When trying to get weight under control, many people are looking for any help they can get. The core of weight management is focused on diet, exercise, and lifestyle changes. However medications can provide a bit of a “boost” that can improve these efforts. These pharmaceutical formulations can not replace diet changes and exercise but they can provide an adjunct treatment. There are both FDA approved medications and compounded medications that a doctor can prescribe to help with a patient’s weight loss efforts.
Weight Management Medications
The Body Mass Index (BMI) is still used to determine whether a person is overweight or obese. People who have a BMI between 25 and 30 are considered to be overweight. Obesity is defined as having a BMI of 30 or greater. The BMI is a number calculated using your weight and your height. Typically diet and lifestyle changes are required to help get weight under control.
Medications can be used to aid the weight control process. Usually medications work by either reducing cravings for food or speeding up the body’s metabolism. Combining a medication with diet changes and increased physical activity can help speed up the weight loss process and help maintain weight so it does not increase.
When a medication reduces cravings or makes you feel full faster, you start consuming fewer calories and over time can lose more weight. Many people need this extra help to get their weight loss started and maintained. There are FDA approved medications that are indicated for assisting with weight loss.
FDA Approved Weight Management Medications
Orlistat – Reduces the amount of fat absorbed by the body from food.
Phentermine-topiramate – Used to make you feel less hungry and feel full sooner.
Naltrexone-bupropion – Used to make you feel less hungry and feel full sooner. Naltrexone was first used to treat alcohol dependence and may help reduce cravings.
Liraglutide – Mimics a hormone that targets areas of the brain that regulate appetite.
Compounded Weight Management Medications
If a medication is not FDA-approved it can sometimes still be made by a compounding pharmacy. When a medication is used in a way that is not approved by the FDA it is considered “off-label.” It is acceptable and common for doctors to prescribe medications off-label. It is also common for doctors to order medications to be compounded for their patients when they need something different than what is commercially available. A compounding pharmacy makes customized medications based on a prescription. For weight management, a compounding pharmacy can make formulations that include multiple weight loss ingredients in one capsule or cream.
Here are some example formulations:
- Bupropion HCl 65mg, Caffeine 20mg, Oxytocin 100IU, Topiramate 15mg, Naltrexone HCl 8mg, Methylcobalamin 1mg
- Bupropion HCl 65mg, Oxytocin 100IU, Topiramate 15mg, Naltrexone HCl 8mg, Methylcobalamin 1mg
- Bupropion HCl 65mg, Metformin 250mg, Oxytocin 100IU, Topiramate 15mg, Naltrexone HCl 8mg, Methylcobalamin 1mg
- Metformin HCl 250mg, Leucine 250mg, Methylcobalamin 0.2mg, Sildenafil 0.7 mg
- Methionine 150mg, Inositol 300mg, Choline Bitartrate 300mg
- Caffeine 25mg, Chromium Picolinate 0.025mg, DHEA 10mg, Inositol 25mg, Methionine 25mg, Methylcobalamin 0.5mg, Naltrexone HCl 8mg (Slow Release)
- Chromium Picolinate 0.025mg, DHEA 10mg, Inositol 25mg, Methionine 25mg, Methylcobalamin 0.5mg, Naltrexone HCl 8mg
- Aminophylline 0.5%, 7-Keto DHEA 2.5%, Phenylephrine HCl 0.25%
- Aminophylline 0.5%, 7-Keto DHEA 5%
The above formulations are not available from typical retail pharmacies and must be made by a compounding pharmacy with a prescription.
Most commercially available treatments for weight are taken orally however some topical creams can be made by a compounding pharmacy as well. In particular these creams have been used to help reduce waist circumference. In one study, the difference in waist circumference was 11cm for the treatment group and 5cm for the control group using an aminophylline cream.
Benefits of Weight Management Medications
Lowering weight with a medication can have numerous benefits including lowering blood sugar and blood pressure. In most cases, a medication is suggested when weight loss would have an impact on a person’s health. They are not recommended and prescribed as often to improve appearance. That is mostly because medications have potential side effects. There needs to be a balance between a medication’s side effects and its potential benefits. Weight management medications are not intended to be used alone without changes to diet and physical activity.
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