The latest data shows that 73% of adults in the U.S. are overweight or obese, and nearly half are actively trying to lose weight. For many women—especially those in their 40s, 50s, and beyond—losing weight and keeping it off feels like an uphill battle. Even with the best intentions, making healthy lifestyle changes and sustaining them over time can be incredibly challenging.
Choosing nutrient-dense foods, practicing mindful eating, and increasing physical activity are powerful steps toward healing. In fact, losing just 5–10% of your body weight can lead to meaningful improvements in blood sugar, blood pressure, and triglycerides. But what happens when you’ve made these changes and the scale still won’t budge—or worse, the weight comes back?
That’s where prescription weight loss medication may enter the conversation. The FDA has approved several weight loss drugs for long-term use, often referred to as anti-obesity medications (AOMs). These medications, including options like Semaglutide for weight loss, are designed to be used alongside sustainable lifestyle changes—not as a standalone fix. When used appropriately, they can offer a helpful boost, but they’re not a magic solution.
Most prescription weight loss medications require a doctor’s approval and are typically recommended for individuals who have already attempted to lose weight through nutrition and physical activity. To qualify, a person generally needs to have a BMI of 30 or higher, or a BMI of 27 or higher along with a related health condition—such as type 2 diabetes or high blood pressure—where losing additional weight would significantly benefit their health.
These anti-obesity medications are designed to support ongoing lifestyle changes, not replace them. When used as part of a comprehensive wellness plan, they can enhance weight loss by an additional 3–12% compared to lifestyle changes alone. However, they’re not recommended for women who are pregnant, breastfeeding, or trying to conceive.
In this article, we’ll cover the key basics of using weight loss drugs—including how they work, their potential side effects, and important nutrition strategies that can support both your results and your overall well-being while taking them.
What Are Weight Loss Drugs and How Do They Work?
There are several types of long-term weight loss drugs (also called anti-obesity medications) available today. But here’s the truth: there’s no one-size-fits-all option. What works well for one person might not be effective for another. That’s why it’s important to start with an open, personalized conversation with your doctor.
Your provider will consider your current health status, family history, any medications or supplements you’re currently taking, and the potential costs and side effects of each medication. Together, you can determine the best path forward for your body and goals.
The Obesity Medicine Association emphasizes that prescription weight loss medications are most effective when combined with a healthy eating plan and regular movement. These medications work in a few different ways—most of them help by:
- Reducing hunger
- Helping you feel full sooner
- Minimizing food cravings
They do this by interacting with your body’s natural systems—including hormones like leptin and ghrelin, neurotransmitters such as GABA and serotonin, and peptides like GLP-1, which is found in the gut, brain, and fat tissue.
This strategy supports sustainable weight loss by making it easier to eat fewer calories—without relying on willpower alone.
One medication, Orlistat, works a bit differently. Instead of affecting appetite, it alters how your body absorbs dietary fat in the digestive tract.
Semaglutide, Tirzepatide, and Liraglutide
Two of the most talked-about prescription weight loss medications right now are Semaglutide and Tirzepatide—both given as weekly injections. Semaglutide is a GLP-1 receptor agonist, and Tirzepatide is a dual GLP-1 and GIP receptor agonist. These medications work by targeting specific areas of the brain that regulate appetite and food intake, helping you feel satisfied with less food.
Because they can cause digestive side effects like nausea, bloating, or constipation—along with occasional headaches or fatigue—these medications start at a low dose that gradually increases over 16 to 20 weeks. This slow progression allows the body time to adjust and helps minimize discomfort.
Liraglutide is another GLP-1 medication, but it’s taken as a daily injection. It supports weight loss by acting on gut hormones, helping you feel fuller, faster, while also reducing hunger signals.
Naltrexone-Bupropion
This oral medication is a combination of two drugs: bupropion, an antidepressant that can aid weight loss, and naltrexone, which is commonly used to treat alcohol and drug dependence. When taken together, they affect the brain’s pleasure-reward system, helping reduce cravings and promote early fullness and appetite control.
