Best Weight Loss Medications

If you’ve been researching weight loss medications to see if they’re right for you, you’re not alone. A 2022 study in Frontiers in Cardiovascular Medicine found searches for GLP-1 receptor agonists are surging. With four in 10 Americans living with obesity, there are plenty of people looking to lose weight using medications.

Decades before the now popular glucagon-like peptide-1 (GLP-1) medications, your options for weight loss medications were in pill form, a popular one being phentermine.

In 2014, liraglutide became the first GLP-1 receptor agonist medication approved for weight loss. Since then, popularity has grown quickly for this class of medications, with semaglutide (Ozempic and Wegovy) approved in 2017 and 2021 and tirzepatide (Zepbound) approved more recently in 2023.

With these new medications and the increase in online weight loss programs, it’s important to make sure the medications you’re buying from online providers are safe. We’ll discuss what medication options are out there for weight loss, as well as how to purchase them online through reputable services.

Weight loss medications are typically a pill or injection under the skin. They work by decreasing your appetite so you don’t feel as hungry or you feel fuller from fewer calories.

Weight loss medications can be prescribed to people who have a body mass index (BMI) over 30 or a BMI over 27 if they also have a weight-related health condition, such as diabetes or high blood pressure.

Most weight loss medications are by prescription only, except for orlistat (Alli), which is available over the counter. Any other OTC weight loss product is considered a supplement and isn't FDA-approved.

Just a note, though: If you’re trying to get pregnant or are currently pregnant or breastfeeding, weight loss medications aren't recommended.

Most weight loss medications reduce your appetite by making you feel less hungry or making you fill up faster after eating. This makes you want to eat less. One exception is the medication orlistat that causes the intestines to absorb less fat.

The main weight loss medications approved by the Food and Drug Administration (FDA) include the following.

Semaglutide (Wegovy, Ozempic)

Semaglutide was first approved as a diabetes medication under the brand name Ozempic — the brand name Wegovy is only approved for weight loss. It's given as a weekly injection and works by mimicking the effects of GLP-1, which is a gut hormone that stimulates insulin release from the pancreas. It can cause gastrointestinal (GI) side effects, headache and tiredness.

Tirzepatide (Zepbound)

Originally approved for Type 2 diabetes under the brand name Mounjaro, tirzepatide was renamed Zepbound as a medication for weight loss. Tirzepatide acts on two hormone receptors, GLP-1 and glucose-dependent insulinotropic polypeptide (GIP), to decrease your hunger levels and food intake. Side effects can include GI upset, hair loss and tiredness.

Phentermine/topiramate (Qsymia)

One option that’s available is a combination of weight loss medication (phentermine) and anti-seizure medication (topiramate). Phentermine is a stimulant that has the potential for abuse. Qsymia can cause side effects such as trouble sleeping, constipation and high heart rate and blood pressure. Topiramate shouldn't be used while pregnant because it can increase the chances of birth defects.

Naltrexone/bupropion (Contrave)

Another chemical combination for weight loss is a medication used for alcohol and opioid addiction (naltrexone) and a medication used to treat depression (bupropion). Bupropion, also used to help quit smoking, can increase the risk of suicidal thoughts. The combination medication Contrave can raise blood pressure and can cause GI issues and headaches.

Orlistat (Xenical, Alli)

Alli is available over-the-counter (OTC). You need to be on a low-fat diet to take orlistat. Orlistat works a little differently in that it prevents your body from absorbing fat. Side effects include liver concerns, gas and diarrhea.

Liraglutide (Saxenda)

Approved as a GLP-1 receptor agonist for weight loss, liraglutide is given as a daily injection. Its side effects can include nausea and vomiting.

Weight loss medications are considered to be effective if you lose more than 5% of your weight after 12 weeks of being on the medication.

Wegovy was the most successful weight loss medication at the time it was approved. Study participants in the FDA’s 2021 randomized-controlled trials lost an average of 12.4% of their body weight. Another study in the New England Journal of Medicine found success rates of about 15% of body weight loss.

Studies on Saxenda efficacy rates show people lost about 8% of their body weight. Zepbound has reportedly been the most successful weight loss medication — research shows it helped people lose about 21% of their body weight at the highest dose.

While they aren't making headlines right now, weight loss pills are still an effective tool for losing weight. Those taking Qsymia can expect to lose up to 11% of their body weight on the maximum doses after one year. Research on Contrave shows people can lose at least 5% of their body weight on average after 12 weeks.

What weight loss medication you choose depends on several factors, such as:

• Other medical conditions you might have: This includes if you have allergies to certain medications. If you're allergic to semaglutide, for instance, you can't take any medication containing that ingredient.
• How much you want to pay: Weight loss injections cost more than pills.
• Whether you want to take a pill or do injections: Some people may not enjoy the fact that they would have to give themselves an injection with GLP-1s.
• How much weight you want to lose — and how quickly: GLP-1s can help you lose weight in a shorter amount of time than calorie restriction and exercise can.

