Medications
Medications can assist people who are trying to lose weight.
When used in combination with healthy diet and exercise, medications can result in meaningful and sustainable changes in weight.
They can also be considered for the prevention of weight regain after weight loss or after weight loss surgery.
Medications can be considered if:
- BMI > 27kg/m2 with an obesity related complication
- BMI > 30kg/m2 or above
In Australia there are currently 5 licensed medications for the management of obesity:
Xenical™ (orlistat)
-
- Lipase inhibitor: Inhibits absorption of fat by the gut which can lead to weight reductions
- Common side effects: oily bowel motions or leakage of bowel contents
- Tablet – 3 times per day
Duromine™ (phentermine)
-
- Appetite suppressant and mild stimulant: Acts directly on the area of the brain that controls your appetite making you feel less hungry, which can lead to weight loss
- Common side effects: dry mouth, trouble sleeping, increased heart rate, headaches, restlessness/agitation
- Tablet – once daily
Contrave™ (bupropion/naltrexone)
-
- Combination tablet: Appetite suppressants and works directly on the brain to promote a feeling of fullness, reduce food intake, and improve energy expenditure. It also acts to reduce cravings
- Common side effects: nausea, vomiting, constipation, headaches, dizziness
- Tablet – twice daily
Saxenda™ (liraglutide)
-
- GLP-1 inhibitor which mimics our natural gut hormones: works in your stomach to slow make you feel fuller for longer by slowing down stomach emptying as well as directly in your brain on your appetite control centre to reduce hunger and cravings
- Common side effects: nausea, vomiting, constipation or diarrhoea
- Daily Injection
Wegovy™ (semaglutide)
-
- GLP-1 inhibitor which mimics our natural gut hormones: works in your stomach to slow make you feel fuller for longer by slowing down stomach emptying as well as directly in your brain on your appetite control centre to reduce hunger and cravings
- Common side effects: nausea, vomiting, constipation or diarrhoea
- Available mid-late 2023
Like in other types of medicine, some medications are used “off label”. Off label means using a drug for a condition other than that for which it has been officially approved. Some off label medications which are used in Australia and around the world for the management of obesity include:
Topiramate – used for epilepsy and migraine management
-
- Has some appetite suppressing effects
- Tablet – once daily
Ozempic™ (semaglutide) – currently used for the treatment of type 2 diabetes
-
- GLP-1 inhibitor which mimics our natural gut hormones: works in your stomach to slow make you feel fuller for longer by slowing down stomach emptying as well as directly in your brain on your appetite control centre to reduce hunger and cravings
- Common side effects: nausea, vomiting, constipation or diarrhoea
- Weekly injection
- * In 2022 semaglutide (Wegovy™) received TGA approval in Australia for treatment of chronic weight management, as an adjunct to a reduced-energy diet and increased physical activity.
Mounjaro™ (Tirzepatide) – currently used for the treatment of type 2 diabetes
- Dual agent which mimics the action of two gut hormones GLP-1 (Glucagon like peptide- 1) and GIP (glucose-dependent insulinotropic polypeptide).
- These hormones slow down emptying of the stomach to make you feel fuller, as well as working in the brain. to reduce appetite and decrease food cravings. They also help manage blood sugar levels.
- Common side effects: nausea, vomiting, diarrhoea and constipation, indigestion and abdominal pain, reflux.
- Weekly injection.
- * in 2023 Zepbound (TM) (Tirzepatide) received FDA approval in the USA for chronic weight management.