Exploring the Best Weight Loss Medications

07.01.24 02:36 PM Comment(s) By Vivek Gupta

For the first time in a century, we have molecules that can help counteract the negative effects of the modern food environment. However, the multitude of different names for these medications can be confusing for both patients and healthcare providers when trying to determine the best option.

One of the main advantages of these medications is that they target the underlying mechanisms that contribute to weight gain. Many people struggle with overeating or have difficulty controlling their appetite. These medications work by suppressing appetite and reducing cravings, making it easier for individuals to consume fewer calories and maintain a calorie deficit.

When considering these medications, it is essential to consult with a healthcare provider who can determine the best option based on individual needs and medical history. Some medications may have side effects.

How do these medications work?

To understand the effectiveness of these medications, it's important to first understand how our hunger-decreasing pathways work. As food moves through our gastrointestinal tract, hormones like GLP, GIP, CCK, and amylin are released by our intestines and pancreas. These hormones then signal our brains to decrease hunger, cravings, and slow down our digestion to make us feel full.

Semaglutide and Tirzepatide

Now, we have developed molecules that mimic these fullness hormones and help us decrease our hunger, satiety, and cravings to help us cope with a food industry making trillions of dollars trying to seduce us with their addictive calories every day.

To start with, it's worth remembering that each medication has both a molecule name and a brand name. For example, ibuprofen is the molecule name, while Motrin and Advil are the brand names.

As of January 2024, there are two main drugs that have shown the most effectiveness in treating obesity: semaglutide and tirzepatide. Semaglutide emulates the satiety hormone GLP, while tirzepatide emulates both GLP and GIP. In 2016, Novo Nordisk branded semaglutide as Ozempic for diabetes treatment. In 2021, they rebranded it as Wegovy for weight loss. Similarly, Eli Lilly introduced tirzepatide as Mounjaro for diabetes in 2021 and rebranded it as Zepbound in December 2023.

Why the rebranding?

But why the rebranding? In the complex world of American healthcare, health insurance companies categorize obesity medications separately. This means that the decision to cover these medications is made by the insurance plan provider. Insurance companies also want to differentiate between prescriptions for diabetes and weight loss, as coverage for obesity medicine may vary, i.e. they want to know the ones to easily deny (I understand all the arguments, and big pharma is a necessary evil in this whole thing, but I find this as frustrating as everyone else!)

Compounded Versions

What about compounded versions of these medications? If you're among the 10 million Americans without obesity medicine coverage, there are options for compounded versions of these molecules. Compounding pharmacies legally have the framework to create these medications when they are in short supply. These pharmacies purchase the raw materials from FDA-approved suppliers and compound the medication in a sterile manner for individual patients. They are regulated by state boards of pharmacies and must hold an active sterile lab license.

Other medications used for weight loss?

There are several other medications that are commonly used for weight loss in addition to the ones mentioned earlier. Let's take a closer look at some of them:

  1. Saxenda (molecule name Liraglutide): Originally approved for the treatment of type 2 diabetes, liraglutide has also been approved for weight loss as Saxenda. It is a daily shot, but in studies, semaglutide has been shown to be more effective.
  2. Contrave: Contrave is a weight loss medication that combines two active ingredients, bupropion and naltrexone. Bupropion is an antidepressant that can also help reduce appetite, while naltrexone is used to treat addiction. Together, they work to suppress appetite and control cravings.
  3. Qsymia: Qsymia is a combination medication that contains phentermine and topiramate. Phentermine is an appetite suppressant, while topiramate is an anticonvulsant that can also help reduce appetite.
  4. Phentermine: Phentermine is an FDA-approved appetite suppressant that is commonly prescribed for short-term weight loss. It works by stimulating the release of certain chemicals in the brain that help control appetite.
  5. Orlistat: Orlistat is typically recommended for individuals with a BMI of 30 or higher, or for those with a BMI of 27 or higher who have other obesity-related health conditions such as high blood pressure or diabetes. It is important to note that Orlistat should be used in conjunction with a reduced-calorie diet and regular exercise for optimal results.

Which one is right for you?

So, which medication is right for you? The answer depends on your goals, insurance coverage, personal preferences, and financial situation. It's best to consult with a trained professional, ideally an obesity medicine or similar specialist.

At Mindfulwellness.com, we strive to find the most cost-effective treatment options for our patients. Feel free to reach out to us through text, call, email, or any other preferred method of communication.

Vivek Gupta

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