I remember way back in the day (okay, about 4-5 years ago) when I first started practicing, I thought that helping people lose weight was going to be easy.
All I needed to do was write a prescription for a couple of weight loss medications, have the patients take them, and BOOM weight loss.
Well… it didn’t quite turn out that way, but I learned a LOT in the process.
While I don’t practice anymore, I still have had the advantage of using prescription medications for many years on MANY patients.
And through this experience, I’ve learned quite a lot including which medications work best, how to use them effectively, when they should be used, and much more.
Today I want to talk about just that:
Prescription medications that can help YOU lose weight.
This article is for you IF…
You’ve tried losing weight the old-fashioned way through diet and exercise without much success.
If you find that weight loss is incredibly difficult no matter how hard you try.
If you’ve tried and failed multiple diets in the past and feel like nothing works for you.
Or if you just want to find a way to lose weight faster.
Prescription weight loss medications can be incredibly effective if the right ones are used and only if they are used correctly.
These medications can help in the following ways:
- Help accelerate your efforts (you lose weight faster)
- Break through weight loss plateaus
- Augment existing therapies such as diet and exercise
- Help to balance hormones
- Help manage your appetite and food cravings
Sounds good, right?
Well, hold on, because even though these medications can be VERY effective they should never be used by themselves.
This is the part where I tell you that diet and exercise is still very important when looking at any prescription medication.
I know your eyes are glazing over but this is really important.
If you really want to have long-lasting weight loss then you need to combine these medications with diet (eating a whole food-based diet), regular exercise, and intermittent or prolonged fasting.
This will get you the BEST results possible for your body.
And lastly, before we jump in, make sure that you touch base with your doctor before using any of these medications.
These medications are powerful and can have a serious impact on the body.
With this in mind, let’s jump in…
The Most Effective Prescription Weight Loss Medications
Believe it or not, there are many different types of weight loss medications on the market (1) and they all work a little bit differently.
Some weight loss medications help to boost your metabolism, others help manage your appetite, and others balance your hormones.
Every single aspect is important for long-lasting weight loss, which is why it may be important to stack these medications on top of each other.
You should also be aware that many of these medications are considered “off-label” when used for weight loss.
Medications get this distinction if they are not FDA-approved for a specific condition, even though they work well for that condition.
I’ll let you know when a medication is FDA-approved or not if that sort of thing is important to you.
It may also further surprise you to know that insurance RARELY covers them.
Doesn’t make any sense, right?
I know but this is where we are at right now.
Even though losing weight virtually guarantees better health outcomes (2), reduced inflammation in the body, and a decreased risk of diabetes, heart disease, stroke, and so on, they still won’t be covered.
In addition, it’s unlikely that your doctor is aware of these medications or how effective they are.
Again, it may be surprising, but it shouldn’t be.
Our current healthcare system is focused more on management and not prevention.
And what is weight loss if not prevention?
Losing weight improves mental health, physical health, and overall well-being.
But these are not important in a management-based system.
It’s frustrating but it is what it is.
#1. Ozempic & Other GLP-1 Agonists
First on the list are probably the most effective out of all of the medications we are going to talk about.
While they are very effective they also come with a long list of potential side effects.
As someone who is trying to lose weight, you always need to weigh the pros and cons of each medication before actually using them.
In many cases, it’s probably preferable to accept some risk of side effects if the potential outcome is 40-50 pounds or more of weight loss.
This may not be true for you but it’s something to consider.
In terms of FDA approval, Saxenda is FDA-approved for weight loss (3) while Victoza is not.
But don’t let that worry you because both medications are virtually identical.
They both use the same underlying medication (known as liraglutide) and these medications differ only in their maximum dose.
Saxenda can be titrated up to 3.0mg per day while Victoza has a smaller maximum dose.
The story behind Victoza is very interesting.
Victoza was FDA-approved to treat type II diabetes but it was found that when patients used this medication they lost a ton of weight (4).
The pharmaceutical company that manufactured Victoza then decided to create a separate medication and get that medication FDA-approved for weight loss.
The result was Saxenda.
This is both good and bad.
Good because it means that it’s easier to get your doctor to prescribe it and bad because it means that it isn’t covered by insurance.
The good news is that you can sometimes get Victoza covered but only if you can confirm a diagnosis of insulin resistance or diabetes.
Both of these medications work by impacting the GLP-1 receptor and are known as GLP-1 agonists.
The result of impacting this receptor is a decrease in your appetite and a corresponding change in several important hormones including insulin and leptin.
Many people who start taking Saxenda or Victoza notice a dramatic decline in their appetite.
Normally this would be a problem (we will talk more about this when we get to Phentermine) as it tends to cause a RISE in leptin.
Fortunately, both medications blunt the normal rise in leptin that would occur and prevent leptin resistance from occurring due to appetite suppression.
There are many other types of medications that fall into the class of GLP-1 agonists and they can all work.
The key to finding which one works for you will require some trial and error as well as working with your insurance company to see if you can get them covered.
The cash price for Saxenda is very high at around $1,300 per month.
So it’s best to try and get insurance to cover one of the other medications if possible!
#2. Invokana/Farxiga & Other SGLT-2 Inhibitors
Next on the list do not come in order of effectiveness!
Even though these are number 2 on the list doesn’t mean they are the second most effective.
From here on out, the effectiveness of each medication is highly variable and depends on the individual.
