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How safe are weight loss drugs?

Weight loss drugs aren’t safe to use without medical supervision, and are generally prescribed to help in the treatment of specific medical conditions. 

8
 minutes read
Last updated on 
June 29, 2023
January 19, 2024
Person taking weight loss drugs
In this article

“Weight loss drugs” and diet culture 

Having a fixation on weight loss is one of the most dangerous aspects of diet culture. Encouraging people to focus on the numbers on a scale, instead of on their overall health and nutrition, can promote disordered eating behaviors. As can the promotion of taking a pill to lose weight.

Prescribing someone a drug for reasons other than its official approval is called prescribing something “off-label.” Some of the “weight loss drugs'' listed in this article would be “off-label” prescriptions – as their primary use is for treating conditions like diabetes, mental health disorders, and epilepsy – not for losing weight.1

 Nevertheless, the pharmaceutical industry has catered to this fixation on “weight loss” by getting Food and Drug Administration (FDA) approval for some of these drugs to be used specifically for weight loss. 

at the doctor's office

What are “weight loss drugs”?

“Weight loss drugs” are a class of medications that are designed to encourage a reduction in body weight. They achieve these results by altering fundamental biological processes dealing with energy absorption and appetite. 

Generally, these medications work by:1

  • Making you feel less hungry
  • Making you feel fuller, faster
  • Making it more difficult for your body to absorb fat from the foods you eat
  • Increasing your energy levels and internal temperature

 As a whole, drugs that decrease appetite are sometimes referred to as anorectics. But many of these medications are more commonly known by their brand names. These medications are not safe to use without medical supervision, and should not be used “off-label.”

what are weight loss rugs define graphic

Types of “weight loss drugs”

While the market is flooded with purported “weight loss pills”, very few of these drugs have actually been approved for weight loss by the FDA. Even fewer have been approved for long-term use.

 And in nearly all cases, even when a “weight loss drug” is prescribed by a doctor, medications are meant to supplement changes to diet and lifestyle.1

Bupropion
Diethylpropion
Metformin
Naltrexone
Orlistat
Phentermine
Semaglutide
Topiramate
Zonisamide
Tirzepatide

Side effects of “weight loss drugs”

In an open and loosely regulated diet supplement market, it’s possible for people to purchase any number of pills that claim to help them lose weight. These supplements can, in turn, have any number of health impacts, ranging from benign to potentially dangerous.

If you’re considering adding a weight loss supplement to your daily regimen, it’s important to speak with your doctor first, to determine any potential side effects, including if it interferes with any current medications you may be taking.

For FDA-approved “weight loss drugs,” some of the most common side effects include:2,3,4,5,6

  • Increased heart rate
  • Sleeplessness
  • Nervousness or increased anxiety levels
  • Constipation
  • Diarrhea
  • Loose or oily stool
  • Nausea
  • Vomiting
  • Gas or stomach pain
  • Dizziness
  • Dry mouth
  • Headache
  • Increased blood pressure
  • Liver damage
  • Insomnia
  • Headache
  • Fatigue
  • Depression or suicidal ideation

In general, any medication that increases energy levels, or suppresses appetite through amphetamines are tied to the potential of developing dependency.7 Those that inhibit fat absorption by and large change the quality of stool or frequency of bowel movements.  

The long list of potential effects is one of the reasons why it’s so important to speak with your doctor before using any type of medication to lose weight.

When are “weight loss drugs” prescribed? 

In a majority of cases, weight loss is a side effect of so-called “weight loss drugs,” rather than a desired outcome of the medication. Most patients should be prescribed these medications only for reasons related to their approved label.

Prescribing someone a drug for its “off-label” weight loss outcomes is a harmful part of diet culture. And while “off-label” use is a common and technically legal practice in modern medicine, the ethics behind it are questionable.

In all cases, health is an extremely personal, individual, and unique subject. If you’re struggling with certain health conditions, such as an eating disorder, it’s important to speak with a doctor and work together on both short- and long-term strategies that feel achievable and healthy.

But overall, it may be beneficial to focus on aspects of health outside of body weight. This can help promote not just a healthier lifestyle but an overall greater sense of wellbeing.

doctor consulting with patient

Overall safety of “weight loss drugs”

Drugs that are approved by the FDA are generally considered safe—for the treatments they’re approved for, not for their “off-label” weight loss outcomes. It’s possible for these drugs to be considered safe to treat some issues, but to be potentially problematic in other ways, especially for anyone struggling with an eating disorder. 

