Weight Loss Medications

Weight loss medications used to be referred to as “Appetite Suppressants.” These days, the term weight loss medications is preferred; however, in medical circles, we are now referring to these treatments as “Anti-Obesity Medications,” or “AOMs.” Because obesity has been recognized as a chronic disease similar to diabetes or hypertension, we are using similar terminology. Just as one might be treated with an “anti-diabetic” or “anti-hypertensive,” one’s weight may be treated with an “anti-obesity” medication.

Which Weight Loss Medication Works Best For You?*

Phentermine, Tenuate (diethylpropion)

These medications have the benefit of nearly 60 years of clinical experience (Phentermine was approved in 1959), low cost, and are very effective. We generally use them first-line for these reasons. They have a mild stimulant effect (not too unlike caffeine), so unless directed otherwise, take first thing in the morning. Side effects may include: dry mouth, constipation, elevation in heart rate or blood pressure, agitation and insomnia. Most side effects are minor and resolve as your body gets used to the new medication; however, if you experience severe side effects, please discontinue your medication immediately and let us know. We typically avoid this class of medications in people with pre-existing heart disease or uncontrolled high blood pressure.

We recommend avoiding other stimulants (caffeine, Sudafed) while taking appetite suppressant medication.

Contrave® (bupropion er / naltrexone)

Contrave is a combination of 2 medications – bupropion and naltrexone. It works in two separate areas of the brain to control hunger and reduce cravings. Side effects may include suicidal thoughts and other neuro-psychiatric reactions, nausea, vomiting, headache, and insomnia. In a study called COR-BMOD, completers who engaged in intensive lifestyle intervention and stayed on Contrave for one year lost 11.5% of their starting body weight. Most side effects are mild and go away quickly. It can’t be used if you are on narcotic pain medications. It also can’t be used if you have a history of seizure, or risk factors for seizure (including anorexia or bulimia, heavy alcohol use). It can interact with narcotic pain medications (such as oxycodone / hydrocodone / etc.) It is approved for chronic use for appropriate adults age 18 and up.

Qsymia® (phentermine / topiramate er)

Qsymia is a combination of 2 medications – phentermine and topiramate. The EQUIP study showed that the average weight loss after 1 year of treatment with the maximum dose of Qsymia (15 mg phentermine / 92 mg topiramate) was 10.9%. The phentermine is at lower dose than what we typically use with the older forms of phentermine, and the topiramate is time-released. This gives very good appetite control – the phentermine through the first half of the day, then the topiramate during the second half of the day. Side effects can include numbness or tingling in the hands, arms, feet, or face (paraesthesia); dizziness; changes in the way foods taste or loss of taste (dysgeusia); trouble sleeping (insomnia); constipation; and dry mouth. This drug can cause birth defects if a woman becomes pregnant while taking it; therefore, if you are of childbearing potential, special counseling is needed to determine if this is a safe choice. It is approved for chronic use for appropriate individuals including teens down to age 12 with obesity.

GLP-1 Injectable Weight Loss Medications

Click here for information on the new GLP-1 medications including Wegovy, Zepbound, Saxenda, and Ozempic and Mounjaro.

Successful Life-Long Weight Loss is Possible!

For many patients losing weight or maintaining weight loss, controlling the diet can be difficult. After weight loss, people often find themselves constantly dwelling on what they should and shouldn’t eat, and after trying to restrict calories all day, overeat at night. Weight loss medications can be very helpful to keep the appetite at bay and improve your ability to stick to your healthy food plan.

*Weight Loss medications are not appropriate for all individuals and will be prescribed only if deemed an appropriate treatment option by Dr. Lazarus, Heather Thomas, PA-C or Jamie Shriver, PA-C. The purchase of prescription medications from us is completely optional – programs do not include the cost of medication. We stock many medications, but you are welcome to request a written prescription or have our providers e-prescribe to the pharmacy of your choice.

Our fees for Medications

(one month supply, as of 4/8/2024):

  • Stocked at CNC
    • Phentermine / diethylpropion (Tenuate) #28: $21 – $60
    • Contrave #120 (taken 2 tablets twice a day, 30 day supply): $126
    • Metformin 500 mg ER #60: $11 / month
    • Topiramate 25 or 50 mg, #60: $21 / month
    • Bupropion ER (Wellbutrin) #30: $31 – 41 / month
    • Naltrexone 50 mg #30: $31 / month
  • Not stocked at CNC – check with pharmacy / your insurance
    • Qsymia: available directly from the manufacturer.
    • Wegovy (semaglutide): check if you have coverage here.
    • Saxenda liraglutide): check if you have coverage here.
    • Zepbound (tirzepatide): read more about it here.
    • Mounjaro (tirzepatide): only approved for treatment of type-2 diabetes. Discuss coverage / cost with your insurance provider.
    • Ozempic (semaglutide): only approved for treatment of type-2 diabetes. Discuss coverage / cost with your insurance provider.
  • Not Recommended for use:
    • Compounded semaglutide / Compounded tirzepatide: consistent with guidance from the FDA, we do not recommend the use of compounded semaglutide or tirzepatide, as we are unable to verify the source ingredients. Further, we will not prescribe it, nor will we accept patients using compounded versions of semaglutide or compounded tirzepatide. See FDA warning here. See Obesity Medicine Association position statement here.