5 Weight Loss Medications You Need to Know About!

Weight loss diet pills and supplements have gained notoriety since the 1950’s for a promise of a skinnier tomorrow; however, the fads of weight loss medications seem to always come with concerns of efficacy and safety. Despite the notion, weight loss pills are not a quick fix to being overweight or obese. They are typically used adjunctively to healthier dietary changes and exercise. General side effects can range from gastrointestinal issues of constipation, nausea, and diarrhea, to more concerning side effects of heart palpitations, high blood pressure, and even fatality, depending on the ingredients listed (or not listed), and where the supplements are derived from.

In general, it is recommended to discuss with your health care provider if weight loss medications are right for you. There are a variety of medications to consider, including FDA-approved medications which have been tested for safety and efficacy for use in the market. There are also weight loss supplements, like peptides and nutraceuticals which naturally do not have FDA indication as most supplements not considered “prescription drugs” do not. However, there are some evidence in studies that show their efficacy in weight management and control.

Below we discuss 5 weight loss medications and supplements making their mark in weight loss, and discuss their mechanism of action, risk vs. benefits, and efficacy for use. We have divided the section into 4 most popular categories for weight loss medication use: Increasing metabolism, increasing insulin sensitivity, decreasing appetite, and increasing the utilization of fat.

Increasing Metabolism:

Sermorelin/Glycine

Class: GHRH peptide/amino acid

Mechanism of Action: Sermorelin is a peptide hormone that is similar to the GHRH peptide hormone our bodies naturally produce. It works by stimulating the production and release of IGF-1 from our pituitary to burn fat. Sermorelin also works to build lean muscle which can help improve body tone, and can aid in boosting the immune system. Glycine is an amino acid that plays an important role in controlling hypothalamic-pituitary function. It can work synergistically with sermorelin in increasing IGF-1 to burn more body fat.

Risks vs. Benefits: Studies are limited when it comes to sermorelin and its effects on weight loss. