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Obesity: Should I Take Weight-Loss Medicine?
You may want to have a say in this decision, or you may simply want to follow your doctor’s recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Obesity: Should I Take Weight-Loss Medicine?
1Get the |
2Compare |
3Your |
4Get the |
5Quiz |
6Your Summary |
Get the facts
Your options
- Take weight-loss medicine, along with trying to eat healthy foods and being active.
- Try to lose weight without weight-loss medicines by eating healthy foods and being active.
Key points to remember
- Being very overweight makes you more likely to have serious health problems, such as heart disease and type 2 diabetes.
- Weight-loss medicines may be an option if you haven’t been able to lose weight with lifestyle changes, such as healthy eating and exercise, and if:
- Your BMI (body mass index) is at least 30 (or at least 27.5 if you are Asian).
- Your BMI is at least 27 and you also have another health problem related to your weight, such as diabetes, high blood pressure, or high cholesterol.
- Medicine may help you lose a small amount of weight. But without permanent changes in eating and exercise habits, most people gain weight again after they stop taking the medicine.
- You must decide if the benefit of taking a certain medicine outweighs its side effects. Side effects of weight-loss medicines may include headaches, nausea, and bowel problems.
- Weight-loss medicines can be expensive. They may not be covered by your health plan.
- It is important to talk with your doctor about how much weight you expect to lose and how long you would need to take the medicine.
What are weight-loss medicines?
Weight-loss medicines work by making you feel less hungry, making you feel full more quickly, or changing how you digest fat.
These prescription medicines include:
- Orlistat (Xenical). This drug prevents some of the fat calories you eat from being absorbed in your intestines. A lower strength of it, sold as Alli, is available without a prescription.
- Appetite suppressants (benzphetamine, diethylpropion, phendimetrazine, phentermine). These drugs keep you from feeling as hungry. They are approved only for short-term use.
- Phentermine/topiramate (Qsymia). This medicine combines the drugs phentermine and topiramate. Taking it once a day can help you eat less.
- Lorcaserin (Belviq). This medicine can help you eat less and feel satisfied with eating smaller amounts of food. You take it twice a day.
- Bupropion/naltrexone (Contrave). This medicine may reduce your appetite and help you avoid overeating.
- Liraglutide (Saxenda). This medicine may help you eat less. It’s given as a shot once a day.
How well do weight-loss medicines work?
Weight-loss medicines help some people lose weight. The medicines are used along with diet changes and more physical activity.
Without making lifestyle changes, you will gain back the weight if you stop taking the medicine.
Medicine doesn’t work for everyone. If you don’t lose weight within 4 weeks of starting the medicine, it probably won’t help you.footnote 1
What are the risks and side effects of some weight-loss medicines?
Weight loss medicines often cause side effects such as nausea, headache, and dizziness. Some also may cause diarrhea. Sometimes the side effects are mild and go away over time.
Each medicine also has its own side effects. Here are a few examples:
- Orlistat (Xenical) can cause changes in bowel habits. These may include oily or fatty stool and being unable to control bowel movements.
- Liraglutide (Saxenda) may cause low blood sugar (hypoglycemia) in people who have diabetes. In anyone, it may cause stomach pain and upset. It also can make the heart beat faster. Cases of inflammation of the pancreas (acute pancreatitis) have been reported.
- Appetite suppressants (benzphetamine, diethylpropion, phendimetrazine, phentermine) can make you nervous and irritable. They may raise your blood pressure. You may have trouble sleeping.
If you are under a lot of stress, have an emotional illness such as anxiety or depression, or have an alcohol or drug problem, you need treatment for that problem before you use weight-loss medicine. If you don’t treat it, you will have a harder time losing weight.
Why might your doctor recommend weight-loss medicine?
Your doctor may recommend weight-loss medicine if:
- Your BMI is at least 30 (27.5 if you are Asian).
- Your BMI is at least 27 and you have other problems related to your weight, such as:
- High blood pressure.
- High cholesterol.
- Type 2 diabetes.
- You have tried for some time to lose weight with diet and physical activity.
- You don’t have untreated depression or another major mental illness, and you don’t misuse alcohol.
If your doctor prescribes a weight-loss medicine for you, tell him or her about all prescription and over-the-counter medicines, vitamins, herbs, and supplements that you are taking.
Your doctor will want to know your side effects and watch to see if your weight loss improves your type 2 diabetes, cholesterol, and/or blood pressure.
Compare your options
Compare
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What is usually involved? |
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What are the benefits? |
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What are the risks and side effects? |
- Depending on the type of drug, you take a pill 1 to 3 times a day or get a shot once a day.
- You also try to make lasting changes in your diet and physical activity level.
- Weight-loss medicines can help you lose a small amount of weight.
- The weight loss that you see right away can motivate you to continue your healthy eating and exercising after the medicine is stopped.
- If you lose weight, you may be less likely to have related health problems, including heart disease and type 2 diabetes.
- Possible side effects include:
- Increased blood pressure.
- Headache.
- Sleep problems.
- Unpleasant changes in bowel habits.
- Unless you make long-term changes in your eating and exercise habits, you are likely to gain back the weight after you stop taking the medicine.
- Weight-loss medicines can be expensive. They may not be covered by your health plan.
- You try to make lasting changes in your diet and physical activity.
- Eating fewer calories while being more active may help you lose weight.
- You avoid the risks and side effects of taking weight-loss medicines.
- You avoid the cost of taking medicine.
- If you aren’t able to lose weight using diet and exercise, you’re more likely to have related health problems. These may include heart disease and type 2 diabetes.
Personal stories about using medicine for obesity
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I was concerned about taking a weight-loss medicine. I was worried about those stimulant diet pills that people took years ago that had such a questionable reputation. But I’ve learned that some of the newer medicines are different. And after struggling to lose not even 5 pounds over the past 8 months, I am now ready to see if medicines can add anything to the good habits I’ve tried to establish. I know the medicine isn’t going to be a magic bullet. But I hope it can give me that little extra help I seem to need.
John, age 50
I realize that I didn’t gain my extra weight in just a few months. I don’t expect to be able to lose it all quickly. I want to get back to eating a more balanced diet again and to set a good example for my kids so that they don’t develop poor eating habits as they grow up. I plan to start taking them for walks and introducing them to lots of outdoor activities that we can do together. I don’t want to be on pills for the rest of my life. I need a long-term solution.
George, age 45
My sister has been taking a weight-loss medicine for about 4 months now, and she has been on a low-fat diet. We have been walking together 3 times a week. She has lost about 10 pounds already. I don’t think I’ve lost any weight yet, even though I have been watching what I eat, too. Maybe medicines can help me lose weight.
Susan, age 42
The side effects of Xenical sound pretty unpleasant to me. I have made a few changes in my diet, and I am walking twice a week. I’m going to give myself at least a year of a balanced diet and exercise before I think about taking a medicine.
Carla, age 40
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take weight-loss medicine
Reasons not to take weight-loss medicine
I am desperate to lose weight, and I think medicine will help me.
I don’t like the idea of taking medicine.
I have tried diet and exercise, and I just can’t seem to lose weight.
I want to keep trying diet and exercise before I start taking medicine.
I’m not worried about the cost of medicine.
I don’t think I can afford the cost of medicine.
I think losing a little bit of weight is worth the side effects of medicine.
I don’t think the side effects are worth the small amount of weight I might lose by taking medicine.
Along with taking medicine, I’m willing to work hard to make permanent changes in my eating and exercise habits.
Medicines aren’t worth it to me if I’ll just gain the weight back without permanent lifestyle changes.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you’ve thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking weight-loss medicine
NOT taking weight-loss medicine
What else do you need to make your decision?
Check the facts
Decide what’s next
Certainty
1. How sure do you feel right now about your decision?
Your Summary
Here’s a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Your decision
Next steps
Which way you’re leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits and References
| Author | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | E. Gregory Thompson MD – Internal Medicine |
| Primary Medical Reviewer | Kathleen Romito MD – Family Medicine |
| Primary Medical Reviewer | Martin J. Gabica MD – Family Medicine |
| Primary Medical Reviewer | Theresa O’Young PharmD – Clinical Pharmacy |
| Primary Medical Reviewer | Caroline S. Rhoads MD – Internal Medicine |
| Primary Medical Reviewer | Heather Quinn MD – Family Medicine |
Obesity: Should I Take Weight-Loss Medicine?