Nearly all “weight loss drugs” create this result as an unintended side-effect. Biologically and physiologically, they introduce certain elements into the body that aren’t needed for someone taking these prescriptions “off-label”. Aside from weight loss, this could lead to a cascade of other unintended effects.

It’s also possible for some so-called “weight loss drugs” to have potentially dangerous reactions when used alongside other prescription medications. For these reasons and more it’s crucial to discuss these choices with your doctor, and consider all possible angles of health when determining priorities.

What to remember about “weight loss drugs”

The prevailing idea of weight loss as a health solution has strong ties to the toxic beliefs of diet culture. It is, in fact, possible to achieve health at any size, so long as someone is eating foods that are healthy for their body and getting physical activity.

Remote treatment for eating disorders

Taking a more manageable approach to eating and finding joy in movement also have the added benefit of promoting better mental health, which is a crucial aspect of overall health. If an eating disorder is causing you to have challenges with your eating, exercise, or body image, know that help is available now at Within.

Call (866) 293-0041

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

Resources

  1. Apovian, C. M., Aronne, L. J., Bessesen, D. H., McDonnell, M. E., Murad, M. H., Pagotto, U., Ryan, D. H., & Still, C. D. (2015). Pharmacological management of Obesity: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, 100(2), 342–362. 
  2. Mayo Foundation for Medical Education and Research. (2022, June 29). Do any diabetes drugs help you lose weight? Mayo Clinic. Retrieved April 28, 2023.
  3. Mayo Foundation for Medical Education and Research. (2022, November 2). Phentermine weight-loss medicine: Know the side effects. Mayo Clinic. Retrieved April 28, 2023.
  4. U.S. National Library of Medicine. (n.d.). Phentermine and Topiramate: Medlineplus drug information. MedlinePlus. Retrieved April 28, 2023.
  5. Sherman, M. M., Ungureanu, S., & Rey, J. A. (2016). Naltrexone/Bupropion ER (Contrave): Newly Approved Treatment Option for Chronic Weight Management in Obese Adults. P & T : a peer-reviewed journal for formulary management, 41(3), 164–172.
  6. U.S. National Library of Medicine. (n.d.). Orlistat: Medlineplus Drug Information. MedlinePlus. Retrieved April 28, 2023.
  7. Moini, J., Koenitzer, J., & LoGalbo, A. (2021). Substance-related disorders. Global Emergency of Mental Disorders, 273–301. 
  8. National Center for Biotechnology Information. (n.d.). Retrieved April 28, 2023. 
  9. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Diethylpropion. [Updated 2018 Jan 3]. Retrieved April 28, 2023.
  10. Corcoran, C., Jacobs, T. F. (2022). Metformin. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 
  11. Fariba, K. A., Saadabadi, A. (2023). Topiramate. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
  12. Kadian, R., Kumar, A. (2022). Zonisamide. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.

FAQs

Further reading

Tirzepatide for weight loss (Mounjaro)

Tirzepatide (Mounjaro) was approved in 2022 by the Food and Drug Administration (FDA) for treating type 2...

Semaglutide for weight loss (Ozempic)

Semaglutide, also sold under the brand names Ozempic and Wegovy, is an injectable medication prescribed to...

Metformin for weight loss (Fortamet, Glumetza)

Metformin is a medication prescribed to treat type 2 diabetes by managing blood sugar levels. However...

Bupropion for weight loss (Wellbutrin, Zyban)

Bupropion, also sold under the brand names Zyban and Wellbutrin, is an antidepressant medication. It is...

Phentermine for weight loss (Adipex-P, Lomaira)

Phentermine is the generic name for the prescription drug sold under the brand names Adipex-P and Lomaira...

Orlistat for weight loss (Alli, Xenical)

Orlistat, is a medication sold under the brand names Alli and Xenical that is available over the counter...

Topiramate for weight loss (Topamax)

Topiramate, also sold under the brand name Topamax, is a prescription anticonvulsant medication used to...

Naltrexone for weight loss (Revia, Vivitrol)

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Further reading

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