Though the best weight loss medications vary depending on an individual’s unique health care needs as evaluated by a physician, it’s helpful to know about some of the options. Below, Dr. Sepulveda and George offer their recommendations for FDA-approved medications for weight loss.
Wegovy
Wegovy, recommended by George, is an injectable medication containing the active ingredient semaglutide and is manufactured by Novo Nordisk. According to the FDA, it’s approved “to reduce excess weight and maintain weight reduction long term in certain adults with obesity or overweight and certain children with obesity, for use in addition to a reduced calorie diet and increased physical activity.” The drug may also treat heart disease in individuals who have experienced acute myocardial infarction.
Wegovy works similarly to a naturally occurring appetite hormone, helping to regulate the amount of food and calories a person consumes, potentially supporting weight loss, according to the company. This GLP-1 receptor agonist targets areas of the brain to manage appetite and may help users feel fuller for longer.
The drug is administered once weekly via prefilled, single-dose injection pens and is available in five dosage strengths. A medical professional can adjust the dose over time depending on individual goals and health needs.
Zepbound
George recommends Zepbound, an Eli Lilly and Company medication that is FDA-approved for weight management and intended to treat adults with obesity, as well as some adults with overweight and weight-related medical concerns and moderate-to-severe obstructive sleep apnea.
Zepbound’s active ingredient is tirzepatide, which mimics the effects of two naturally occurring hormones—GLP-1 and glucose-dependent insulinotropic polypeptide (GIP)—and may lead to improved blood sugar management and weight loss in individuals with type 2 diabetes. Individuals with type 2 diabetes may respond better to a dual agonist drug like tirzepatide compared to other types of medications, says Dr. Sepulveda. Zepbound is available in five dosage strengths and is injected once a week.
A 2023 review in The Senior Care Pharmacist assessed five clinical trials, all of which found tirzepatide effectively lowers blood glucose and enhances weight loss, with side effects comparable to other GLP-1 drugs . Of note, Eli Lilly and Company exclusively manufactures Zepbound. External companies or compounding pharmacies may utilize the same active ingredient, mixed with other ingredients, to create a cheaper product; however, these are not FDA-approved and may pose additional health risks, as these medications may be impure or contain formulation errors.
Saxenda
George also recommends Saxenda (liraglutide), which is FDA-approved for chronic weight management in individuals aged 12 and older who have obesity. The drug is a GLP-1 receptor agonist that is injected daily. Liraglutide has a shorter half-life, or time when it maintains its maximum concentration in the body, than semaglutide (13 to 15 hours compared to 165 hours), potentially making it a less convenient option, as it must be administered daily rather than weekly.
Meanwhile, research indicates Saxenda may be less effective compared to other options. One 2022 clinical trial in the Journal of the American Medical Association found that after 68 weeks, the use of once-weekly semaglutide resulted in significantly more weight loss among adults with obesity or overweight without diabetes when compared to once-daily liraglutide .
Though Saxenda may be less effective compared to other FDA-approved weight loss drugs, it may be more accessible through insurance for some individuals.
Qsymia
Combination therapies, which refer to a combination of drugs from two different classes of medications, may aid in weight management, according to Dr. Sepulveda.
“Traditional anti-obesity medications include short-term sympathomimetic agents like phentermine, which suppress appetite by stimulating norepinephrine release,” he explains. Phentermine is an appetite suppressant within a class of medications called anorectics. Meanwhile, topiramate is an anticonvulsant medication with a common side effect of appetite suppression, allowing individuals taking it to feel fuller for longer.
A combination capsule of phentermine and topiramate, called Qsymia, was FDA-approved for chronic weight management for certain individuals in 2022. One 56-week, double-blind, placebo-controlled study of 223 individuals aged 12 to less than 17 years old found that participants taking varying doses of Qsymia lost 4.8% to 7.1% of their body mass index (BMI) when compared to a placebo .
While Qsymia and other combination drug therapies appear effective in maintaining weight loss, their lower potencies may make the amount of initial weight loss lower than newer medications.