How Contrave Helps with Weight Loss + Who should use it

Is Contrave really a miracle weight loss medication? 

Well, it is a newer weight loss medication but it's far from perfect. 

This particular medication helps people lose weight by influencing certain factors in the body ranging from hormonal control to appetite modulation. 

Because of this, certain people stand to benefit more from using this medication than others. 

Learn how Contrave can help with weight loss and determine if it is right for you: 

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Contrave for Weight Loss

Everyone and I mean everyone, is looking for an easy way to lose weight. 

So, naturally, you are probably wondering if Contrave fits the bill?

Well, before we jump into that answer - let's discuss weight loss more generally. 

First: 

You should know (or at least come to appreciate) that there will probably never be a super simple weight loss pill.

Instead, there will be medications that may augment (or make easier) your weight loss efforts - but it's unlikely that medication will ever cause significant weight loss by itself.

Why?

Because weight gain is much more complex than simply eating more than you exercise.

Weight loss with wellbutrin

​The process by which your body gains weight has to do with multiple hormone systems that become dysregulated that then tell your body to cling on to fat and reduce the amount that you lose. 

And this is important because this is how the NEW AGE weight loss medications work.

They don't work by simply reducing your appetite and hoping that you lose weight.

They work by modulating these hormones that make your body cling onto fat and make weight loss more difficult.

We are going to talk in detail about how Contrave works below, but for now, just realize that it works by altering these hormone levels in your body. 

Who should use Contrave? ​

Having said that - does this mean that Contrave will work for you?

Actually, it might not.

Why?

Because the reason that YOU are gaining weight may be for a different reason than your neighbor or cousin or brother or sister.

We know that there is not just ONE cause to weight gain, and by using that simple logic we know that there will never be a universal weight loss treatment.

Science has shown us that we gain

Because of this, we know that only certain people will benefit from using these special weight loss medications.

​So who will benefit from using Contrave?

Contrave tends to work best if you fall into any of the following categories: 

  • Patients with body set point malfunction (those who are "stuck" at a certain weight or who have reached a weight loss plateau)
  • Those who struggle with binge eating or emotional eating
  • Those with high levels of inflammation or those with autoimmune disease (such as Hashimoto's thyroiditis)
  • Those with hypothyroidism or thyroid issues
  • Patients with insulin resistance or issues with blood sugar
  • Patients struggling with chronic pain and weight gain or weight loss resistance
  • Patients with eating disorders 
  • Patients with PCOS or who are on the PCOS spectrum

​If you are suffering from any of these symptoms PLUS you are struggling to lose weight then Contrave may actually help you. 

How does Contrave Work?

Contrave is actually a combination of two medications:

Wellbutrin and Naltrexone.

Wellbutrin you probably know as an anti-depressant but chances are high that you've never heard of naltrexone before.

Naltrexone is an opiate blocker which means that it blocks the effects of pain medication. 

Traditionally, it's used to treat alcohol addition. 

But at small doses, Naltrexone causes some interesting changes in the body that can actually promote weight loss. 

Another interesting fact is that Wellbutrin has been shown to cause weight loss by itself as well. 

But it's really the combination of these medications that work synergistically with one another to promote significant weight loss. ​

To understand HOW they work I've compiled a list of scientifically proven reasons that they help: ​

#1. Helps modulate body set point

​This is not #1 because it is the most important, but it is #1 because modulating body set point can be very important for certain people. 

So what is the body set point?

Body set point refers to a metabolic state that your body sets based on a number of factors which results in you maintaining a certain and specific weight (1).

This set point is what keeps healthy people at a relatively normal weight despite eating very large meals, reducing caloric expenditure, etc.

It allows your body to achieve homeostatic balance based on a set of averages, rather than absolute numbers. 

Your hypothalamus (part of your brain) helps set your basal metabolic rate and your total weight through its influence on leptin and thyroid hormone (2).

Thyroid hormone is largely responsible for heat and energy production in your body, while leptin is a regulatory hormone secreted from fat cells which communicate with your brain and hypothalamus. 

Disarray in this body set point leads to conditions such as thyroid resistance and leptin resistance which make weight loss almost impossible. ​

For practical purposes, it means that your body will stay a certain weight regardless of other influences that you put on the system.

So if you've been working out, changing your diet, taking supplements and medications and you still aren't losing weight then you may have an issue with this body set point.

Body set point also comes into play when someone is in the process of losing weight.

Some people are able to lose 10-20 pounds but find themselves hitting a "plateau" after a certain amount of weight loss. 

This plateau may be your body resisting further weight loss due to your body set point.

So how does Contrave fit in?

Naltrexone, along with Wellbutrin, influence hypothalamic function which may be part of the reason why this medication helps certain people lose weight. 

