Weight Loss Drug Options
For many people today, choosing a weight loss medication may come down to several factors, including what other medications they take, which drugs their insurance covers, affordability, and whether they prefer pills or injected medicines, Dr. Jay says.
“I advise people to speak to their physician to choose an initial medication and see how they respond,” says Jay. “It’s not uncommon to switch medications or have to add a second or third medication.”
Here’s what you need to know about currently approved prescription weight loss drugs.
Tirzepatide (Zepbound)
This weekly injected medicine was approved by the FDA in 2023 to treat adults with obesity and overweight adults with at least one weight-related chronic health problem.
Common side effects: Nausea, diarrhea, vomiting, and constipation.
Interactions and risks: Rare but potentially dangerous reactions include severe gastrointestinal disease and acute injury to the pancreas, kidneys, or gallbladder.
Semaglutide (Wegovy)
Wegovy was approved by the FDA to treat adults with obesity as well as adults who are overweight and also have at least one weight-related chronic health problem. The weekly injected form of the medicine was approved in 2021, and the once-daily oral version was approved in 2025.
How it works: It’s another GLP-1 receptor agonist that mimics a hormone in the brain that regulates appetite.
Common side effects: Nausea, diarrhea, vomiting, constipation, stomach pain, headache, and fatigue.
Interactions and risks: It can’t be used in combination with liraglutide or other GLP-1 receptor agonists that are prescribed for type 2 diabetes. Like other drugs in this family of medicines, including tirzepatide and liraglutide, it carries an increased risk of pancreatitis and has been linked to thyroid tumors in animals.
Orforglipron (Foundayo)
How it works: Orforglipron works like other GLP-1 receptor agonists, meaning it mimics a hormone that regulates appetite and fullness. But because it’s a small-molecule drug, it enters the bloodstream more easily and works when taken on a full stomach, unlike semaglutide.
Common side effects: This drug may cause abdominal pain, constipation, diarrhea, vomiting, nausea, headache, gas, bloating, and fatigue.
Interactions and risks: Rare adverse effects include gallbladder disease, kidney injury, retinal damage in people with type 2 diabetes, and pancreatitis. People using another GLP-1 receptor agonist shouldn’t use orforglipron. This medication has been linked to thyroid tumors in animal studies.
Naltrexone-Bupropion (Contrave)
This oral drug was approved by the FDA in 2014.
How it works: It’s a combination of two drugs that are used to treat addiction and depression, and it suppresses appetite and makes people feel full sooner.
Common side effects: Constipation, dizziness, diarrhea, dry mouth, headache, increased blood pressure, elevated heart rate, insomnia, liver damage, nausea, and vomiting.
Interactions and risks: People with uncontrolled blood pressure, seizures, a history of anorexia or bulimia, those taking psychiatric drugs containing bupropion (Wellbutrin, Zyban), or individuals dependent on opioids or in withdrawal from drugs or alcohol should avoid this medication. It can increase suicidal thoughts or actions.
Liraglutide (Saxenda)
The FDA approved this daily injected drug in 2014 for adults and in 2020 for children ages 12 and older with obesity.
How it works: It’s in a family of medicines known as glucagon-like peptide-1 (GLP-1) receptor agonists, which work by mimicking a hormone in the brain that regulates appetite and food consumption.
Common side effects: Nausea, diarrhea, constipation, vomiting, dizziness, hypoglycemia (low blood sugar), and increased heart rate. Rare side effects include an increased risk of pancreatitis, gallbladder disease, allergic reactions, and suicidal ideation. It’s also been linked to thyroid tumors in animals.
Interactions and risks: In a smaller dose, liraglutide is used as a diabetes medication called Victoza, which should not be used in conjunction with Saxenda.
Phentermine-Topiramate (Qsymia)
This pill was approved by the FDA in 2012 for adults who are overweight or obese, and in 2022 for patients ages 12 and older with obesity.
How it works: This combination pill suppresses appetite and makes people feel full sooner.
Common side effects: Constipation, dizziness, dry mouth, tingling in hands and feet, brain fog or cognitive impairment, depression, and difficulty sleeping.
Interactions and risks: People with closed angle glaucoma or hyperthyroidism, those who are pregnant or breastfeeding, and some individuals with a history of heart attack, stroke, heart rhythm disorders, kidney disease, or mood problems shouldn’t use it.
Orlistat (Xenical, Alli)
The FDA approved this pill in 1999 as a prescription weight loss drug (Xenical) and in 2007 at a lower dose for nonprescription use (Alli).
How it works: Orlistat works in the gut to limit the amount of fat you absorb from food.
Common side effects: Diarrhea, gas, stomach pain, and oily stool leakage.
Interactions and risks: It’s linked to rare cases of severe liver injury, dangerous interactions with cyclosporine (a drug to prevent organ transplant rejections), and the potential for malnutrition if patients don’t take a multivitamin.
Evidence suggests orlistat decreases the absorption of fat-soluble vitamins as well as some prescription medications, including Amiodarone (used to treat irregular heartbeats). It may also affect the dosage of warfarin, an anticoagulant.
People with malabsorption issues and those who are pregnant should avoid this medication.
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