Written and medically reviewed by Dorcas Morak, Pharm.DYou should be proud of your body regardless of its size, shape, and height. But there may be some reasons you'd like to lose weight, from a personal goal of reaching a certain fitness level to a health issue your doctor has advised you about. While lifestyle modification is a good approach to weight loss, you might want to consider weight loss drugs, especially if you typically struggle to lose weight. The majority of Americans with obesity cannot achieve sustained weight loss through diet and exercise alone.
The Institute for Clinical and Economic Review (ICER) has published a final report on medications prescribed for obesity management. The goal is not only to develop safe and effective medications to treat obesity but also to ensure the price of those medications aligns with their benefits.
Obesity in the United States 101
- It is a major public health challenge.
- 37% of adults are classified as obese.
- The prevalence of obesity has increased by 75% since 1980.
- About 50% of US adults will be obese by 2030.
- About 15 million Americans have a BMI of at least 40 kg/m2.
- It is the second-leading cause of preventable deaths after smoking.
- It increases the risk for chronic medical conditions including type 2 diabetes, heart disease, etc.
When are medications recommended as a treatment for obesity?
Guidelines recommend that all weight loss programs include lifestyle modification that includes a low-calorie diet, increased physical activity, and behavioral therapy, to which drug therapy may later be added. Drug therapy is indicated for patients with a body mass index (BMI) of at least 30kg/m2 or a BMI of at least 27 kg/m2 with obesity-related comorbidities.
What types of drugs are prescribed for obesity?
Obesity medications are classified as those for short-term and long-term use. An example of short-term use obesity medication is phentermine. Long-term use medications include orlistat, lorcaserin, naltrexone-bupropion, and liraglutide.
What weight loss medications are approved by the FDA?
Current weight loss medications with FDA approval include:
- benzphetamine - lowers appetite
- phentermine (Lomaira)- lowers appetite
- orlistat (Alli) - prevents fat absorption
- phentermine/topiramate (Qsymia) - lowers appetite
- naltrexone/bupropion (Contrave) - lowers appetite
- phendimetrazine (Stabec -1) - lowers appetite
- diethylpropion (Tenuate Dospan) - lowers appetite
- semaglutide (Wegovy) - lowers food intake and appetite
- setmelanotide (Imcivree) - lowers food intake and appetite
- liraglutide (Saxenda) - lowers appetite
Are weight-loss medications effective?
Is semiglutide (Wegovy) a cost-effective weight loss medication?
No. Both phentermine/topiramate and bupropion/naltrexone meet the cost-effectiveness threshold when compared with lifestyle modification alone. But semaglutide does not meet the cost-effectiveness threshold when used to treat obesity in a non-diabetes patient. It is still more effective, and more cost-effective however than liraglutide.
Semaglutide's ICER projected annual net price of $13,618 is higher than the ICER Health-Benefit Price Benchmark (HBPB) range of $7,500 to $9,800. Additionally, the estimated net price of liraglutide is $11,760, which is higher than the HBPB price range of $3,800 to $4,800.
How do I choose the best weight-loss medication?
The best medications for weight loss depend on many factors such as adverse reactions, drug interactions, cost-effectiveness, abuse, misuse, and overdose potential. Work with your doctor to decide the best treatment plan for your personal circumstance.