In my own personal practice, I tend to look to these medications when someone has hit a plateau and is unable to lose further weight despite doing everything else perfectly. 

#2. Helps reduce Insulin Resistance & Improve Thyroid Function

​Beyond its effects on the brain, Contrave also helps influence other hormone systems in the body. 

In particular, it alters thyroid function (for the better) and helps reduce insulin resistance.

​You probably know thyroid function is important for regulating your total weight, but you may not understand just how important your thyroid is for optimal weight loss. 

Simply gaining weight has actually been shown to reduce thyroid hormone which may further weight gain and make weight loss more difficult. 

You've probably heard of people "blaming" their thyroid for weight gain (which is true in some individuals) but it's important to realize that having excess fat on your body WILL impair thyroid function somewhat. 

Naltrexone has been shown to improve thyroid hormone status by increasing T4 to T3 conversion and by increasing total T3 (3).

Thyroid regulation and control

This means that your body will ​be producing more of the ACTIVE thyroid hormone T3 which may improve metabolism. 

In addition, studies have also shown (4) that Naltrexone may reduce insulin resistance by sensitizing the body to blood sugar.

This is important because it is estimated that about 50% of people in the US have some degree of insulin resistance contributing to their weight and health overall.

​The effect of naltrexone to reduce blood sugar and insulin resistance seems to be more effective in women who also suffer from PCOS like symptoms (high testosterone or high androgens). 

#3. Reduces Binge Eating and Overeating

​Traditionally we think that in order to lose weight we must reduce how much we eat and exercise more, right?

Well, it turns out to not be as straightforward as we thought.

While overeating can definitely lead to weight gain, undereating does NOT lead to significant and long-lasting weight loss. 

So why is it helpful that Contrave reduces binge eating?

Binge eating tends to be more harmful than simply overeating because of the stimulus it sends to your body.

An abundance of high sugar foods and carbohydrates can spike insulin levels and promote hormone imbalances like insulin resistance.

Because of the effects that binge eating has on hormonal balance, and therefore weight loss, it becomes very important to treat if you are interested in weight loss. ​

For the purpose of this article, I am lumping together overeating, binge eating and emotional into eating into 1 category. 

These are all different, but how they impact your hormones is very similar. 

So how does Contrave fit in?

Studies have shown that taking Wellbutrin (5) has been shown to help promote a remission in binge eating in certain patients. 

Contrave and binge eating

While patients who underwent this study didn't notice any weight loss, they did, however, notice a reduction in binge eating episodes. 

It's important to note that this study was done with Wellbutrin ONLY.

The benefit of using Contrave (the combination of Wellbutrin PLUS naltrexone) is that Wellbutrin can reduce the number of binge eating episodes while naltrexone works to reduce the hormone imbalances caused by previous binging. 

I have found that using Contrave (or even just Wellbutrin by itself) can be very helpful for certain patients who suffer from eating disorders. 

#4. Suppresses Appetite

Generally, I am not a fan of medications that simply reduce the total amount of calories that someone consumes UNLESS they are also overeating (see above).

For this reason, I generally recommend that patients avoid appetite suppressants like Phentermine or other amphetamine-based medications designed for weight loss. 

Why?

Because once you stop taking the medication, and your appetite returns, you will invariably gain all of your weight back. 

When I talk about weight loss I am always looking for long terms solutions that not only result in weight loss but that result in long-lasting weight loss (not just temporary weight loss). 

The reason I let Contrave slip by is that in certain individuals this suppression in appetite can help reduce sugar cravings and reduce cravings for unhealthy and insulinogenic foods in general. 

If you decide to use Contrave please do not use it solely for the purpose of reducing your appetite. 

I recommend that you use Contrave if you are having trouble staying away from sugary foods, sugary beverages, refined carbohydrates, sweets and other foods that stimulate insulin and promote hormone dysregulation. 

It's also important that if you do decide to use Contrave that you make sure you are eating enough food to maintain metabolic balance in your body. 

That means you are consuming enough food to maintain muscle mass while avoiding the hormone changes that occur with calorie restriction. 

thyroid metabolism reset poster for side bar

#5. Reduces Inflammation

​Next on the list is inflammation. 

Contrave, particularly naltrexone, has been shown in certain studies (6) to act as an anti-inflammatory agent.

Why is this important?

Inflammation, in general, promotes certain changes in the body which both promote weight gain and make weight loss more difficult: 

  • Inflammation promotes poor thyroid function leading to high reverse T3 and low free thyroid concentration
  • Inflammation increases appetite
  • Inflammation lowers testosterone which may result in a decrease in muscle mass and therefore metabolism
  • Inflammation promotes the development of leptin resistance
  • Inflammation promotes the development of insulin resistance
  • Inflammation may lead to increased intestinal permeability and changes in bacterial microflora leading to changes in caloric absorption

No matter how you look at it, chronic low-grade inflammation is not something you want going on in your body if you are serious about losing weight. 

