Anti-Obesity Medications: Hear from a Bariatric Expert

Article By: Rachel Ignomirello, MS, RDN, CSOWM, LDN

Rachel Ignomirello is a Bariatric Dietitian and Board-Certified Specialist in Obesity and Weight Management.

Managing obesity is a unique journey for everyone, and Anti-Obesity Medications (AOMs) can be a key part of this strategy for many. With advancements in this field, new options like Zepbound have emerged, enhancing the FDA-approved medication arsenal. This blog aims to illuminate these medications, their workings, differences, and roles in weight management.

1) Understanding anti-obesity medications. AOMs are designed for individuals struggling with obesity or overweight issues, particularly when other weight loss methods haven't been successful. Generally, they are prescribed to:

• Adults with a Body Mass Index (BMI) of 30 or higher (obesity).

• Adults with a BMI of 27 or higher (overweight) who also have weight-related health problems such as high blood pressure, type 2 diabetes, or high cholesterol.

AOMs aid in weight loss through mechanisms like reducing appetite, increasing fullness, or decreasing fat absorption. These medications are part of a broader weight management plan that includes diet, exercise, and lifestyle changes. It's essential to consult with a healthcare professional to determine if AOMs are suitable for your specific health needs and goals.

2) A look at FDA-approved medications.

• Orlistat (Xenical, Alli): Inhibits fat absorption. Taken as a pill with meals.

• Phentermine (Adipex-P, Lomaira): Suppresses appetite. Administered as a daily pill.

• Bupropion-naltrexone (Contrave): Decreases appetite. Taken as a pill, usually twice a day.

• Liraglutide (Saxenda): Controls blood sugar and appetite. Administered as a daily injection.

• Semaglutide (Wegovy): Regulates appetite, initially indicated for diabetes as Ozempic. Taken as a weekly injection.

3) Zepbound: A promising new option in weight management. Zepbound, the brand name for tirzepatide, marks a significant advancement in AOMs. Initially approved by the FDA in May 2022 as Mounjaro for type 2 diabetes, tirzepatide received subsequent approval for weight loss as Zepbound in November 2023.

This dual-agonist medication activates both GIP and GLP-1 hormone receptors, enhancing glucose control and prolonging satiety. It’s administered as a once-a-week pen injection, offering convenience and ease of use. Clinical trials have shown remarkable results, with patients losing an average of 26% body weight over 88 weeks, surpassing the weight loss achieved with semaglutide.

4) Bariatrics & anti-obesity medications. The evolving landscape of AOMs brings enhanced options for managing weight, crucial in both preoperative and postoperative bariatric care. Selecting the right AOM requires healthcare professionals to carefully consider medical history, health goals, medication interactions, and safety warnings.

Currently, the primary challenges in accessing AOMs include production limitations, cost, and insurance coverage. Despite these hurdles, AOMs remain an integral component of a comprehensive weight management strategy, which should encompass lifestyle changes and, if applicable, integration with bariatric surgery.

BariMelts provides general recommendations, not to be construed as medical advice. Please consult your doctor.