake, and a drop in body weight. Contrave works wonders for folks struggling with emotional eating and food addiction. But be aware, it messes with your brain chemistry, so side effects like anxiety and mood swings might pop up. Still, if you’re a good match for Contrave, you could see a weight loss of around 4.8%.

Saxenda

Saxenda is also known as liraglutide, which you might recognize as Victoza if you’re dealing with diabetes. This drug kicks the glucagon-like peptide-1 (GLP-1) receptor into gear, helping to lower food intake, tame your hunger, and slow down digestion. You’ll need to give yourself a daily shot of Saxenda. Bonus: it also helps improve blood sugar levels in diabetics, plus it’s good for your blood pressure and lipid levels. Users typically see a weight loss of about 5.4% with Saxenda.

Qsymia

Qsymia is a tablet that slowly releases a mix of phentermine and topiramate. Phentermine kicks your sympathetic nervous system into gear, making you eat less and possibly burn more energy. Meanwhile, topiramate, usually used for epilepsy and migraines, helps with weight loss by making food taste less appealing and reducing your intake. Qsymia combines these two effects, making it great for curbing your appetite and fighting binge eating. Plus, it’s safer for long-term use compared to just phentermine, and it’s just as, if not more, effective for weight loss. People using Qsymia can expect to lose about 8.6% of their body weight.

Wegovy

Wegovy is the drug semaglutide, also known as Ozempic for diabetes. Similar to Saxenda, but stronger and longer-lasting, Wegovy is given as a weekly shot. It works by cutting down on your food intake, reducing your hunger, and slowing down digestion. Wegovy marks a new era of highly effective weight loss meds that are also safer to take. For instance, instead of possibly causing heart problems, people on Wegovy have actually seen improvements in their heart health. Those using Wegovy can look forward to losing around 12.4% of their body weight.

Zepbound

Zepbound, which is tirzepatide, is also known as Mounjaro for diabetes. This one’s a dual receptor activator, hitting both the GLP-1 and GIP receptors. This combo packs a punch, seriously cutting down your food cravings, reducing hunger, and slowing digestion, all with potentially fewer side effects. Given as a weekly shot, Zepbound is currently one of the most effective weight loss meds out there. Although, things might change soon with the arrival of retatrutide. Users can expect a significant 15.4% body weight loss with Zepbound.

Used off-label

Let’s dive into some medications often used off-label for weight loss. When we say “off-label,” it means doctors prescribe these meds for weight loss even though they’re not officially FDA-approved for it. These drugs were originally made for other purposes, but their side effects or how they work might suggest they could help with shedding pounds. Doctors usually weigh the pros and cons and decide if these meds could aid in weight loss for a particular person.

But here’s the catch: because they’re used off-label, there’s usually less research on how well they actually work or how safe they are for weight loss. The evidence might not be as clear, making it tough to know for sure if they’re effective compared to FDA-approved meds. Plus, these off-label meds tend to be less powerful for weight loss and might be harder to use correctly. They could also come with more serious side effects and might not be safe for long-term use. That’s why it’s crucial to consult a doctor before trying them out.

Bupropion

Bupropion was initially designed for depression and smoking cessation, and it has a side effect of causing weight loss. While the weight loss observed with bupropion is modest, it stands out as a preferred alternative to many antidepressants that often lead to weight gain. When used off-label for weight loss, bupropion is typically administered in sustained-release formulations at doses of 400 mg, and results in an average weight loss of around 2.8% body weight.

Metformin

Metformin is an antidiabetic medication that not only lowers blood sugar levels but also helps with a bit of weight loss. Studies on diabetic patients consistently show a 2-3% decrease in weight compared to those on a placebo, with even more significant weight loss in people with higher insulin resistance.

Pramlintide

Pramlintide is an injection approved for diabetes treatment. It mimics the hormone amylin, which helps regulate blood sugar levels. Pramlintide’s impact on weight loss is thought to work through brain receptors that improve appetite control. People using pramlintide have seen a placebo-corrected reduction in body weight of about 3.7%.

Sodium-Glucose Transporter-2 Inhibitors

Sodium-Glucose Transporter-2 (SGLT2) Inhibitors are another class of medications mainly used for diabetes. These meds work by helping your body get rid of extra glucose through urine, which lowers your blood sugar levels. In the US, four SGLT2 inhibitors are approved: canagliflozin, dapagliflozin, ertugliflozin, and empagliflozin. Studies involving adults with type 2 diabetes have shown that they can lead to about a 2-3% drop in body weight.

Topiramate

Topiramate id originally used to treat epilepsy and approved for migraine prevention, it’s been discovered to help with weight loss in various conditions. Controlled trials have proven that topiramate is both safe and effective, resulting in patients losing around 2-3% of their body weight.

Zonisamide

Zonisamide is another medication primarily used for epilepsy. Randomized-controlled studies have shown that it can lead to modest weight loss, ranging from 2 to just over 3% of body weight loss in patients with obesity.

Learn more about

• Phentermine vs Topiramate vs Qsymia
• Bupropion vs Contrave vs Naltrexone
• What Forms of Semaglutide are Available?
• Ozempic vs Rybelsus vs Saxenda vs Victoza for Weight Loss
• Comparing other GLP-1 Agonists for Weight Loss
• 5 Things To Know Before Starting Weight Loss Medication
• Other weight loss medications

See also

• 
  Comparing Weight Loss Drugs in 2024
  Ozempic and Mounjaro are highly effective at treating obesity, however there are many other approved and off-label options that also work.
• 
  Bupropion vs Contrave vs Naltrexone
  Contrave is a synergistic combination of buproprion and naltrexone, which can be replicated to some degree using the generics individually.
• 
  New Obesity Drugs in 2024
  New obesity drugs target more than just GLP-1 and do much more than suppress appetite for a more nuanced approach to weight loss.
• 
  Mounjaro: Who Loses the Most Weight?
  White or Asian younger women who use metformin and have lower sugar and lipid levels tend to experience more weight loss with Mounjaro.
• 
  How does Oforglipron compare?
  Orforglipron, Semaglutide, and Danuglipron are oral GLP-1 agonists that are all similar enough that cost may end up being the winning factor.