Weight Loss Drugs: What Are Your Options?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on March 25, 2024.

What is the newest weight loss drug?

The newest weight loss drug approved by the FDA is Zepbound (tirzepatide), a dual GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 receptor agonist. Zepbound was approved on Nov. 8, 2023 and is given as a once-weekly subcutaneous (under the skin) injection. In studies, participants lost an average of 21% of their body weight, equal to 48 lb (21.8 kg) using the 15 mg once weekly dose.

The GLP-1 (glucagon-like peptide-1) receptor agonists approved for weight loss include Wegovy (semaglutide) and Saxenda (liraglutide). They are also given by subcutaneous injection and result in significant weight loss. Wegovy is injected once weekly, while Saxenda is injected once daily.

Over the last decade, the weight loss drugs approved by the FDA include:

• Zepbound (tirzepatide): approved Nov. 8, 2023
• Wegovy (semaglutide): approved June 4, 2021
• Saxenda (liraglutide): approved Dec. 23, 2014
• Contrave (bupropion and naltrexone): approved Sept. 10, 2014
• Qsymia (phentermine and topiramate): approved July 17, 2012

Other agents like Ozempic (semaglutide) and Mounjaro (tirzepatide) are approved for blood sugar control in type 2 diabetes, but have also been prescribed "off-label" for weight loss. “Off-label” means they may be prescribed by your doctor for a generally accepted use not specifically approved by the FDA or listed in package labeling.

Prescription weight loss drugs may be an option for adults or children who have serious health risks, such as high blood pressure, type 2 diabetes, or high cholesterol and cannot control their weight with diet and exercise alone. Medication treatment for weight loss typically also includes a plan for lower fat and calorie foods, as well as a regular exercise program.

Learn more: How do Ozempic, Mounjaro, Wegovy & Zepbound compare for weight loss?

There are very few proven choices in over-the-counter (OTC) or nonprescription medications for effective weight loss. One agent that is available without a prescription is alli (orlistat), a lower-dose version of the prescription drug Xenical.

Patients who are overweight or obese with any health condition should consult with their physician prior to beginning a weight loss or exercise program.

How effective are weight loss drugs?

Zepbound

In the SURMONT-1 study over 72 weeks, adults using Zepbound injected weekly at the 15 mg dose lost an average of 21% of their body weight (21.8 kg or 48 lb). With the lower 5 mg dose, people lost an average of 15% of their body weight (15.5 kg or 34 lb). People taking a placebo (inactive) agent lost an average of 3% of their weight, or 3.2 kg (7 lb).

The percent of patients using Zepbound that lost 5% or more of their body weight ranged from 85% to 91%, based on dose.

Wegovy

Wegovy (semaglutide) is also injected weekly and has led to an an average 15% weight loss in adults and a 16.1% decrease in body mass index (BMI) in children 12 years of age and older.

• Wegovy and Zepbound are both approved to be used in addition to diet and exercise for long-term weight management in adults with obesity (BMI ≥30 kg/m²) or overweight (BMI [body mass index] ≥27 kg/m2) with weight-related medical conditions like high blood pressure, type 2 diabetes, sleep apnea, heart disease or high cholesterol.
• Wegovy is also approved for chronic weight management in pediatric patients aged 12 years and older with an initial BMI at the 95th percentile or greater for age and sex (obesity).
• In March 2024, Wegovy was also approved to reduce the risk of major adverse cardiovascular events (like heart-related death, heart attack, or a stroke) in adults with established heart disease and either obesity or overweight.

Saxenda

Results from a Saxenda clinical trial showed that patients had an average weight loss of 4.5% of their weight compared to treatment with a placebo (inactive pill) at one year. In this trial, 62% of patients treated with Saxenda compared with 34% of patients treated with placebo lost at least 5% of their body weight. 

• Saxenda is approved to be used with diet and exercise for long-term weight management in adults with overweight (BMI ≥27 kg/m²), in the presence of at least one weight-related medical condition ( such as high blood pressure, type 2 diabetes, or elevated cholesterol levels) or obesity (BMI ≥30 kg/m²).
• Saxenda is also approved for use in adolescents 12 years and older with body weight above 60 kg and an initial BMI corresponding to 30 kg/m² or greater for adults (obese), in addition to a reduced calorie diet and increased physical activity.

Anorexiants

Patients using anorexiant weight loss pills like Contrave or Qsymia may lose roughly 5% to 10% of their initial weight over one year when used as part of an effective diet and exercise plan. But if you have not lost at least 5% of your initial body weight after 12 weeks, it is unlikely that you will achieve meaningful weight loss with continued treatment, and your healthcare provider may decide to stop treatment.

Table of Common Weight Loss Drugs

Many people who are trying to lose weight may choose dietary supplements or herbal medications, but most of these products have not been adequately studied for effectiveness or safety. None are approved by the U.S. Food and Drug Administration (FDA) for weight loss. Check with a healthcare provider for advice before using herbal or dietary supplements for weight loss.

Who Should Use Weight Loss Drugs?

Generally, most people should initially try to lose weight using diet and exercise. Prescription diet drugs may be used as "second-line" treatment, when weight loss has not been successful and the patient has important health risks associated with being overweight or obese.

Many weight loss medicines are not covered by health insurance, may have a high copay or be part of a "stepped-therapy" plan, meaning you have try other weight loss options first, so check with your prescription plan.

Most prescription weight loss drugs note in the package labeling that a person should meet certain requirements, such as a specified body mass index (BMI) or have a serious weight-related medical risk before using these drugs.

Weight loss drugs are usually indicated for obese patients with an initial body mass index (BMI) greater than 30 kg/m² or overweight patients with a BMI greater than 27 kg/m² in the presence of other risk factors (eg, high blood pressure, type 2 diabetes, high cholesterol / lipids, sleep apnea).

Some people with established cardiovascular disease and either obesity or overweight who are in Medicare Part D or Medicaid programs may be eligible for Wegovy now that it has been approved for a cardiovascular risk reduction indication, according to the Centers for Medicare and Medicaid Services (CMS).

Plenity for Weight Loss

In April 2019, the FDA approved Plenity to aid in weight management, in conjunction with diet and exercise, in overweight and obese adults with a Body Mass Index (BMI) of 25 to 40 kg/m².

• Plenity is an oral, non-systemic capsule that contains hydrogel particles that absorb water and expand in the stomach leading to a feeling of fullness.
• In a placebo-controlled study of Plenity in 436 overweight or obese adults, the primary endpoint was achieved with 59% of adults in the treatment group achieving weight loss of 5% or greater after six months.
• There were no statistical differences in side effects between treatment groups, which primarily included stomach side effects (fullness, bloating, flatulence, and/or abdominal pain).

Your doctor is always your primary medical expert; however, you might consider joining the Drugs.com Weight Loss Support Group to discover others with similar questions and shared health values. 

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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