Phentermine and Phentermine-Topiramate
Phentermine is one of the oldest and most widely used anti-obesity medications available. It’s taken in pill form and works by suppressing appetite. When paired with topiramate—a medication used for seizures and migraines—the two can have a synergistic effect to further reduce hunger and cravings.
Setmelanotide
While not commonly prescribed, Setmelanotide is worth mentioning because it’s designed for people with rare genetic conditions that impact weight, such as POMC deficiency, PCSK1 deficiency, or leptin receptor deficiency. This daily injection helps regulate hunger signals and may increase the number of calories burned at rest. It’s not used for general weight loss but can be a powerful tool for those with specific genetic challenges.
Orlistat
Orlistat stands apart from the other long-term weight loss medications. It’s available both by prescription and in a lower-dose, over-the-counter version. Rather than working on the brain or appetite centers like most other medications, Orlistat works directly in the digestive system.
Taken as a capsule with meals, Orlistat helps reduce the amount of dietary fat your body absorbs—by about 30 percent. It does this by blocking the enzymes responsible for breaking down fats in food. As a result, some of the fat you eat isn’t digested or absorbed and instead passes through the digestive tract and is excreted.
Because of how it works, Orlistat may cause gastrointestinal side effects like oily stools or more frequent bowel movements, especially if high-fat meals are consumed. This is why it’s important to pair this medication with a nutrient-dense, lower-fat diet for both comfort and effectiveness.
What are some common side effects of weight loss medications?
While these medications are considered safe when used as directed, there are still some potential side effects to be aware of (6). The good news is that most side effects tend to be mild and often improve or resolve with continued use (4).
The most common side effects are digestive in nature—nausea, constipation, and diarrhea are frequently reported (7,8). Others may experience dry mouth, abdominal discomfort, vomiting, headaches, dizziness, nervousness, insomnia, or fatigue (5,7,8). As with any medication, there’s a small risk of more serious side effects, so it’s important to keep open communication with your healthcare provider (7).
Orlistat, in particular, may lead to abdominal pain, loose stools, and increased gas, as the unabsorbed fat continues through the digestive system without being broken down (4,7). These symptoms are more common when meals are high in fat.
Another important consideration is the potential for regaining weight after stopping these medications (4,5,7,8). This is a normal metabolic response to weight loss, whether that weight was lost with or without the help of medications (5). A slowing of the resting metabolic rate and shifts in hunger and fullness hormones can both contribute. According to the Mayo Clinic, maintaining healthy lifestyle habits like nutritious eating and regular movement can help minimize post-medication weight gain (7).
What nutrition advice should you know when taking weight loss medications?
The most important factor when taking weight loss medications is to maintain a nutritious eating plan. These medications are meant to support weight loss efforts, but they won’t work effectively if they’re not paired with a healthy diet. Your goal should be to consume the right balance of nutrients and eat the optimal quantities of food to support your body’s needs during the weight loss process (7).
Avoid jumping into weight loss programs that promise extreme results or rely on unsustainable practices. Healthy, gradual weight loss is more sustainable and effective in the long run (1). It’s best to focus on nutrient-dense, whole foods that nourish your body while promoting fat loss and supporting overall health. Working with a registered dietitian or nutritionist may help ensure you’re meeting your dietary needs during this journey.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, a safe and successful weight loss program includes 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 maintaining the weight loss (1).
The goal of any effective weight loss program is to establish realistic weight loss goals, promote healthy long-term behaviors, and provide tools for tracking progress and overcoming obstacles (1). Ideally, all of these elements would be personalized to your unique needs and situation by a licensed nutrition professional such as a registered dietitian or certified nutritionist. These experts are equipped to guide you through each stage of your weight loss journey and ensure that the strategies you’re using are both effective and sustainable.
While there is no one-size-fits-all weight loss program, there are several important nutritional guidelines to keep in mind when working toward your weight loss goals:
- A realistic weight loss target is to aim for about one pound per week (9).
