The pharmacological treatment of obesity is a fast-changing landscape, and care providers must strive continuously to stay current. With a growing selection of weight loss medications available, patients may ask what the strongest or most effective weight loss prescription medication is, and which one is best for them. Determining whether someone is a candidate for weight loss medications begins with BMI. For each individual case, the doctor and patient should discuss the patient’s current health issues, other medications, and family medical history.
The Evolving World of Anti-Obesity Medications (AOMs)
Before 2012, there were few weight loss medications approved by the FDA. Some weight loss medications have been on the market for many years, and new ones emerge frequently. It can be easy to overlook first-generation AOMs, but these may be appropriate for some patients, especially when cost is a factor.
In the 2020s, glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists) exploded in popularity and media attention. Next came a dual receptor agonist, Mounjaro, which is indicated for type 2 diabetes, and Zepbound, which is indicated for obesity. In 2024, millions of adults took a GLP-1 for weight loss.
Understanding Weight Loss Medication Options
With more options available, doctors will be increasingly able to personalize treatments. FDA-approved anti-obesity medications (AOMs) are safe, evidence-based therapies that target specific physiology to improve the disease and are most effective when used as part of a comprehensive treatment plan. Some medications are administered orally, and others are given as subcutaneous injections. Some patients who are less comfortable with injections may ask about weight-loss pills.
GLP-1 Receptor Agonists
GLP-1s are not meant to be stopped and restarted at will. The dosing for some of these includes a long ramp-up period-up to five months-to reach full dosage. While GLP-1s have grabbed a lot of headlines, they are only the latest in a long history of evolving weight loss medications.
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- Semaglutide (Wegovy, Ozempic): Wegovy is a brand name for semaglutide, a GLP-1 receptor agonist. It was FDA-approved in 2021. It is administered as an injection and approved for use in adults and children aged 12 years or more with obesity (BMI ≥30 for adults, BMI ≥ 95th percentile for age and sex for children) or some adults with excess weight (BMI ≥27) who also have weight-related medical problems. The dose must be increased gradually over 16 to 20 weeks to arrive at the 2.4 mg dosage. This progression can help to alleviate side effects, which include gastrointestinal symptoms, headache, dizziness, and fatigue. It is intended to be used indefinitely, in combination with a healthy diet and exercise. Ozempic may be a more familiar name to some patients.
- Liraglutide (Saxenda, Victoza): Liraglutide is a daily injectable medication that acts on hormones that send signals from the gut to the brain to make the patient feel full quicker and decrease hunger signals. Doses start at 0.6 mg to 3 mg a day. Some patients may lose 5-10% of body weight, especially with the higher dose of liraglutide. Liraglutide is also approved for Type 2 Diabetes, under the brand name Victoza. Side effects include nausea, diarrhea, constipation, vomiting, headache, decreased appetite, dyspepsia, fatigue, dizziness, abdominal pain, increased lipase, and renal insufficiency.
Dual Receptor Agonists
- Tirzepatide (Zepbound, Mounjaro): Zepbound is approved to treat obesity in adults with a BMI of 30 or greater. It is both a GLP-1 and a GIP receptor agonist. Like semaglutide, it works by reducing appetite and is meant to be used in combination with diet and exercise to lose weight. In the SURMOUNT-1 trial, adults with obesity or overweight (without diabetes) taking tirzepatide achieved up to 22.5% average body weight reduction at 72 weeks. Tirzepatide is a dual GIP and GLP-1 receptor agonist that suppresses appetite, improves satiety, and supports metabolic health. In addition to impressive weight loss, studies show improvements in cardiovascular risk factors and metabolic markers.
Other FDA-Approved Medications
- Phentermine: Phentermine is the oldest and most widely used weight loss medication. It was originally used as a short-term medication to jump-start weight loss, but now newer medical guidelines have added it to long-term therapy. Side effects include headache, overstimulation, high blood pressure, insomnia, rapid or irregular heart rate, and tremor.
- Phentermine-Topiramate (Qsymia): Topiramate can be combined with phentermine to decrease appetite and cravings. Adults with migraines and obesity are good candidates for this weight-loss medication. Some patients may lose an average of 5-10% of body weight. Daily doses with four strengths start at 3.75 mg/23 mg to 15 mg/92 mg. Side effects include abnormal sensations, dizziness, altered taste, insomnia, constipation, and dry mouth.
- Naltrexone-Bupropion (Contrave): Naltrexone-bupropion combines an opioid receptor antagonist with an antidepressant to affect the pleasure-reward areas of the brain and thereby decrease cravings and appetite. Start with a daily dose of one 8/90 mg tablet and gradually increase to four tablets a day. The most common side effects include nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, and diarrhea.
