The latest numbers show that 73 percent of adults in the U.S. are overweight or obese, and almost half are struggling to lose weight and keep it off (1,2). It’s about as easy as running a marathon in high heels—not that running one in sneakers is a breeze either 🙃, but you get the point! Making those healthy lifestyle changes and sticking with them through busy weeks, celebratory weekends, and endless holidays can feel impossible (3). For many, a balanced diet and regular exercise aren’t enough to combat the complex cocktail of genetics, hormones, and stress contributing to weight gain. This is where weight loss medications can lend a hand. But let’s be clear: these aren’t magic pills. Nutrition still plays a starring role in your weight loss journey.

In this blog, we’re not just sharing the essential nutrition strategies to help you succeed with weight loss medications—we’re also breaking down what medications are available, how they work, and how to use them effectively. Whether you’re curious about the options or already exploring a treatment plan, this post guides you toward sustainable, long-term results (and maybe even makes the journey a little easier!).

Choosing nutrient-packed foods in the right portions and moving your body more are smart choices for boosting your physical and mental health! Losing just 5-10 percent of your weight can lower triglycerides, blood pressure, and blood sugar levels (4). However, even after adopting a healthier lifestyle, some may need or want additional help to reach their weight loss goals (3).

The good news? The FDA has approved several medications for long-term use, with many more in the pipeline. These medications, often referred to as “anti-obesity medications” (AOMs), are designed to provide that extra help. (5) However, they work best when paired with healthy eating habits and regular physical activity to support both short- and long-term results (3,4,5,6).

Most of these weight loss medications require a prescription from your doctor. They’re typically for individuals who have already tried to lose weight through diet and exercise but either have a BMI of 30 or higher or a BMI of at least 27 with an added health concern—like diabetes or high blood pressure—where losing weight could bring significant health benefits (5,7). Think of them as a supportive tool that boosts those who could use extra help—not a shortcut, but part of a well-rounded weight loss plan.

These medications aim to help manage weight while eating a nutritious diet and doing regular physical activity (7). Combining one of these drugs with a healthy lifestyle will help to boost weight loss by 3-12 percent more than diet and lifestyle changes alone (4,7). They are not recommended for anyone pregnant, breastfeeding, or trying to get pregnant (7).

In this blog, we’ll cover the pros and cons of these medications, including their benefits, how they work, potential side effects, and the essential nutrition strategies you need to know for success.

What are the weight loss drugs, and how do they work?

A wide range of long-term weight loss medications are available (5). But here’s the deal: there’s no magic, one-size-fits-all solution. Finding the right fit can feel like trial and error—it’s hard to predict which medication will work best for you or how effective it’ll be (5). So, what’s the best first step? Have an open conversation with your physician. Together, you can weigh all the factors (no pun intended 😉)—your current health, any medications or supplements you’re taking, your family history, plus the cost and possible side effects of each option (4,5). From there, you and your doctor can create a plan that suits your unique needs. (And yes, I’m always here to chat through things with you, too!)

According to the Obesity Medicine Association, “All weight loss medications work best in the context of a healthy eating plan and exercise” (5).  In other words, these meds don’t work alone—they need a little teamwork! Most help by making you feel less hungry, fuller faster, and less tempted by those tricky cravings (5,7). They do this by working with your body’s natural systems, like hormones (think leptin and ghrelin, as discussed here), neurotransmitters (like GABA and serotonin), and peptides (like GLP-1) found in your brain, digestive system, and even fat tissue (5,6).

The current weight loss medications

Semaglutide (Ozempic®) and Tirzepatide (Mounjaro®  for diabetes treatment, and Zepbound® for weight loss) are weekly injections of what’s known as “GLP-1 and GIP receptor agonists” (4,5). These medications target areas in the brain that help control appetite and food intake (4,5). You’ll start on a low dose, gradually increasing over 16-20 weeks (5). Why the slow start? It helps reduce potential side effects like digestive issues, headaches, dizziness, and fatigue—keeping things as comfortable as possible while your body adjusts (5).