Invokana and Farxiga fall into the class of medications that are known as SGLT-2 inhibitors.
Both of these medications are NOT FDA approved for weight loss and yet they have been shown to cause weight loss (5).
They work by blocking a special receptor in the kidney which absorbs glucose in the blood.
Normally, your kidneys are VERY good at absorbing sugar back into the body because it’s a valuable resource used to create energy.
By taking an SGLT-2 inhibitor like Invokana, your kidneys can not absorb that sugar back into the body and you instead pee it out.
This results in lower blood sugar levels and a reduction in insulin levels.
What you will find is that most medications that truly reverse insulin resistance also tend to result in weight loss because insulin resistance causes weight gain and weight loss resistance.
There are many types of SGLT-2 inhibitors on the market so it’s often best to start with whichever version your insurance will cover.
Like Victoza, these medications can be somewhat difficult to get because they are primarily used to treat type II diabetes.
They can obviously be effective for people who don’t have type II diabetes but it is harder for these people to get them.
You can pay cash for them at any time if your insurance won’t cover them, but right now the average monthly cash price is around $500 per month.
You do NOT want to use these medications if you have no issues with insulin resistance, though!
And you should be aware that peeing out extra sugar/glucose can come with problems such as increasing your risk of developing urinary tract infections.
#3. Naltrexone
Naltrexone is probably one of the least well-known of all medications on this list.
Originally designed to treat alcohol dependence (6), it has shown additional benefits as it relates to weight loss.
No one really knows exactly how it helps with weight loss but there are a few theories.
My personal opinion is that it is helping to reduce something called the body set point (7) which is a sort of thermostat that your brain uses to set your weight.
When your weight is “set” at a certain point it can be difficult to lose any weight as your body will do whatever is necessary to keep you at that weight.
The idea is that taking Naltrexone can help reset that body set point and help your brain to recognize your new lower weight as the new “set point”.
That way you can actually keep the weight off that you’ve lost!
We also know that Naltrexone can help balance hormones such as insulin.
Naltrexone itself isn’t FDA-approved for weight loss but it is found in a combination weight loss medication that is FDA-approved.
That medication is known as Contrave and it contains a combination of naltrexone and bupropion.
If you are having trouble getting your doctor to prescribe naltrexone by itself then you might have better luck getting him or her to prescribe Contrave due to its FDA approval.
One thing is for sure, though:
Researchers and pharmaceutical companies wouldn’t spend millions of dollars to advertise a medication that doesn’t work and I’ve had a lot of success using naltrexone by itself for purposes of weight loss.
You may also find naltrexone referred to by different names including LDN or low-dose naltrexone.
The reason this is important is that the FDA-approved dose for alcohol dependence is MUCH higher than is required for weight loss.
Doses of naltrexone in Contrave vary but start at 8mg.
I’ve personally found a lot of success with Naltrexone in doses ranging from 4.5mg to 13.5mg.
The alcohol dependence dose is somewhere around 50mg which is significantly higher than what we are talking about here.
Another big benefit to using naltrexone is that it is very well tolerated and has very few side effects!
The downside is that it’s not quite as effective as the other medications we’ve discussed.
But this trade-off of efficacy for side effects is very helpful to you as someone who is trying to lose weight.
It means you can add naltrexone to other medications or start with it if you want to be as conservative as possible.
#4. Metformin
Metformin is an oldie but a goodie.
It’s one of those medications that many of you have probably already tried if you are listening to it.
If not, then it may be one of the first medications you want to try before using the others I’ve discussed here.
Why?
Because it’s incredibly cheap, pretty well tolerated, and has a huge range of benefits.
Metformin is considered first-line therapy for pre-diabetes, insulin resistance, and even in many cases of type II diabetes.
It is most noted for its effects on helping to reduce blood sugar and insulin resistance but it also has an impact on many other systems in the body.
It’s frequently used by anti-aging doctors to help with the aging process and is also used for weight loss purposes as well.
The biggest downside to metformin is that it’s not quite as effective as the other medications.
Metformin can definitely work but I think it shines best when used in very specific situations.
As an example, metformin can be used in addition to the other weight loss medications we’ve discussed when you hit a weight loss plateau.
Metformin appears to have a synergistic effect on other medications, especially those that target insulin resistance.
If you are looking to dip your toes into the water of weight loss medications then metformin may be the best place to start.
Most doctors have no problem prescribing it even if it means using it off-label for weight loss.
In addition, even if your insurance doesn’t cover it, you shouldn’t pay more than 10 bucks per month.
Metformin is NOT FDA-approved for weight loss.
#5. Phentermine
Last on the list is Phentermine.
Phentermine is well known by conventional doctors and may be one of the most commonly prescribed weight loss medications on this list.
It is FDA-approved for weight loss (8) when combined with diet and exercise.
Even though Phentermine CAN be an effective weight loss medication, in order for it to assist with long-lasting results, it must be used correctly.
If you use it the standard way your doctor prescribes then you may lose weight but this weight loss will be temporary and short-lived.
Phentermine works by doing 2 things:
The first is suppressing your appetite and the second is boosting your metabolism.
It falls within the family of stimulants and these medications tend to have an effect both on metabolism and appetite suppression.
Sounds good, right?
Well, yes and no.
Appetite suppression is not always good and, in fact, can be the enemy of thyroid patients.
If thyroid patients suppress their appetite too much then they may cause more thyroid damage and cause damage to their metabolism.