- Orlistat (Xenical, Alli): Orlistat is a lipase inhibitor that comes in a capsule. Undigested fat is then passed through the body. Some patients may lose about 5% of their body weight. An over-the-counter formulation is available at 60 mg capsules with each fat-containing meal. The only over-the-counter medicine for weight loss currently approved by the FDA is Alli (orlistat). Other over-the-counter products are considered supplements.
- Setmelanotide: Setmelanotide is a melanocortin-4 receptor agonist indicated for chronic weight management in adult and pediatric patients six years and older, with obesity due to certain rare genetic disorders.
Medical Devices
- Plenity: A medical device rather than a medication, Plenity was FDA-cleared in 2019 for people with a BMI of 25 to 40. It consists of a capsule that releases a biodegradable, super-absorbent hydrogel into the stomach. The gel helps to increase satiety, enabling the person to eat less.
The Importance of a Comprehensive Treatment Plan
A treatment plan for obesity can comprise multiple forms of treatment, including medications, diet, exercise, and/or surgery. All weight loss medications work best in the context of a healthy eating plan and exercise. Some weight management medications are designed for short-term use and others for long-term use. Those approved by the FDA for long-term use include orlistat (Xenical, Alli), phentermine-topiramate (Qsymia), naltrexone-bupropion (Contrave), liraglutide (Saxenda), semaglutide (Wegovy, Ozempic), and tirzepatide (Zepbound, Mounjaro).
While no specific vitamin or supplement is considered a “treatment” for obesity or overweight, certain ones help support metabolic health. For example, studies suggest that calcium and vitamin D may play a role in regulating belly fat.
Considerations and Precautions
The average weight loss varies from 5% to 21%, with some people losing more and some people losing less. Most people regain weight if AOMs are discontinued. AOMs may counter the effects of metabolic adaptation and prevent weight regain. After weight reduction, the body metabolically adapts, often causing an increase in hunger hormones and a decrease in satiety hormones and resting metabolic rate, all of which can contribute to weight regain.
There are many medications that can be obesogenic or cause weight gain. Antidepressants are broken down into categories: selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, monoamine oxidase inhibitors (MAO inhibitors), and others. In the SSRI group, paroxetine shows the highest associated weight gain. Weight-positive medications in the tricyclic antidepressant category include amitriptyline, doxepin, and imipramine. Bupropion (Wellbutrin), an aminoketone, is considered weight-negative and is prescribed both to assist in weight loss and to treat depression.
The guidelines for tirzepatide (Zepbound) and semaglutide (Wegovy) state that a patient should have a BMI of 30 or a BMI of 27 with weight-related health problems. They can also interfere with hormonal birth control. Older AOMs also have indications based on BMI and may be contraindicated for use with certain other medications.
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Some online healthcare providers claim to sell Ozempic, Wegovy, or Zepbound at reduced prices. However, the FDA warns against buying medications from any source other than a state-licensed pharmacy. In April 2025, they banned the sale of “counterfeit” semaglutide and tirzepatide. These medications are not made or packaged by the original manufacturers. Instead, they are compounded medications. Compounded versions of medications are made by compounding pharmacies, often to tailor a medication to specific patient needs, like an allergy to an inactive ingredient. Compounded medications are not FDA-approved. Some patients have taken these alternatives, which are generally more affordable, without ill effects. has received 520 reports of adverse events associated with compounded semaglutide and 480 reports of adverse events associated with compounded tirzepatide (as of April 30, 2025).
The Future of Weight Loss Medications
With fervent consumer demand for weight loss medications, combined with rising obesity rates, more medications are bound for the market in the coming years. Pharmaceutical platform Ozmosi predicts one to two GLP-1 launches annually starting in 2026 specifically for obesity.
Lilly is developing at least two new options. The first, orforglipron, is an oral GLP-1 inhibitor that completed a Phase 3 clinical trial in early 2025 and Phase 3 results expected soon at 36 weeks. It could provide a welcome alternative for people who do not want injections. The other, retatrutide, targets GLP-1, GIP, and glucagon. At this writing, it is in Phase 3 clinical trials. In Phase 2, participants lost up to 24.2% of body weight at 48 weeks. Amgen is developing MariTide, a monoclonal antibody designed to increase GLP-1 receptor activity while reducing GIP receptor activity. The once-monthly injection entered Phase 3 clinical trials in March 2025. Researchers continue to study hormones that play a role in appetite for other ways to target obesity with medication. Those of interest include not only GLP-1, but also peptide tyrosine-tyrosine (PYY) and cholecystokinin (CCK).
