For many people struggling to lose weight, weight loss medications seem to be a simple way to “melt off” the pounds. Unfortunately, the evidence shows this is not the case. Current diet medications reduce appetite, but do not eliminate the need for diet and exercise. People usually only lose a modest amount of weight and the weight loss stops after several months. Maintaining the weight loss is often impossible without continuing the diet medication. Like all medications, diet medications have significant side effects. The new diet medications can also have a huge cost per pound lost. Four examples are list below. Costs listed are retail prices in the Peoria area. Average weight loss and the time for weight loss to stop are estimated from the medication’s package insert:

Qsymia is a combination drug with phentermine and topiramate that costs $195 per month.

*   Cost to lose 14 pounds more than placebo over 10 months – $1,950 dollars.

• Cost to take for a year – $2,340.
• Side effects: numbness, headaches and constipation

Contrave is a combination drug with bupropion, an antidepressant, with naltrexone, a drug used to treat narcotic overdoses costing $210 per month.

• Cost to lose 7 ½ pounds more than placebo over seven months – $1,470
• Cost to take for a year – $2,520
• Side effects: nausea, vomiting and headache

Liraglutide (Saxenda) reduces appetite in the brain and delays emptying of the stomach that costs $1,100 per month.

• Cost to lose 10 pounds more than placebo over nine months – $9,900
• Cost to take for a year – $13,200
• Side effects: nausea and diarrhea

Alli (orlistat) blocks the absorption of fat in the intestines and costs $80 per month.

• Cost to lose 10 ½ more pounds than a placebo over one year – $960
• With continued use, most people gain one-third of the weight back after a year.
• Side effects: abdominal pain, cramps and greasy diarrhea. Also reduced absorption of vitamins A, D, E and beta-carotene.

All of these weight loss medications work better than a placebo, but none is ideal. Weight loss is modest and all have side effects. The monthly cost is unaffordable for most people to pay the full cost without insurance. It is still best to lose weight the “old fashion way” using diet and exercise.

Selected References

1. http://www.goodrx.com/weight-loss (Basic information and local medication prices.)
2. https://contravehcp.com/ (Contrave web site for health professionals.)
3. http://www.gene.com/download/pdf/xenical_prescribing.pdf (Xenical prescribing information)
4. https://qsymia.com/hcp/include/media/pdf/prescribing-information.pdf (Osymia prescribing information)
5. http://www.novo-pi.com/saxenda.pdf (Saxenda prescribing information)