Appetite suppression may cause weight loss, that’s true, but what happens once you stop taking the medication?
The weight comes right back on.
In addition, because phentermine is a stimulant, it can’t be taken forever.
Your body may become tolerant to the medication and it may cause side effects such as insomnia and elevated blood pressure.
So why do I recommend phentermine?
I only recommend it in certain scenarios and if used correctly.
My method of using phentermine includes using it only periodically and only when you are also utilizing certain fasting techniques.
By combining phentermine with fasting you enhance the beneficial effects of fasting while reducing the potential for side effects of the medication.
You also don’t have to worry about weight gain when you stop using it AND you don’t have to worry about tolerance to the medication.
These benefits occur when you use phentermine no more than twice per week.
As I mentioned previously, if you use phentermine daily you may lose some weight initially but that weight will come back once you stop it.
And each subsequent time you use phentermine you will see a diminished weight loss effect.
So if you decide to use phentermine make sure you use it correctly!
How to Get These Medications From Your Doctor
What good is a prescription weight loss medication if you can’t actually get your hands on it?
Your doctor may pay lip service to the idea that you need to lose weight but are they actually willing to do something about it?
Probably not.
For whatever reason, doctors really don’t like prescribing weight loss medications.
This includes the standard FDA-approved weight loss medications like Phentermine and Contrave!
Why they don’t like prescribing them is somewhat of a mystery to me but I believe it probably has to do with the fact that they just aren’t used to using them very often.
Your doctor has MUCH more familiarity with metformin than they do with Saxenda.
As a result, they will probably have no issue prescribing you metformin off-label but not Saxenda even though the latter is FDA-approved for weight loss.
So what can you do to get these medications?
Even though your doctor may be hesitant to prescribe them, they are still the best first place to start.
Schedule an appointment with your doctor with the specific purpose of talking about weight loss.
Do NOT tack this conversation on to the end of another appointment or visit!
I’ve been with many patients who try to do this and it never works.
Come in with a plan and come in with the topic of weight loss in mind.
If your doctor knows what to expect during the appointment he/she will be much more likely to work with you.
The next step is to come prepared to discuss these various medications.
And by prepared, I mean you may need to come with medical studies or information directly from the pharmaceutical website.
Come prepared with printed handouts to give to your doctor!
The easier you make this for them the more likely they are to prescribe the medication for you.
You’ll also want to have a basic understanding of the potential side effects that the medication you are looking at may cause, as well as some idea on dosing.
In addition to all of this information, make sure you come to your appointment with a plan for diet and exercise!
If you can show your doctor that you are willing to do more than just take medication then they will be much more likely to write that prescription.
Lastly, if your doctor isn’t willing to work with you at all or even willing to hear out your request then it may be time to seek out a second opinion.
You can find doctors who specialize in weight loss, hormone balancing, and anti-aging medicine who are more familiar with these medications.
The only downside to these doctors is that they usually don’t accept insurance so the price of a visit may be more expensive than what you are used to paying.
Don’t be afraid to be persistent. The squeaky wheel gets the grease, as they say.
Don’t Forget These
Way back at the beginning of this article, I mentioned that whenever you consider using prescription weight loss medications you should also combine them with other therapies.
I mentioned diet, exercise, sleep, as well as supplements.
Every single therapy you can add to your weight loss regimen will increase your results.
Supplements are a great way to augment your weight loss regimen and can even enhance the effects of the prescription weight loss medications we’ve discussed above.
Some of my favorites include:
- Berberine – Berberine is a plant compound that can help build muscle mass, suppress appetite, and help build lean muscle mass.
- Protein Powder – Protein powder can help with weight loss by reducing food cravings and by helping to build lean muscle mass.
- Leptin sensitizers/fat burners – Leptin sensitizers work to help your body more efficiently use leptin to burn fat.
- Energy boosters – Energy boosters help increase metabolism.
- Probiotics – Probiotics can influence how many calories you absorb from the food that you eat as well as impact your hormones.
- Fish oil – Fish oil helps reduce inflammation and assists in building lean muscle mass as well as burning fat mass.
- Appetite managers – Appetite managers help you stay on track and keep eating healthy whole foods!
Wrapping it up
My own personal experience tells me that many patients can benefit from prescription weight loss medications.
Does everyone need them? No!
But can they help get you to your target weight faster? Yes!
Before you consider using any prescription weight loss medication you should take a good look at its side effect profile and consider if those side effects are worth the risk for YOU.
If you have more than 50 pounds to lose then the side effects then using weight loss medications are almost always worth it.
The reason is simple:
Those 50 pounds are guaranteed to cause problems for you down the line including a whole host of health issues.
It’s far better to trade some temporary side effects now in an effort to prevent virtually guaranteed medical conditions later in life.
But I’m not you, so make sure you do your own research!
Finally, don’t forget to add other healthy habits such as changing your diet, exercising regularly, taking the right supplements, and getting enough sleep.
These things will have a synergistic effect on your weight and will help you lose more weight.
Now I want to hear from you:
Are you considering using any of the prescription weight loss medications listed above?
Have you already used them? Did they work for you?
Did you experience any side effects while trying them?
Do you think that the side effects are worth it in your situation?
Leave your questions or comments below!
