Alternatives to GLP-1 Medications for Weight Loss

This transcript has been edited for clarity. 

Hi. My name is Dr Sarah Barenbaum. Today, I’m going to be talking about alternative weight loss medications other than glucagon-like peptide 1 (GLP-1) receptor agonists. 

Losing weight and maintaining weight loss are really hard because of biological forces that limit weight loss and promote weight regain over time. Fortunately, for those who qualify, we have FDA-approved medications that can help individuals lose and maintain weight loss.

There’s been a large amount of hype more recently about our incretin agonists, often called the GLP-1 receptor agonists, semaglutide and tirzepatide. But these medications are not magic bullets by any means, and they have several limitations. 

For example, some people do not lose weight with them, or some people cannot tolerate them. And many people don’t have access to them, either due to shortages or restricted insurance coverage and high out-of-pocket costs.

This is why it’s important to know there are five other medications that are FDA approved for weight management. These medications are phentermine; orlistat; a combination pill of phentermine and topiramate; a combination pill of bupropion and naltrexone; and liraglutide, which is actually a once-daily GLP-1 receptor agonist.

Phentermine is only approved for short-term use or 3-month use. The rest are all approved for long-term use for chronic weight management. 

If your patient is unable to take a GLP-1 for whatever reason, or if [GLP-1s] are ineffective, consider using one of these other medications, which can also be highly effective in helping patients lose and maintain weight loss.