There are a few options, with variable results and side effect profiles. Following are the main weight loss drugs available to Australians
Oral:
- Phentermine/Duromine
- Qsymia (Low-dose phentermine + Topiramate)
- Contrave (Bupropion + naltrexone)
Injections:
- Saxenda (Liraglutide)
- Ozempic or Wegovy (Semaglutide)
- Mounjaro (Tirzepatide)
You may benefit from the use of one or more of these medicines. Many considerations come into play before deciding which of these would be the best choice for you. These considerations include, but are not limited to, your current weight/BMI, medical and surgical co-morbidities, personal and family history of cancers, your weight loss target.
Remember that:
When it comes to medicines, it cannot be one-size-fits-all!
There are certain contra-indications to the use of different medicines. Your doctor should assist you in deciding the best medicine for you.
Most medicines have to be used long term to keep the weight off. Hence consider the cost
Medicines (or other interventions) are no alternative to healthy eating habits and an active lifestyle.
Liraglutide (Saxenda), Semaglutide (Ozempic and Wegovy) and Tirzepatide (Mounjaro) are the newer class of weight loss drugs. In Australia only Saxenda is TGA (Therapeutic Goods Administration) approved for weight loss. However Ozempic/Wegovy and Mounjaro are available and are widely prescribed off-label.
Sexanda is a daily injection, while Ozempic and Mounjaro are once a week injection
General consensus is that Mounjaro induces most weight loss, followed by Ozempic and then Saxenda.
If someone has type 2 diabetes, ozempic works both for diabetes and weight loss, and hence is an obvious first choice.
These are costly drugs. They induce weight loss, but have to be taken long term to keep the weight off. Hence give a good consideration to the cost before starting on them.
Indigestion, nausea, vomiting, change in bowel habits are common side effects
More severe though uncommon side effect is acute pancreatitis.
People with a history of thyroid cancer (Medullary thyroid cancer) or an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), should not take these medicines.
Gall bladder or bile duct stones: This happens due to weight loss, and hence is linked to any form of weight loss therapy.
Obesity is a chronic disease, like type 2 diabetes and hypertension. This means it has to be managed life long. It is hence good to have different options available to you for fighting this fight long term. While deciding what option to chose first, remember the following general principles:
Class 1 Obesity (BMI 30-35) are much more likely to benefit from weight loss drugs or endoscopic intervention (Endoscopic Sleeve Gastroplasty) ALONE.
Higher BMIs (35 and above) need to lose more weight, and hence likely to need a more aggressive strategy. This can include either a weight loss surgery alone Or a combination of Endoscopic Sleeve Gastroplasty and weight loss drugs.
It is also quite reasonable and practical in many cases to use these treatments in a sequence.
Request an Appointment with Dr Fazal for a detailed consultation. He will recommend a weight loss plan that suits your circumstances best. You will need a referral letter from your GP