Weight-Loss Medications

Weight-loss medications—also called anti-obesity medications—are prescription treatments used alongside diet, physical activity, and behavioral support to help adults with obesity or overweight lose clinically meaningful weight and improve their health. They are not a substitute for lifestyle change, and they are not quick fixes.

Obesity is a chronic, relapsing medical condition, and these medications work with the body's physiology—chiefly appetite and satiety signaling—to make long-term weight loss achievable, albeit not guaranteed. On the bright side, the latest generation of these drugs has produced results that were until recently only possible with surgery:

The main weight-loss medication options

Several medications are FDA-approved for chronic weight management. They differ in how they work, how they are taken, and how much weight loss they typically produce.

GLP-1 receptor agonists (semaglutide).¹ Semaglutide (marketed for weight management as Wegovy) is a once-weekly injection that mimics a natural gut hormone regulating appetite. In the pivotal STEP 1 trial, adults lost an average of 14.9% of their body weight over 68 weeks, versus 2.4% with placebo, and roughly half achieved 15% or more weight loss. An oral form and a lower-dose version (Ozempic) approved for type 2 diabetes are also in wide use.

Dual GIP/GLP-1 agonists (tirzepatide).² Tirzepatide (marketed for weight management as Zepbound, and as Mounjaro for diabetes) is a once-weekly injection that acts on two gut-hormone pathways. In the SURMOUNT-1 trial, adults lost an average of 15% to 20.9% of body weight over 72 weeks depending on dose, and more than half of those on the highest dose lost 20% or more—results approaching those of some bariatric surgery. See our detailed comparison of Wegovy vs. surgery outcomes for how these medications stack up against sleeve gastrectomy and gastric bypass over the long term.

Other approved medications. Older or alternative options include naltrexone-bupropion (Contrave), phentermine-topiramate (Qsymia), orlistat (Xenical/Alli), and short-term phentermine. These generally produce more modest weight loss than the newer injectables but may suit certain patients based on medical history, preferences, and cost.

Who is a candidate for weight-loss medication?

These medications are generally approved for adults with a body mass index (BMI) of 30 or higher, or 27 or higher with a weight-related condition such as type 2 diabetes, high blood pressure, or sleep apnea. See our bariatric surgery requirements for a fuller breakdown of BMI thresholds and comorbidities. They may be used on their own or in combination with procedures such as an intragastric balloon or endoscopic or surgical weight-loss options.

Because each drug has specific considerations—including personal and family medical history—candidacy is determined individually. The GLP-1–based medications are not appropriate for everyone; for example, they carry warnings related to a rare thyroid tumor seen in animal studies and are avoided in people with a personal or family history of medullary thyroid carcinoma.

What to expect on weight-loss medication

The newer injectable medications are started at a low dose and increased gradually over weeks to reduce side effects. The most common effects are gastrointestinal—nausea, diarrhea, constipation, and vomiting—which are usually mild to moderate, tend to appear during dose increases, and often ease with time. Weight loss builds over months rather than days. Importantly, these medications treat obesity as an ongoing condition: research consistently shows that much of the lost weight is regained when treatment stops, so they are intended for long-term use paired with sustained lifestyle changes and regular follow-up.

Cost, access, and considerations

Brand-name GLP-1 and dual-agonist medications are expensive, and insurance coverage for weight management varies widely; some plans cover them, others do not, and coverage rules change frequently. See our weight-loss medication insurance guide for what to expect from Anthem BCBS, Aetna, Medicare, and other major plans, plus deep dives on Virginia Medicaid and COVA and appealing a denial or paying cash. Supply has also been variable. Our team can help you understand your options, verify coverage, and—where appropriate—discuss financing so that cost is not the only factor in your decision. As with any medication, the right choice depends on your goals, health profile, and how the benefits weigh against the risks for you personally.

Next steps: schedule a medical weight-loss visit

If you are considering medication for weight management, the first step is a consultation to review your health history, goals, and the options best suited to you. For patients who need larger or more durable weight loss than medications alone deliver, Dr. Fitzer can also discuss gastric sleeve surgery (sleeve gastrectomy) as a complementary or alternative option. Our team provides comprehensive evaluation, prescribing, and long-term support. Contact our office to schedule an appointment.

Additional Reading

Read Dr. Fitzer's articles about weight-loss medications for more information.

• Weight Regain After Wegovy/Zepbound Treatment?—Part 3
• Weight Regain After Wegovy/Zepbound Treatment?—Part 2
• Weight Regain After Wegovy/Zepbound Treatment?—Part 1
• Will I Regain when I stop Wegovy/Zepbound?
• Wegovy vs. Surgery Outcomes