Contrave and inflammation

Luckily it's quite easy to check for chronic inflammation through simple blood tests. 

If you think you have inflammation I recommend checking these 3 basic lab tests:

  • CRP (C-reactive protein) - Nonspecific marker of inflammation
  • ESR (erythrocyte sedimentation rate) - Non-specific marker of inflammation
  • Ferritin - Non-specific marker of inflammation, but also a potential marker of iron stores in the body

​If these tests are positive (or flag as high) then you know inflammation is present in your body. 

The next step is to go about finding the source and treating it. ​

Using Contrave as part of a Weight Loss Plan

​So while Contrave definitely stands to benefit some people you need to be realistic about whether or not it will work for you. 

The first thing to do is ​check to see if you are one of the people who would stand to benefit from using it (see list above). 

If you fall into any of those categories does that mean Contrave will definitely work for you?

Not necessarily.

Remember:

There is no magic weight loss pill.

While Contrave acts through a number of mechanisms to help with weight loss it should NEVER be used by itself.

You should always layer several therapies on top of each other to get the best results.

For instance:

If you find that hormones are contributing (like low thyroid) to your weight loss problem, then it makes sense to use a combination of hormones, prescription medications (Like Contrave or Saxenda), supplements and ​lifestyle changes like exercise and a healthy diet. 

​If you walk into weight loss and think you are going to get serious results by just taking an extra pill each day - think again. 

The way to get serious results (I'm talking 50+ pounds of weight loss) like the patients I discuss in my case studies, is to take this layered approach. 

Using Naltrexone for Weight loss by itself

Another question you might be asking is this:

Can I take Naltrexone by itself for weight loss?

And the answer is yes, it can potentially help certain people, even if it isn't used with Wellbutrin.

Many people (and I understand why) would prefer not to interfere with neurotransmitter levels​ if they aren't at all necessary. 

So if you are a person who ISN'T suffering from depression, anxiety or binge eating, you don't necessarily have to use the combination of Wellbutrin plus Naltrexone to get optimal weight loss.

In these situations, you should be able to get many of the benefits by cutting out the Wellbutrin and going straight to the Naltrexone. 

In order to get this prescribed, you will have to ask for "low dose naltrexone" somewhere in the range of 4.5 to 13.5mg per day.

You can learn more about using low dose naltrexone for weight loss and other conditions like autoimmune disease in this post. ​

Combining individual Wellbutrin and Low Dose Naltrexone Prescriptions together​

One of the drawbacks of Contrave (and other newer weight loss medications) is that they are incredibly expensive.

Pharmaceutical companies know that they can charge high prices for newer weight loss medications and they know that some people will be willing to pay those prices.

Unfortunately, most insurance companies don't really cover weight loss medications (not the newer ones) which leaves some people in an unfortunate situation where they can't afford the newer medications. 

​One way to get around this is by simply combining Wellbutrin with low dose naltrexone in two separate prescriptions to get the same benefit. 

Remember:

Contrave is really just a medication which comes two other medications (which allows the pharmaceutical company to patent the medication and charge higher prices).

​You can get around this by getting two separate medications. 

If you choose to go this route you even have more control over the individual dosages which may be beneficial for certain people.

If you go this route try to get ​your medications in the following dose range: 

  • Naltrexone -> Around 4.5 to 12 mg per day
  • Wellbutrin -> 100 to 200mg per day (depending on tolerance and symptoms)

​Over to you 

​Contrave is a newer weight loss medication that works by influencing hormone levels in your body, by manipulating your appetite and by modulating your body set point through your hypothalamus. 

Contrave really is just a combination of two medications: Wellbutrin and Naltrexone.

But just because this is a new weight loss medication doesn't mean it will work for you.

Before you consider using it make sure you check the list of people who stand to benefit the most from this medication!

Now I want to hear from you:

Are you using Contrave?

Has it helped you with weight loss? Why or why not?

Leave your comment below! ​

References (Click to Expand)

This post was most recently updated on February 19th, 2019

Dr. Westin Childs

Dr. Westin Childs is a Doctor of Osteopathic Medicine. He provides well-researched actionable information about hormone-related disorders and formulates supplements to treat these disorders.He is trained in Internal Medicine, Functional Medicine, and Integrative Medicine. His focus is on managing thyroid disorders, weight loss resistance, and other sex hormone imbalances.You can read more about his own personal journey here.

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