Scientific References
#1. https://www.niddk.nih.gov/health-information/weight-management/prescription-medications-treat-overweight-obesity
#2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386197/
#3. https://www.fda.gov/drugs/drug-safety-and-availability/fda-approves-weight-management-drug-patients-aged-12-and-older
#4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5358074/
#5. https://pubmed.ncbi.nlm.nih.gov/28105986/
#6. https://pubmed.ncbi.nlm.nih.gov/18703474/
#7. https://www.bidmc.org/about-bidmc/wellness-insights/nutrition/week-one-the-science-of-set-point
#8. https://pubmed.ncbi.nlm.nih.gov/25580419/
Is there a reason you don’t list Ozempic? My understanding is that semaglutide as outperformed liraglutide for weight loss. Wegovy looks very promising.
Hi Sarah,
No particular reason, Ozempic/Wegovy both have the potential to work as well.
I read that if you, ora family member, has had a certain type of thyroid cancer.
I received your articles on Berberine and glucomannon for weight loss. Is it safe to use these both at the same time as suggested in your articles?
Hi Christina,
You really wouldn’t want to use glucomannan at the same time as any supplements due to how it works.
I got on Phentermine a few years ago. 2012. Dropped weight like crazy. Kept it off for about a year then started putting it back on. Got back on Phentermine. Didn’t do much. God married in 2015 and gained 15-18 lbs. in the first couple of years. Tried Phentermine again. Nothing!!!!! Ugh. I’m 52 1/2 and a full-time Special Ed teacher. Work 50-60 hrs a week. Don’t eat a lot. Still flabby and cellulite. Just gross. 5 ft 3 1/2 inches tall, 130 lbs all in my belly, hips, and butt. Frustrated. Running myself to death and no weight loss.
Very discouraged.
Hi Tamela,
That is pretty standard for those using Phentermine. You can read more about why that happens here: https://www.restartmed.com/phentermine/
This article was very informative! I am amazed at how little my doctor actually knows I have since changed providers and will be taking this article with me next visit!
Hi Suzanne,
Glad you found it helpful!
Hello
I have used Phentermine in the past. I used the Fen-Phen combo years ago and dropped weight pretty quick. The most recent use I didn’t really lose anything. I now have problems with my parathyroid and am wondering if there is any relationship
Thanks
Sandy
I’ve been taking phentermine for 2 years. It definitely helps me reduce water weight and i have an increase of energy. Most importantly, it gives me the urge to use the bathroom but only when I take it. I am starting to only use it twice week as you mentioned, but I am unable to use the bathroom on days that I do not take it. Do you have any recommendations or advice for this issue?
Hi S. Baker,
I’m planning on writing a blog post on how to manage constipation in the setting of hypothyroidism which should be out soonish. Keep an eye out for that which will have plenty of recommendations.
I am 40 years old and have NEVER been so huge in my entire life !!!
I want to loss weight at least 40 lbs
I have no idea why, where or how I have gained so much weight in such little time (5 years ago I was about 140)
I have hypothyroidism and have been diagnosed with it many years now. My doctor frequently monitors my tsh t3 & t4 levels which always come back normal. I am 5’3″ and now weigh 175-180 lbs but I used to be a healthy 125-130 …. I exercise moderately; however if I eat “healthy” I actually gain weight… I did physicians weight loss many years ago before I knew that I was hypothyroid. Immediately after diagnosis and 25 mcg synthyroid I had no need to watch what I ate and stopped starving myself. I don’t have any children so I never gained “baby fat” (I know that I am not in my 20s anymore however I was wondering if you have any suggestions for me). Like I said I am moderately active. I live in the South and it gets really hot in the summer. I had joined a gym about 2 years back but when I would exercise like five to ten minutes
even on an eliptical machine or stationary bike or even brisk walking/slight jogging on a treadmill I got beet red in the face, felt like I was going to pass out and couldn’t seem to cool off for a long time afterwards and also had a horrible headache …..
I have had hypertension but it seems well controlled now with metroprolol losartan and Clonidine thankfully… Is there any safe way to loss weight?
To sum it up, what are my prescription medication options to suggest to my doctor given my hypothyroidism as well as my ‘controlled’ hypertension?
I know many people take Adepex and have positive results …. My doctor has me on topiramate 25 mgs and said at the next visit it is possible to increase it to 50 mgs; however, after five weeks I see no change in my weight at all…. What do you recommend medicine wise to ask him about and or is there any other questions or lab tests maybe he should be checking. I don’t have a history of diabetes in my family and at occasional testing of it he says it is normal, also.
Hey Dr. Childs, this is not right!! GlucoSlow Fiber – Propolmannan. The directions say to take six per day. There are 30 pills in each bottle. That means it only lasts five days and it is $50.99!! I would like to purchase some supplements but not at that price for so little!
Hi Nellie,
Each bottle has 180 capsules 🙂 6 capsules per serving x 30 servings = 180 capsules per bottle. You can even split up the serving to 3 capsules before a meal if you want to extend it out a little longer. Hope this clarifies!
