Hormonal
Phentermine/topiramate and naltrexone/bupropion are effective alternative pharmacotherapies for weight loss (4-10%) in patients without cardiovascular contraindications, offering oral administration options.
If you cannot take or afford weekly injections, oral medications like phentermine/topiramate or naltrexone/bupropion are effective alternatives. They typically result in 4-10% weight loss. Side effects like nausea or insomnia are common but often improve over time, especially if you start with a low dose and increase slowly. These are not suitable if you have heart disease, high blood pressure, or a history of seizures.
Phentermine/topiramate (7.5/46 mg or 15/92 mg) results in an estimated 8–10 kg bodyweight loss in 12 months... Naltrexone/bupropion resulted in approximately 5–8% weight loss
Why this rating
Based on RCTs cited, but side effects limit long-term adherence.
Source
Pharmacotherapy for the management of overweight and obesity?
Patrice M. Forner et al. · Australian Journal of General Practice · 2025
DOI 10.31128/ajgp-09-24-7411
More from this paper
- Pharmacotherapy using GLP-1 receptor agonists (semaglutide) or dual GIP/GLP-1 agonists (tirzepatide) produces significant weight loss (10-20%) and improves obesity-related comorbidities, serving as a necessary adjunct to lifestyle intervention for patients with BMI ≥30 kg/m2 or ≥27 kg/m2 with complications.Strong
- Discontinuation of obesity pharmacotherapy leads to significant weight regain and recurrence of metabolic benefits loss, necessitating lifelong treatment or intensive lifestyle support.Strong
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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