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the Facts
Your options
- Take weight-loss medicine, along with trying to eat healthy foods and being active.
- Try to lose weight without weight-loss medicines by eating healthy foods and being active.
Key points to remember
- Being very overweight makes you more likely to have serious health problems, such as heart disease and type 2 diabetes.
- Weight-loss medicines may be an option if you haven’t been able to lose weight with lifestyle changes, such as healthy eating and exercise, and if:
- Your BMI (body mass index) is at least 30 (or at least 27.5 if you are Asian).
- Your BMI is at least 27 and you also have another health problem related to your weight, such as diabetes, high blood pressure, or high cholesterol.
- Medicine may help you lose a small amount of weight. But without permanent changes in eating and exercise habits, most people gain weight again after they stop taking the medicine.
- You must decide if the benefit of taking a certain medicine outweighs its side effects. Side effects of weight-loss medicines may include headaches, nausea, and bowel problems.
- Weight-loss medicines can be expensive. They may not be covered by your health plan.
- It is important to talk with your doctor about how much weight you expect to lose and how long you would need to take the medicine.
What are weight-loss medicines?
Weight-loss medicines work by making you feel less hungry, making you feel full more quickly, or changing how you digest fat.
These prescription medicines include:
- Orlistat (Xenical). This drug prevents some of the fat calories you eat from being absorbed in your intestines. A lower strength of it, sold as Alli, is available without a prescription.
- Appetite suppressants (benzphetamine, diethylpropion, phendimetrazine, phentermine). These drugs keep you from feeling as hungry. They are approved only for short-term use.
- Phentermine/topiramate (Qsymia). This medicine combines the drugs phentermine and topiramate. Taking it once a day can help you eat less.
- Lorcaserin (Belviq). This medicine can help you eat less and feel satisfied with eating smaller amounts of food. You take it twice a day.
- Bupropion/naltrexone (Contrave). This medicine may reduce your appetite and help you avoid overeating.
- Liraglutide (Saxenda). This medicine may help you eat less. It’s given as a shot once a day.
How well do weight-loss medicines work?
Weight-loss medicines help some people lose weight. The medicines are used along with diet changes and more physical activity.
Without making lifestyle changes, you will gain back the weight if you stop taking the medicine.
Medicine doesn’t work for everyone. If you don’t lose weight within 4 weeks of starting the medicine, it probably won’t help you.1
What are the risks and side effects of some weight-loss medicines?
Weight loss medicines often cause side effects such as nausea, headache, and dizziness. Some also may cause diarrhea. Sometimes the side effects are mild and go away over time.
Each medicine also has its own side effects. Here are a few examples:
- Orlistat (Xenical) can cause changes in bowel habits. These may include oily or fatty stool and being unable to control bowel movements.
- Liraglutide (Saxenda) may cause low blood sugar (hypoglycemia) in people who have diabetes. In anyone, it may cause stomach pain and upset. It also can make the heart beat faster. Cases of inflammation of the pancreas (acute pancreatitis) have been reported.
- Appetite suppressants (benzphetamine, diethylpropion, phendimetrazine, phentermine) can make you nervous and irritable. They may raise your blood pressure. You may have trouble sleeping.
If you are under a lot of stress, have an emotional illness such as anxiety or depression, or have an alcohol or drug problem, you need treatment for that problem before you use weight-loss medicine. If you don’t treat it, you will have a harder time losing weight.
Why might your doctor recommend weight-loss medicine?
Your doctor may recommend weight-loss medicine if:
- Your BMI is at least 30 (27.5 if you are Asian).
- Your BMI is at least 27 and you have other problems related to your weight, such as:
- High blood pressure.
- High cholesterol.
- Type 2 diabetes.
- You have tried for some time to lose weight with diet and physical activity.
- You don’t have untreated depression or another major mental illness, and you don’t misuse alcohol.