I have mast cell activation with MTHFR not exactly sure which of the MTHFR though . I’ve come down with CRPS in my rt arm . Used to be called RSD . I’ve been getting stelate ganglion blocks in my neck and ketamine infusions. I now have a thyroid issue with weight gain all over with extra in my arms , lower belly , upper thighs and hips and back along with cellulite. I’m frustrated because I’m extremely dehydrated and my hair is crunchy and falling out . It’s thinning fast . I started taking the adrenal thyroid reset and the T3 booster conversion . What else should I be taking ? I’m thinking I need the fiber and Leptin as well ! Please help me get my youth back ! Thank you
Hi Jacklyn,
The T3 and thyroid adrenal are great for thyroid and adrenal support but won’t help much with weight. I would say it depends on what your primary goal is. If you are most interested in weight then adding in glucoslow fiber and leptin resistance rx would be the right move. If you want more general health and support then adding something like Thyroid Daily Essentials, Omega Soothe SR, and Functional Fuel DETOX would be ideal.
Hi Dr. Childs,
I just started Saxenda, I am always sensitive to meds so I started very low, about .12 rather than the starting .6 dose. It has been a week and I am down 2.5lbs and my appetite is significantly reduced. Do you think I need to increase in order to get the full benefit? I was planning top titrate up when my hunger increased but I want to increase if there are benefits other than appetite suppression that I am missing out on at such a low dose.
Thank you!
Anna
Hi Anna,
It’s usually not a good idea to titrate up unless necessary because you aren’t losing weight.
There are two new meds for diabetes 2 and weight loss : Ozempic and Rybelsus that you haven’t mentioned
I started taking Rybelsus and i am on Tirosint-Sol (thanks to your article). I will follow up in 90 days with my results.
Hi Eliza,
Ozempic and Rybelsus are both GLP-1 agonists and would fit with Victoza/Saxenda.
I have taken Phentermine and combo bupropion hcl sr and naltrexone for weight loss and these really did work great, I did lose weight, had great energy. Only problem that they cause hair loss, when you did deep online
on these meds. you do find that side effect, and I struggle with hair loss to begin with, so I cannot take them anymore.
Do any of these prescription meds. for weight loss work, Without causing hair loss, so you don’t have to choose between being fat or bald !
Hi Pat,
These medications should NOT cause hair loss. If they are then it’s probably more related to your diet and/or nutrient deficiencies that may occur secondary to a suppressed appetite.
I used the phen/fen combination years ago and lost at the most 5 lbs. I tried metformin no weight lose. I always wondered why because whenever I ate, It ran straight through me. Pretty hard on the GI! I tried berberine, notice nothing. I am curious, do certain body types respond to diet differently. I purchased a new scale that gives you muscle weight, bone weight, water weight and fat weight. I was surprised at how much muscle and bone weight I had. Yet I can not get rid of the fat around my middle! I got an opportunity to try a CGM (fitness one not diabetic) and was surprised to see that my glucose bounces around more than it should even when eating strict keto. I read that in order to lose weight, your glucose levels should be in the 80’s, except for the timeframe of 90 mins following eating. I feel like my whole life I have been trying to lose weight. The one time I managed to lose about 20lbs I did lose muscle mass in my legs, maintaining most of the belly fat. I can say keto diet made me feel great. Less aches and pains and more energy. Having a continuous glucose monitor is a wonderful tool. It shows you how food effects you. The fitness world has several CGM on the market, if you can afford one, I recommend doing it.
Hi Sher,
Absolutely, each person is an individual and will respond differently to different diets. This is why a personalized approach to diet and weight loss is so important and also why you will see that some people do well on certain diets while others do not. It’s more about finding what works for your body.
I have be diagnosed for breast cancer and I am remission.
I have put on weight. I have be diagnosed for hypothyroidism and I am taking Levothyroxine 50 micrograms a day.
I am trying to loose weight but I can’t
Hi Annette,
Have you already tried eating a whole food diet, intermittent fasting, and regular exercise? If not, that would be the first place to start. From there you can determine if you need additional medications.
Hi Dr Child’s,
I have hashi thyroid and celiac and over the last 4 years I had gained 20 lbs despite a clean, organic, g-free diet.
My doc prescribed tenuate 20 mg 3 times a day. For 3 months I only took it once a day for energy and was experiencing very little weight loss. Then around Thanksgiving time I got a cappuccino machine and started having one daily in the afternoon loaded with cinnamon on top. I use a really pure mildew free coffee. In 2 months I have lost 18 pounds effortlessly. I’m doing nothing else different. I am so grateful but so curious – could the coffee and cinnamon have something to do with this since I’m only taking 1- 20 mg pill a day?
Thanks for all of your great info! Terri
Ps I was always tired and had low energy- now I feel normal again!
Hi Terri,
It’s difficult to know for sure but it’s certainly a possibility that they are helping.
I was on Metformin years ago for insulin resistance and to lose weight. The side effects were horrible for me. Six weeks in the bathroom – no thank you. I did lose weight, but it wasn’t worth it! I just changed my diet and increased my exercise and lost the weight.
Hi Shannan,
Glad you found what worked for you! Medications are by no means necessary for weight loss in all cases.
The Dr from YOU TUBE is a cardiologist at the Mayo Clinic. Black coffee not foo foo coffee and about 1/2 tsp of cinnamon is his go to advice. It’s on his video for this week. Take a look at his videos. I wish he practiced here. GOOD LUCK
CHERI Utah.
Hi, I’m on ozempic .50mg and on week 8, I’ve lost 1.5kg only,I eat well but can’t exercise due to a foot op which limits me. I have pcos, Endriometriosis,thyroid, insulin resistance, candida,blocked lymphatic system, feels like an endless list of issues. Should I add metformin to the ozempic to see better results?
Hi Alouise,
You could certainly consider adding it. I typically don’t add metformin to other medications until a plateau has been hit.