Setmelanotide (Imcivree®) is a daily injection designed for individuals with rare genetic conditions, such as pro-opiomelanocortin deficiency, proprotein subtilisin-kexin type 1 deficiency, or leptin receptor deficiency (7). While it doesn’t address the genetic root of these conditions, setmelanotide can support weight loss by helping people feel fuller, reducing appetite, and even nudging the body to burn more calories at rest (7).

Orlistat (Alli® and Xenical®) stands out from the other long-term weight loss meds. It’s available by prescription, but you can find a lower-strength over-the-counter version (7). Orlistat capsules are taken with meals and work by blocking around 30 percent of the fat you eat from being broken down and absorbed (8). How? It prevents the enzymes responsible for digesting fat from doing their job (5). This means those fat calories continue through your digestive system, eventually exiting quickly! 

Liraglutide (Victoza®) is a daily injection that works with gut hormones to help you feel fuller and less hungry—think of it as a little extra support against snack-time temptations (5).

Bupropion-naltrexone (Contrave®) combines an antidepressant (which helps with weight loss) and an opioid blocker (often used for addiction). Together, they work to dial down cravings and keep you feeling satisfied—making that second cookie easier to resist (4,5).🍪

Phentermine and phentermine-topiramate (Qsymia®) are classic appetite suppressants. Phentermine has been around for ages and cuts hunger on its own, but pairing it with topiramate (also used for migraines and seizures) adds an extra layer of “no thanks” to cravings (5).

What are some common side effects of weight loss medications?

While these medications are safe when used as directed, they can come with a few quirks. Thankfully, most side effects are mild and tend to improve over time. Digestive issues like nausea, constipation, and diarrhea are the usual suspects. Some people may also experience dry mouth, a few stomach grumbles, or the occasional headache or dizzy spell (4,5,7,8). For Orlistat, which blocks fat absorption, the side effects mostly stay in the digestive zone—think gas, loose stools, and perhaps a bit more quality time in the bathroom (4,7).

Once you stop taking these meds, some weight regain is common—your body’s metabolism loves a comeback.🥺 The Mayo Clinic suggests that sticking to healthy habits, like balanced eating and regular activity, can help keep things steady (7). I always recommend a weekly weigh-in to my clients. It’s a simple way to stay on track and determine if adjustments are needed. 

Staying in touch with your doctor while using these meds is essential. Regular check-ins allow you to share your progress, chat about any delightful 🙃 side effects, and plan the next steps together. These conversations help determine if the medication is working for you, whether it’s time for a switch or when to stop (7).

So, What Are The Essential Nutrition Tips for Weight Loss Meds?

When taking these weight-loss medications, the most important thing to consider is sticking to a healthful, nutrient-rich diet. 🌱 This means ensuring you get all the essential nutrients and eating in a way that supports your weight-loss goals. It’s definitely not the time for fad diets making wild promises (1) or for cutting out entire food groups. Balance is key! 

According to the National Institute of Diabetes and Digestive and Kidney Diseases, a safe and successful weight loss program should include “a healthy, reduced-calorie eating and drinking plan, a plan for increasing physical activity if appropriate, guidance and support for adopting these lifestyle habits, and a plan for keeping the weight off” (1). 

An effective weight-loss program sets realistic goals, encourages healthy long-term habits, and offers strategies to track progress and tackle obstacles (1). Ideally, these elements should be customized to your unique needs by a healthcare professional, like a registered dietitian nutritionist (yep, that’s me!).🤗

While there’s no one-size-fits-all approach to weight loss, there are some vital nutritional guidelines to keep in mind as you work toward your goals:

The Essential Nutrition Tips

• Aim for a realistic weight-loss goal of about one pound per week (9).
• Focus on highly nutritious, filling, fiber-rich foods like fruits, vegetables, and whole grains (9).
• Choose lean, lower-fat proteins; if your appetite is reduced, eat your protein first (9).
• Minimize less nutritious foods, like fried items or those high in sugar or salt (8, 9).
• Keep portion sizes in check (8, 9).
• Make water your go-to beverage (9).
• Increase your regular physical activity. Consistency with strength and weight training is a must! 🏋🏽 Some of my clients have noticed feeling less motivated at times while on weight-loss medications, but preserving and building muscle is crucial—not just for short-term weight loss but also for maintaining your progress in the long run.