If your doctor prescribes a weight-loss medicine for you, tell him or her about all prescription and over-the-counter medicines, vitamins, herbs, and supplements that you are taking.
Your doctor will want to know your side effects and watch to see if your weight loss improves your type 2 diabetes, cholesterol, and/or blood pressure.
2. Compare your options
| Take weight-loss medicines | Use only diet and exercise to lose weight | |
|---|---|---|
| What is usually involved? |
|
|
| What are the benefits? |
|
|
| What are the risks and side effects? |
|
|
Personal stories
Personal stories about using medicine for obesity
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
“I was concerned about taking a weight-loss medicine. I was worried about those stimulant diet pills that people took years ago that had such a questionable reputation. But I’ve learned that some of the newer medicines are different. And after struggling to lose not even 5 pounds over the past 8 months, I am now ready to see if medicines can add anything to the good habits I’ve tried to establish. I know the medicine isn’t going to be a magic bullet. But I hope it can give me that little extra help I seem to need.”
— John, age 50
“I realize that I didn’t gain my extra weight in just a few months. I don’t expect to be able to lose it all quickly. I want to get back to eating a more balanced diet again and to set a good example for my kids so that they don’t develop poor eating habits as they grow up. I plan to start taking them for walks and introducing them to lots of outdoor activities that we can do together. I don’t want to be on pills for the rest of my life. I need a long-term solution.”
— George, age 45
“My sister has been taking a weight-loss medicine for about 4 months now, and she has been on a low-fat diet. We have been walking together 3 times a week. She has lost about 10 pounds already. I don’t think I’ve lost any weight yet, even though I have been watching what I eat, too. Maybe medicines can help me lose weight.”
— Susan, age 42
“The side effects of Xenical sound pretty unpleasant to me. I have made a few changes in my diet, and I am walking twice a week. I’m going to give myself at least a year of a balanced diet and exercise before I think about taking a medicine.”
— Carla, age 40
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take weight-loss medicine
Reasons not to take weight-loss medicine
I am desperate to lose weight, and I think medicine will help me.
I don’t like the idea of taking medicine.
I have tried diet and exercise, and I just can’t seem to lose weight.
I want to keep trying diet and exercise before I start taking medicine.
I’m not worried about the cost of medicine.
I don’t think I can afford the cost of medicine.
I think losing a little bit of weight is worth the side effects of medicine.
I don’t think the side effects are worth the small amount of weight I might lose by taking medicine.
Along with taking medicine, I’m willing to work hard to make permanent changes in my eating and exercise habits.
Medicines aren’t worth it to me if I’ll just gain the weight back without permanent lifestyle changes.
My other important reasons:
My other important reasons:
4. Where are you leaning now?
Now that you’ve thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking weight-loss medicine
NOT taking weight-loss medicine
5. What else do you need to make your decision?
Check the facts
1. Weight-loss medicine is all I need to lose lots of weight permanently.
- True
- False
- I’m not sure
2. I may suffer unpleasant side effects if I take weight-loss medicine.
- True
- False
- I’m not sure
Decide what’s next
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
Certainty
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
- I’m ready to take action.
- I want to discuss the options with others.
- I want to learn more about my options.
| By | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | E. Gregory Thompson MD – Internal Medicine |
| Primary Medical Reviewer | Kathleen Romito MD – Family Medicine |
| Primary Medical Reviewer | Martin J. Gabica MD – Family Medicine |
| Primary Medical Reviewer | Theresa O’Young PharmD – Clinical Pharmacy |
| Primary Medical Reviewer | Caroline S. Rhoads MD – Internal Medicine |
| Primary Medical Reviewer | Heather Quinn MD – Family Medicine |
Note: The “printer friendly” document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
Current as of: March 28, 2019
Author: Healthwise Staff
Medical Review:E. Gregory Thompson MD – Internal Medicine & Kathleen Romito MD – Family Medicine & Martin J. Gabica MD – Family Medicine & Theresa O’Young PharmD – Clinical Pharmacy & Caroline S. Rhoads MD – Internal Medicine & Heather Quinn MD – Family Medicine