Weight-loss Medications to Help

Medication options for obesity have advanced significantly in recent years. In this episode, we cover the key principles of pharmacotherapy, its possibilities and limitations. You will learn why medication is not a miracle cure but can serve as important support for individualized lifestyle changes. We present the core pillars of pharmacotherapy and review different obesity management medication options:

Mysimba (naltrexone/bupropion): An oral combination medication that affects the brain’s reward system and curbs appetite.

Saxenda (liraglutide): An injectable GLP-1 analogue that increases feelings of fullness.

Wegovy (semaglutide): An injectable GLP-1 analogue that regulates appetite and increases satiety.

Mounjaro (tirzepatide): The newest injectable GLP-1/GIP analogue, which affects appetite and blood glucose control.

Qsiva/Qsymia (phentermine/topiramate): A capsule-based combination medication that influences both appetite and metabolism.

Orlistat: Prevents the absorption of fats from food. Also available without a prescription.

Combining medication with lifestyle changes is the cornerstone of successful weight management. This episode focuses on how the effects of medication can best support lifestyle change. We discuss practical examples of effective combined approaches and examine why the medication’s effect is assessed regularly at 12–16 weeks. We also explain why adequate follow-up and support from a healthcare professional are crucial to successful weight-loss pharmacotherapy.

The effectiveness of medication becomes evident when combined with individualized and realistic lifestyle changes. In this episode, we delve into which lifestyle adjustments best support the effects of medication. In lifestyle change, it is essential to know which factors matter most so you can focus on the essentials. In obesity lifestyle treatment, attention too often goes to factors with limited impact on weight (e.g., fat or sugar content of foods), while truly central issues (e.g., stress or meal timing) are overlooked. The most important weight-influencing factors most people should work on are:

1) Improving your own stamina and resilience (e.g., stress management, sleep) – would you rate your energy at least 7/10?

2) Sufficient eating earlier in the day – is your breakfast truly adequate? And your lunch? If you tend to snack in the evenings or have strong cravings during the day, you are likely not eating enough.

3) About one kilogram of vegetables per day – do you eat nearly a kilo of vegetables daily, in a way that is easy to maintain for years?

4) Adequate protein intake – is your protein intake about 1.5 g per kilogram of body weight, or at least 1 g/kg if your weight exceeds 100 kg?

5) Sufficient activity – does your activity fall below 6,000 “steps”?

Various challenges may arise during medication. In this episode, we focus especially on medication-related challenges and their solutions:

• How to manage nausea or other adverse effects?

• Preventing constipation with orlistat.

• How to respond if weight loss slows down?

• Hunger and cravings during medication.

• When to evaluate the medication’s effectiveness and decide on continuation?

• When have lifestyle skills been practiced enough?

Discontinuing medication requires planning. In this episode, we focus on how to ensure the maintenance of results achieved. The video covers common challenges when stopping medications, such as the return of cravings and hunger, and provides concrete methods for maintaining lifestyle habits after medication has ended.

It is essential to prepare for ending medication, and good preparation is based on two principles:

1) Start practicing lifestyle skills during medication

2) Do not assume lifestyle habits are fully learned during medication—the end of treatment is a new phase in learning weight management, and lifestyle practice continues for some time after medication ends