I was really pleased with the information provided. Very clearly written. Thanks for the information, I can now have a more informed conversation with my doctor.
Hi Jill,
Happy to help!
Hi Dr Childs
Just wondering can you add metformin to victoza to enhance weight loss Taking 1.8mg a day at moment
Hi Mel,
Yes, they can often be used together but whether or not it makes sense in your specific case is another story. I would recommend touching base with your prescribing doctor before making any changes to your regimen!
Have you heard of Plenity or would you recommend it for weight loss?
Hi Jamie,
Yes, Plenity works in a similar way to glucomannan: https://www.restartmed.com/glucomannan-weight-loss/
I don’t see the benefit of using it over something like propolmannon which is available over the counter and quite easy to get: https://www.restartmed.com/product/glucoslow-fiber/
Dr Childs, Thank you for all the educational information!
Wanted to ask if the pill can cause insulin resistance( or other weight related issues) if you have Hypothyroidism and Does Metformin cause any side effects if taking Synthroid.
Thank you.
Hi Keesha,
Glad you found it helpful! In regards to your question, yes, there does seem to be some connection between birth control medication and insulin resistance. In regards to Synthroid and metformin, metformin can cause issues with TSH levels which you can learn more about here: https://www.restartmed.com/prescription-medications-that-block-thyroid-function/
I was taking ozempic and lost 25 lbs, then I switched to an insurance that does not cover weight loss. Can any of these meds be prescribed off label for other conditions. I am not diabetic.
Hi Jess,
They can be prescribed off-label for weight loss. The only downside to off-label prescribing is that insurance typically won’t cover them but that doesn’t mean you still can’t get them and pay cash. You just need a doctor to prescribe them for you.
Dear Dr. Childs, I just started Ozempic, a couple of weeks ago, .25 mg per week, and I’ve lost about five pounds so far. I also do HGC injections 2x per week on fasting days. I know you’ve used this Metabolic reset protocol with hundreds of your patients. I wanted to know if there are any supplements that should NOT be taken while taking the Ozempic or any GLP-1 agonist, any that may adversely interact with it. I take Ultra B Complex, NAC, Liver GI Detox and Magnesium from Pure Encapsulations, Omega 7, Omega 3, chelated zinc, Vit. C, Vit D3 and chelated zinc from Solgar and Doctors Best. I also take probiotics. I’d been taking Gabatrol as well as Gaia herbs Adrenal health support, Day and Night formulas since I’d been through a burnout a few years ago and am still recovering, but I stopped these three since I wasn’t sure if they’d adversely interact as they have things like reishi, cordyceps and rhodiola, ashwagandha, etc. What would you recommend? Thanks in advance for any guidance. Much appreciated.
Hi Tina,
Because GLP-1 agonists are injectables you really don’t need to worry about other supplements. They work almost immediately and other supplements don’t have a negative impact on their function or use so I wouldn’t worry too much about that. Whether they work on it depends on the dose, typically. There are also some people who don’t respond to one GLP-1 agonist but may respond to another. So if you aren’t seeing results look to your dose first and then to another medication if necessary.
Hi Dr. Childs,
OK, thank you for this info. This is helpful. The Ozempic seems to be working well so far, I’ve dropped several pounds and it’s helping to keep my appetite at bay (along with cravings for unhealthy foods). I took Saxenda five years ago (while following your 60-day metabolic reset program), but my insurance wouldn’t cover it, and I was paying around $400 a month. So I had to discontinue it and regained all the weight I lost. As I am insulin resistant, my insurance will cover the Ozempic. I hope it continues working. I am supposed to go back to my doctor next week to check my progress and, hopefully, get a new prescription. I’m still on the 0.25 dosage. I don’t know if he will titrate it upwards. Thank you so much again. Best Regards
Hi Tina,
Happy to help! Keep up the good work!
Hi!
Thank you so much for the information. Have you heard of Tirzepatide? What are your thoughts on It? Thanks 🙂
Hi Britt,
I am aware of it but haven’t researched it heavily. At some point, I will do more in-depth research and record my thoughts in a future blog post.
This and other articles you have posted have been super helpful in understanding why certain drugs work and don’t work.
That said, I did tack on the conversation with another visit and my doctor was very enthusiastic about Saxenda, prescribed it immediately, and my insurance (Aetna) covered it without issue. So, I think the attitudes might be changing!
I am 80-100 lbs overweight and started it this week along with a reduced calorie diet, hoping for good results!
Hi Kat,
Thanks for sharing! Interesting on the Saxenda, perhaps insurances are now covering the medication. When it first came out that definitely wasn’t the case but perhaps things have changed. I will look into it.
Hi Dr. Childs
I was diagnosed with anxiety/depression and on zoloft and mitarzepin for 10 months now and I have gained 10+ lbs.
My weight gain has added more to my depressions where I don’t feel good about myself. Is it ok to go on wt loss meds while on depression meds?