- Focus on nutrient-dense, filling, and fiber-rich foods, such as fruits, vegetables, and whole grains (9).
- When consuming meat and dairy, opt for leaner cuts and lower-fat options (9).
- Minimize consumption of less nutritious foods like fried foods or those high in sugar or salt (8,9).
- Monitor portion sizes to avoid overeating (8,9).
- Choose water as your main beverage (9).
- Increase the amount of physical activity you engage in on a regular basis (9).
Nutrition Considerations When Taking Orlistat
Because orlistat works by inhibiting the digestion and absorption of fats, there are additional nutrition recommendations to consider.
- Reducing fat absorption can also lower the absorption of fat-soluble vitamins and minerals. It’s important to consult with your healthcare provider about potentially adding a multivitamin or other supplement to your routine (8).
- To reduce common gastrointestinal side effects, such as abdominal discomfort, pairing orlistat with a lower-fat diet can be beneficial (5).
Final Thoughts
According to the Mayo Clinic, “Weight-loss drugs aren’t an easy answer to weight loss. But they may help you make the lifestyle changes that you need to practice to lose weight and improve your health” (7).
If you’re looking to make lifestyle changes that can lead to sustainable weight loss, whether with or without weight loss/anti-obesity medications, we can help. As certified nutrition professionals, we’d love to guide you through the process of creating a customized plan that fits your needs and goals.
At Wholesome Health, we specialize in creating personalized nutrition plans that align with your weight loss goals, whether you’re using medication or focusing on natural, sustainable lifestyle changes.
Our goal is to support your health every step of the way—helping you make informed decisions, nourish your body with the right nutrients, and address any underlying issues that may be affecting your progress. If you’re ready to take control of your health and transform your weight loss journey, book a consultation with us today. Together, we’ll find the best path forward to help you achieve lasting success.
If you’re ready to take the next step in your weight loss journey, visit our Weight Loss Services page to learn more about how we can support you with personalized plans and guidance.
References
- 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. Retrieved January 14, 2025, from https://www.niddk.nih.gov/health-information/weight-management/choosing-a-safe-successful-weight-loss-program
- National Center for Health Statistics. (2018, July 12). Attempts to lose weight among adults in the United States, 2013–2016. Centers for Disease Control and Prevention. Retrieved January 14, 2025, from https://www.cdc.gov/nchs/products/databriefs/db313.htm
- Mayo Clinic. (2023, November 1). Weight loss basics. Retrieved January 14, 2025, from https://www.mayoclinic.org/healthy-lifestyle/weight-loss/basics/weightloss-basics/hlv-20049483
- National Institute of Diabetes and Digestive and Kidney Diseases. (2024, June). Prescription medications to treat overweight & obesity. U.S. Department of Health and Human Services, National Institutes of Health. Retrieved January 14, 2025, from https://www.niddk.nih.gov/health-information/weight-management/prescription-medications-treat-overweight-obesity
- Obesity Medicine Association. (2024, January 26). Top weight loss medications. Retrieved January 14, 2025, from https://obesitymedicine.org/blog/weight-loss-medications/
- Cleveland CliniTop Weight Loss Medications | Obesity Medicine Associationc. (2023, November 20). Appetite suppressants. Retrieved January 14, 2025, from https://my.clevelandclinic.org/health/treatments/9463-appetite-suppressants
- Mayo Clinic. (2022, October 29). Prescription weight-loss drugs. Retrieved January 14, 2025, from https://www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/weight-loss-drugs/art-20044832
- Medline Plus. (2023, July 8). Weight-loss medicines. U.S. Department of Health and Human Services, National Institutes of Health. Retrieved January 14, 2025, from https://medlineplus.gov/ency/patientinstructions/000346.htm
- Johns Hopkins Medicine. (n.d.). Medical nutrition therapy for weight loss. Retrieved January 14, 2025, from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/medical-nutrition-therapy-for-weight-loss