As with other medications, you don’t have to be fully committed to just one. Your provider can help you switch to a different medication, whether it’s due to cost or side effects — or if the medication isn’t helping you lose the amount of weight you want. According to the Mayo Clinic, if you haven't lost at least 5% of your weight after three to six months of being on weight loss medications, you may consider changing to another one.

When you take weight loss medications, you can more successfully lose weight if your treatment plan includes an exercise and nutrition plan. Weight loss medications like Wegovy can’t make you eat more nutritious food and can’t help you get out and move your body. In addition to creating healthier lifestyle habits, you can also consider counseling to help you cope with the mental health aspects of obesity and losing weight.

Injectable GLP-1 medications aren't cheap. As of publishing, Wegovy costs $1,349 for a month’s supply without insurance; Zepbound is a little less expensive at $1,060 for a month’s supply; and Saxenda is $1,349 for a month’s supply. Since the medications are meant to be taken long-term, it can add up.

According to one report, Qsymia is actually the most cost-effective medication among semaglutide and other weight loss medications, at $134 for a month’s supply.

The FDA says compounding pharmacies can step in and make compounded versions of medications during times of shortages. Compounded medications cost significantly less but aren’t FDA-approved. You can expect to pay around $250 to $300 for a month’s supply.

With online weight loss programs, you may also pay a monthly subscription with a possible one-time enrollment fee. For instance, Sesame charges $65 a month without the cost of medication and Ro charges $145 a month without medication, plus a $99 enrollment fee.

Monthly subscriptions may also cover the cost of video consultation, unlimited messaging with your provider, nutrition and exercise support and laboratory testing. Your insurance may or may not cover the cost of these services. Often, you can pay using a Health Savings Account (HSA) or Flexible Spending Account (FSA).

There are a lot of weight loss medications out on the market right now. The FDA approves the same generic drug name for treating different health conditions. Companies can then give unique brand names to these medications.

A reputable online medication program will not prescribe weight loss medications like GLP-1s to just anyone. They will ask for your full health history, including any other medications you’re currently taking.

Compounded medications aren’t made by the original drug manufacturer — they’re made by mixing or changing ingredients to make a customized medication for an individual person. One concern is that some compounding pharmacies could be using salt forms of the active ingredient, semaglutide, which is not the same as the FDA-approved semaglutide.

The FDA also recently alerted the public to the potential dangers of compounded GLP-1s. There have been reports of overdoses resulting in hospitalizations from dosing errors where people measure the incorrect dose or confuse the units of measurement (e.g., milliliters vs. units).

Make sure the online service you’re using gets its medications from reputable pharmacies, and those pharmacies are working with reputable drug manufacturers. You want to be certain that the provider you’re working with only gives out weight loss medications with a prescription.

You should also check to confirm that the footer of a weight loss medication platform shows that it is LegitScript-certified. This ensures that it is not a rogue online pharmacy and complies with all telehealth pharmaceutical regulations.

Many medical providers can prescribe weight loss medications, but ideally, you work with a doctor who specializes in obesity medicine. Obesity medicine physicians have advanced training in managing weight loss safely, especially with the use of medications. If you can’t find one, a doctor trained in internal medicine, such as an endocrinologist, is a great option. These doctors have specialized training in hormone conditions such as Type 2 diabetes, which can be linked to obesity.

Besides qualifications, when searching for a weight loss medication provider, you’ll want to ask yourself these questions:

• Do they take my insurance?
• Do they have a monthly subscription along with a one-time initial fee?
• How do consultations work? Do they offer video sessions to meet with my provider initially for a workup?
• How will I communicate with my provider on an ongoing basis? Will I have weekly or monthly video sessions? Will I have to follow up with my regular care provider? Are they available to answer my questions and address my concerns?
• Are they available in my state? Health care providers need to be state-licensed to practice.
• How long will it take to schedule an initial appointment? How easy is it to get hold of my provider?
• Do they have other specialists, such as registered dietitians, to work with me to help with nutrition and lifestyle changes?

Pros and cons of GLP-1s

The ConsumerAffairs Research Team used a research-backed, data-driven approach informed by our expert editors to choose the best online weight loss medication companies.

We looked at the following factors to make our picks:

• Subscription fee: Some telehealth companies that offer weight loss medications require a subscription fee to use their services. That’s on top of the price you pay for the medications themselves. Companies without subscription fees are rated more highly.
• Medication cost: Weight loss medications can be pricey — the lower a company’s prices for like products, the higher its rating.
• Medications available: The companies we looked at offer between two and five medications to support weight loss. Those with more options are more likely to have the right treatment for you.
• Online support: Being able to talk through your experience using weight loss medications with a medical professional is important. Not all companies offer ongoing support, but those that do get bonus points for it.
• Insurance acceptance: Many telehealth companies don’t accept insurance. Companies that do accept insurance or allow you to pay for medications via your health savings account (HSA) or flexible savings account (FSA) are rated more highly than those that don’t.
• LegitScript certification: LegitScript provides a stamp of approval for businesses that facilitate transactions for pharmacies. Seeing the LegitScript icon on a telehealth company's website shows they are recognized for operating in compliance with applicable laws and regulations.