“…as more physiological mechanisms for weight gain have been unearthed, drugs targeting newly discovered receptors and/or enzymes have been introduced with improved safety profiles and fewer psychological adverse events. Additionally, drugs targeting hunger or satiety signaling have been actively studied and have shown increased adoption by physicians. As with many medications, some weight loss drugs have been on the market longer, have generic alternatives, and tend to be more affordable. GLP-1s are notoriously costly. The Kaiser Family Foundation estimates the annual net price of Wegovy at $13,600 and are not covered by insurance. Insurance coverage varies and will affect many patients’ choices about going on weight loss medications.
Nurx Weight Management Service
Nurx offers a weight management service where a trained and licensed member of their medical team will evaluate your health profile and ask any follow up questions in order to confirm that they can safely and appropriately treat you via telehealth. If so, your provider will create a personalized weight management treatment plan that may include injections or oral medications. For best results, we recommend combining your prescribed treatment with a healthy diet and regular physical activity.
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Depending on your treatment, Nurx will send your prescription straight to your door and check in with you to see how it’s working. You’ll get support with progress tracking, educational content around healthy diet and exercise, and appropriate treatment adjustments. A Nurx medical provider will check in with you about two weeks after treatment begins and ask you questions about how treatment is working and any side effects you may be experiencing. The Nurx provider will provide any support needed and may adjust the treatment plan as necessary. They can also prescribe certain medications to manage side effects if appropriate.
Anyone who requests weight management treatment from Nurx will be charged a $49 consultation fee. This fee covers a Nurx provider evaluating your information and creating your treatment plan, if medically appropriate. If you are prescribed a brand-name GLP-1 pen, pricing typically ranges from $650-1300/month on average for the lowest dose without insurance coverage (ask your local pharmacy to confirm the price). If you are prescribed oral medication, the cash price for your treatment plan will cost $60-329/month depending on your medications, and you may be able to use insurance. If you receive weight management treatment from Nurx, you will pay a recurring monthly $59 provider support fee. This fee covers a Nurx provider managing your medication needs.
Depending on your medical history and weight loss goals, you may be eligible for our weight management service. The care fee is cash pay only, but patients may be able to use their insurance for some weight management medications. Medication cost may vary based on prescribed treatment and applicable insurance coverage, price not guaranteed. Not all insurance plans are accepted. Medications are shipped and billed monthly. Nurx providers can prescribe oral medications as well as GLP-1 injectables. Oral medications include Naltrexone, Bupropion, Topiramate, and Metformin. Nurx providers may prescribe GLP-1 injections, if medically appropriate.
While everyone's weight journey is different and the amount of weight loss varies for everyone, most patients taking weight loss medications who follow a healthy diet and regular exercise lose 1-2 pounds per week. Nurx will work with you to find the treatment plan that is best for you and continue to support you throughout your weight loss journey. To help mitigate any side effects you might experience from these medications, your provider will likely have you start with a low dose of treatment and gradually increase it over time to reach the target dose. If you do experience side effects, your provider can offer personalized guidance and resources to help. They also may prescribe treatment to help manage certain side effects if appropriate.
Insurance coverage for brand-name GLP-1 medications typically require prior authorization, meaning your provider must get approval from your insurance company before you can get the prescription. This process can take several weeks and isn’t always approved, especially if the medication is prescribed for just weight loss (rather than diabetes). At this time, Nurx only provide care in English. They are committed to creating an inclusive experience and are exploring options to expand language support in the future.
WeightWatchers Clinic
WeightWatchers (WW) Clinic offers access to effective medications like Wegovy® and Zepbound,® if you qualify. They provide a dedicated Care Team that handles insurance, refills, and your questions through 24/7 chat, along with expert-led nutrition Workshops and fitness classes. Their tailored app helps you maximize results and feel your best. According to WW, members on prescription weight-loss medications lose up to 54% more weight when pairing meds with the Points® program.
WW Clinic offers various programs with different pricing structures. For Zepbound® (Injectable pen), the cost may vary depending on insurance. For Zepbound® (Single-dose vial), cash pay starts at a certain amount per month, plus a WW Clinic membership fee. They also offer a generic bupropion-naltrexone option with the cost of medication included with membership.
WW Clinic membership provides access to HRT and GLP-1s, if you qualify, support from menopause-trained clinicians, unlimited virtual Workshops, and nutrition counseling with Registered Dietitians, along with science-backed symptom management.
Qsymia Savings Program
Qsymia offers a home delivery pharmacy pricing program that includes 6-week New Patient Packs, 6-week Titration Packs, and all 30-day prescriptions. Additional shipping and handling costs will apply. This is a cash-only program - insurance claims will not be processed.
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