For those using Orlistat, here are a few additional nutrition tips:

• Since orlistat reduces fat absorption, it can also decrease the absorption of essential vitamins and minerals. Talk to your healthcare provider about adding a multivitamin or supplement to your routine (8).
• Pairing orlistat with a lower-fat diet can help reduce gastrointestinal side effects (5).

Bottom Line

According to the Mayo Clinic, “Weight-loss drugs are NOT an easy answer to weight loss. But they may help you make the lifestyle changes you need to practice to lose weight and improve your health” (7).

And a few quotes from my clients: “It feels like a new start for me. I feel so much stronger, mentally.” “It silences all that food noise in my head, telling me to eat all the time.” “I never thought I would see these numbers again.” ❤️

Obesity is not a choice—it’s a complex and challenging condition to manage. However, the benefits are substantial when you find success, whether through lifestyle changes, weight-loss medications, or a combination of both. You can reduce your risk for diabetes and heart disease, lower blood pressure, and enjoy increased daily energy.

Managing obesity requires a multifaceted approach. Prescription appetite suppressants may be one piece of the puzzle. Still, having an open, thorough discussion with your healthcare providers is vital to ensure these medications are the right—and safe—option for you. Don’t hesitate to ask questions; your provider is there to guide and support you every step of the way.

And guess what? So am I! Whether it’s navigating your nutrition alongside a new medication, crafting a meal plan that fits your lifestyle, or making sustainable changes for long-term weight loss, I’m here to help make the process less overwhelming and more empowering. Together, we’ll create a strategy tailored to your unique needs, setting you up for lasting success. As a registered dietitian and health coach always in the trenches with you, I’d love to support you on this journey.  🗓️ Book an appointment today to see how my services can help you reach your goals!

References

1. National Institute of Diabetes and Digestive and Kidney Diseases. (2024, February). Choosing a Safe & Successful Weight-loss Program. U.S. Department of Health and Human Services, National Institutes of Health. https://www.niddk.nih.gov/health-information/weight-management/choosing-a-safe-successful-weight-loss-program

2. National Center for Health Statistics. (2018, July). Attempts to Lose Weight Among Adults in the United States, 2013–2016. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/products/databriefs/db313.htm

3. Mayo Clinic (2023, November 1). Weight loss basics. https://www.mayoclinic.org/healthy-lifestyle/weight-loss/basics/weightloss-basics/hlv-20049483

4. National Institute of Diabetes and Digestive and Kidney Diseases. (2023, March). Prescription Medications to Treat Overweight & Obesity. U.S. Department of Health and Human Services, National Institutes of Health. https://www.niddk.nih.gov/health-information/weight-management/prescription-medications-treat-overweight-obesity

5. Obesity Medicine. (2024, January 26). Top Weight Loss Medications. https://obesitymedicine.org/blog/weight-loss-medications/

6. Cleveland Clinic. (2023, November 20). Appetite Suppressants. https://my.clevelandclinic.org/health/treatments/9463-appetite-suppressants

7. Mayo Clinic. (2022, October 29). Prescription weight-loss drugs. https://www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/weight-loss-drugs/art-20044832

8. Medline Plus. (2023, July 8) Weight-loss medicines. U.S. Department of Health and Human Services, National Institutes of Health. https://medlineplus.gov/ency/patientinstructions/000346.htm
9. Johns Hopkins Medicine. (n.d.). Medical Nutrition Therapy for Weight Loss. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/medical-nutrition-therapy-for-weight-loss