Fatima
Hi Fatima,
Weight loss medications should not interfere with depression medications but, even if they did, there would be an argument to make that losing weight may be more important than taking anti-depressants if the weight gain is causing the depression.
hi
loved your article. Very informative. A friend of mine at pickleball lost weight on Saxenda and because I was overweight, had sleep apnea and high blood pressure I figured the benefits to me outweighed any risks. It was great talking to my friend because I had a huge advantage of her journey. She advised me to stay on the lowest dose rather than keep increasing the dose, as recommended. The side effects were some stomach upset and nausea but this for the most part subsided after a week or so. I did notice my stools were rather larger than normal and tended to be on the hard side (my friend had told me to drink lots). To combat this I started eating more fruit which has worked well. I was already on a good exercise track as one lovely lady, created a group which now plays 5 days a week. Another group play at the same venue on Sunday. (They saved my life as my apnea was causing me huge problems, creating huge stress which I could feel, in my body), the exercise helped me tremendously. I have been on the low dose (just a couple of clicks past the lowest) for nearly three months now and have lost 10 kg in weight. I feel so much better, look so much better and have managed even though I’m 66 to not look haggard, with the loss. Yes it isn’t cheap, however, because you eat a lot less, it mostly pays for itself. Because I found it difficult to play on a full stomach, I started to fast prior to playing so it was 3 or 4 pm by the time I broke fast for the day (apart from my cups of tea with milk and one sugar). I was doing this prior to starting Saxenda but the drug certainly helped reduce my appetite and gave me the impetus to do more…. A simple thing I found is that by being mindful when you eat, concentrating on getting your saliva flowing, while chewing, has two effects. You get heaps more pleasure out of the food you eat, once the saliva is flowing you can switch your mind’s attention to a sort of self hypnosis by telling your self you are full. Huge actually. It works… yes the drug helps but I think the good eating habits will continue once I have finished the course. Sometimes it is just about saying no to food…. delaying when you eat, having a drink first, and being really mindful of the food when you do eat. Another tip is to only grocery shop when you are full. You are much less likely to fill your cart up with crap. If you don’t have the big bag of chocolates in the cupboard… you can’t eat them!!!! So shop when you are full and don’t buy the crap you know you can’t resist bingeing on….
Hi Clare,
Thanks for sharing your experience! It always helps others to hear what’s working.
I have been diagnosed with a condition called Lipedema. It appears this is diet and exercise resistant adipose tissue.
Any chance you have any knowledge or experience with patients with lipedema successfully losing weight?
Hi Shannie,
Unfortunately, I don’t have a lot of experience in treating those with lipedema. I think it would still be worth a try to use the therapies I talk about on my blog, though, as they certainly won’t hurt and still have the potential to help.
How in the world can you write an article on weight loss and list all the Wt loss products that you did and not include Qsymia? Seriously shaking my head?
Hi Steve,
Qsymia is inferior to those listed here and it has its own article. The title of this article is the “top” prescription weight loss medications and I wouldn’t put it at the top: https://www.restartmed.com/qsymia/
Hello, do you have any suggestions for people on antidepressants who feel they cannot lose weight? Like 10-15lbs, but not 50. Does T3 augmentation help with this? Any other thoughts?
Hi LG,
T3 can potentially help with weight loss, in the right setting. Please see this article regarding T3 and weight loss: https://www.restartmed.com/cytomel-weight-loss/
Many antidepressants cause weight gain, as you are probably well aware, which is why it’s ideal to avoid taking them if possible or try alternative supplements/therapies which can take their place.
I have a history of yo yo dieting and an eating disorder. My body thinks it is in starvation mode. I have 50lbs to lose and eat at a moderate deficit, 1700 calories a day, high fiber med carb high protein low fat. I gained 35 pounds rapidly last year after being underweight and tried to lose it on and off last year and ended up gaining 40 more pounds of fat. Exercise doesn’t touch it I could run a marathon and my body wouldn’t even know it. Is there any hope I can lose this 50 pounds with metformin? I was eating 1000 calories for an extended period last year which I wish I didn’t do but I can’t undo that. It sure didn’t make me lose like it used to in the old days. Now my body is just stuck in this permanent hibernation mode. I am back on 90mg NP thyroid too.
Hi Kristen,
Based on the information you provided here it is very unlikely that metformin will help you lose weight. You’ll need to address the metabolic dysfunction first and metformin isn’t the best medication for that. It certainly won’t hurt, but there’s a very low chance it will help you lose a significant amount of weight.
How can I do that? It seems hopeless then. I was hoping metformin would be the magic bullet…
Hi Kristen,
Definitely not! There is no magic bullet when it comes to metabolic damage or weight loss more generally. You can learn more about addressing metabolic damage here:
https://www.restartmed.com/the-reverse-diet/
https://www.restartmed.com/gaining-weight-to-lose-weight/
So if I am starting on Semaglutide injections, is it best to stay on the lowest dose until I plateau? The directions sent with the medication are to increase after 4 weeks. Could I also take glucomannan while I am on semaglutide?
Hi Pam,
I believe it works best that way but you are welcome to use it in another way if you prefer. And, yes, in general, you can use glucomannan with GLP-1 agonists.
Hello Dr. Childs,
Thank you for this information! I am going through peri-menopause, and gained 25 pounds that would NOT come off. My Dr. is trying to balance out my hormones, which are a mess. In the meantime, she put me on Vyvanse for short term. I admit, it’s working for weight loss. But I absolutely hate the way it makes me feel: completely scatter-brained, can’t focus, jittery, can’t remember anything…I hate the feeling. But I’m liking the scale better every day.
What are your thoughts on Vyvanse for weight loss? It’s an ADHD medication, which I do not have.
Thank you!
