Breaking the Stigma of Medications for Weight Loss

There is a long history of stigma surrounding weight loss medications and I need your help to break it. The more people that know the truth, the more we can combat the weight, together.

Excess weight is an independent risk factor for heart disease, including heart attacks, and strokes, and creates body-wide inflammation which can clog blood vessels.

Think about it.

The last time you injured yourself, for example, bumped your arm or leg, there was likely redness and swelling. This is inflammation. Now, imagine this redness and swelling in the blood vessels, slowing down or blocking blood flow.

This is why I am so passionate about treating my patients aggressively to lose excess weight. This is done through thinking purposefully about what you eat, when you eat, physical activity, and medications.

It’s the latter that we’re going to be discussing today.

High blood pressure, diabetes, and high cholesterol are all treated with a combination of lifestyle interventions and medications, and we don’t bat an eye when someone is taking medication for one of these ailments.

So, why do we think any differently about weight loss medications?

One reason is the belief that people gain weight because they are not disciplined, they just overeat, or they are losing control. This is false.

Obesity is a disease just like high blood pressure, diabetes, and high cholesterol, and we should be treating it as such.

I believe medications can have a huge impact on your results and if deemed safe, I often prescribe them for my patients during their first visit.

Who are weight loss medications indicated for?

For adults with a body mass index above 30 or above 27 with comorbidities such as high blood pressure, diabetes, and high cholesterol, weight loss medications can be safely prescribed to assist in your weight loss journey.

Just a 5-10% weight loss can improve both metabolic health (which is the body-wide inflammation, blood pressure, cholesterol, fatty liver disease) and decrease the pain in the body from the excess weight.

At LaRocca Medical Weight Loss, I will closely monitor your health after prescribing the correct medication for your goals. We start with a body composition assessment, EKG, and order
labs to ensure proper monitoring, so you can relax knowing your health is always a top priority.

What are some medications that can be prescribed for weight loss?

Name: Phentermine (generic, Adipex, Lomaira)

How it works: it works as a stimulant by increasing norepinephrine and acting in the hypothalamus to decrease hunger signals, suppressing appetite
TYPICAL RESULTS: 10% weight loss (when prescribed in combination with Topiramate)
Possible Adverse Reactions: insomnia (take early), abnormal heart rhythm, high blood pressure, headaches
Note: It cannot be used in people with heart disease, uncontrolled blood pressure, glaucoma, or hyperthyroidism.

Name: Topiramate (generic, Topamax)
How it works: it stops neurons (which are individual nerves) in the hypothalamus from transmitting hunger signals, suppressing appetite
TYPICAL RESULTS: 10% weight loss (when prescribed in combination with Phentermine)
Possible Adverse Reactions: metabolic acidosis (your doctor would tell you this) or prior allergy, generally this medicine is very well tolerated but can make some people feel sluggish, mentally and physically so it is generally taken at night or counteracted with phentermine; it can also cause tingling (called paresthesias) which can be improved with natural remedies.

*Both the above-mentioned medications can be taken individually, or as a combination pill, called Qsymia.

Name: Semaglutide (Ozempic, Wegovy)
How it works: GLP1RA suppress appetite in the brain and increases satiety, the feeling of being full, this is double action; it also decreases blood sugars and is a well-known diabetes medication
TYPICAL RESULTS: 15% body weight loss in 1 year
Possible Adverse Reactions: gastrointestinal side effects, including nausea, vomiting, diarrhea, or constipation, in rare cases pancreatitis
Note: Contraindicated with personal or family history of some thyroid cancers

Name: Bupropion (Wellbutrin)
How it works: increasing dopamine which stimulates the neurons in the brain that decrease hunger signals, it is also well known as a depression medication
TYPICAL RESULTS: 5% weight loss (when prescribed in combination with Naltrexone)
Possible Adverse Reactions: mood changes, insomnia, headache, increase blood pressure rarely, and nausea/constipation
Note: Contraindicated with seizure disorders as it can lower the threshold to have a seizure and uncontrolled blood pressure

Name: Naltrexone
How it works: synergistically with bupropion, meaning it improves how well bupropion stimulates neurons in our brain responsible for decreasing hunger signals
TYPICAL RESULTS: 5% weight loss (when prescribed in combination with Bupropion)
Possible Adverse Reactions: Contraindicated with opioid use or other drug overuse
Note: Generally, naltrexone is not used individually for weight loss.

*Bupropion can be given alone or with naltrexone in a combination pill called Contrave.

Name: Orlistat (Over the counter or prescription)
How it works: inhibits an enzyme, called lipase, that breaks down fats – this makes it so they are not absorbed and are eliminated through the stool
TYPICAL RESULTS: about 6% body weight loss in 1 year
Possible Adverse Reactions: stool leakage which is not appealing, but some people are willing to deal with this; increased risk for certain types of kidney stones, and poor absorption of fat-soluble vitamins (which are vitamin ADE and K), so recommend taking a multivitamin
Note: constipation is a well-known side effect of weight loss and Orlistat can help to combat that while providing additional weight loss. It is contraindicated in people with chronic malabsorption syndrome or decreased flow of bile, called cholestasis.

How can I have weight loss medications prescribed to me?

If this has resonated with you I recommend that you discuss this topic with your primary care physician or schedule a consultation with me.

*Disclaimer: I do not have affiliations with drug companies or financial interest in these medications. Generic and brand names are used here for brand recognition for your educational purposes.

Till next time, stay healthy.

Dr. Kristine LaRocca

Disclaimer: Although I am a medical doctor, I am not YOUR doctor. So the things I teach are not to be used as medical advice. You should consult your physician to discuss what is best for you personally.

If you would like to become my patient, schedule a free consultation below.