Lori
Hi Lori,
I don’t believe stimulants are a great way to lose weight because they work primarily by reducing your appetite. You may lose some weight while you are on them, but they shouldn’t be used long-term so the weight will come back once you stop. This is basically the same reason I don’t recommend phentermine which is also a stimulant: https://www.restartmed.com/phentermine/
I was just prescribed Wegovy and my insurance will cover it. I am hypothyroid which is under control with tirosint. I am leptin and insulin resistant. I have tried every diet under the sun with little to no results. I take 2000 mg of metformin (started 9 months ago and lost 5 pounds). I’m concerned about starting Wegovy and having to stay on it for an extended period/possibly forever. I was hoping that once I lost weight, I could come off, but the doctor said I may need a maintenance dose for the rest of my life (there are lots of accounts of people stopping the wegovy and regaining all their weight). What are your thoughts about that? If the Wegovy fixes the leptin and insulin resistance and I maintain my healthy lifestyle and diet, why would I need to continue to take it? I am also planning to restart your leptin resistance supplement as it did bring my leptin down to 24 from 42 but it went back up to 42 after I stopped taking it. Anything else I should be thinking about?
Hi Amy,
As long as you lose weight correctly and don’t rely 100% on the medication, you should be able to keep your weight off. If you use it the standard way that the doctor recommends, though, that is unlikely. Once you’ve had leptin resistance and insulin resistance you are much more likely to develop those conditions again which means your diet and lifestyle will need to be on point and you will have to be more strict than the average person but it’s definitely possible to use these medications to lose weight and then get off of them.
What blood do you have done to find out if you are leptin resistant? Do I want to have leptin. Is Trulicity good for weight loss?
Hi Leighann,
Please see this article for more information on that topic: https://www.restartmed.com/how-to-diagnose-leptin-resistance/
Is using low dose Naltrexone superior to using 50mg Naltrexone for weight loss? My Dr. has me on 50mg Naltrexone and 300 mg Wellbutrin for weight and it’s not working. I have terrible feelings of hunger and uncontrolled cravings.
Thank you
Hi Shar,
Yes, the lower doses seem to be more efficacious than the higher doses based on my experience.
Dear Dr. Childs,
I am over 60 and did not find that the combination of Wellbutrin XL and Naltrexone effective for weight loss. Also, my blood pressure increased, and my history of insomnia became worse during the use of these medications. Please share your thoughts on the best weight loss medication for post-menopause women.
Thank you.
Hi Ija,
They would be listed in this article. There’s no way to determine which medication you will respond the best to without some element of trial and error. The good news is that you already know you don’t respond well to Wellbutrin or naltrexone but there are still others you can try that are listed in this article.
Hello Dr Childs-
I am just starting medications and the first trial was Wellbutrin (300mg) with Naltrexone (50mg). I had to stop that combo when I developed tinnitus right after starting, and the dr associated it with Wellbutrin. So, I stayed on just Naltrexone. After a month, I had gained 3lb.
The next step she recommends is Vyvanse (30mg) with the Naltrexone (50mg). I cannot find anywhere discussing Vyvanse for weight loss nor having it paired with Naltrexone. Do you have any references or experience with Vyvanse? I did get prior authorization for Wegovy too, but she wants me to wait as I have had gall bladder removal in the past.
Hi Dr. Child’s,
I have a question about Phen Phen. Years ago I was in medical school and needed to loose weight. My GP put me on Phen Phen and did not advise me on the side effects. In school I started testing my BP and it was going up considerably, I talked to my instructor and was not doing anything different other than the weight loss drug. My instructor told me that one of the side effects was damage to heart valves. So I stopped taking it but I believe it did some damage. I also looked it up in the drug manual and it did mention that.
I did want to share a cautionary tale for anyone who may want to look up side effects of any Phentermine drug.
I really appreciate your insights, as you shed light on what has been a lifelong struggle for me.
Patricia
Hello I was 220 and 5’3 and my sugar was not controlled by metformin and was put on Ozempic and lost 80 lbs my a1c is great at 5.1 so now my insurance will not cover it. I’m about 4-5 weeks off of it and I’ve already started putting on weight again is there a medication that I can use as a “maintenance” medication to help keep the weight off and my daily sugar checks lower? Bc tonight after eating a junk snack which I know if not a good idea my sugar was 286 this never happened while on Ozempic even after eats junk snack but the Ozempic is no longer an option..any ideas?? And there was no weaning off of it just had it one week and not the next it’s unreal!!
Ive been on metformin and phentermine for almost a year, with very little results. Like 3 pounds! My stomach is delayed which makes me stay full anyway. Im wondering which medication would be best for me take? I need to loose at LEAST 30 pounds. Thanks to prednisone! for pain, and recent hip replacement. Could you recommend which medications would be best ?
Thank you!
I’ve used Phentermine and the combination of bupropion HCL SR and naltrexone for weight loss, and they were effective—I lost weight and felt energized. However, I experienced significant hair loss, which I later discovered is a known side effect of these medications.
Since I already struggle with hair loss, I had to stop taking them. Are there any weight loss prescription medications that don’t have hair loss as a side effect? It’s frustrating to feel like you must choose between losing weight and keeping your hair!
Hi Healthywz,
Weight loss is often a side effect of calorie restriction and/or nutrient deficiency that often accompanies calorie deficits (it’s not usually directly related to the medication, though it could be). I’d start by replacing these nutrients because it’s quite possible you can still use them and not experience hair loss if you do this.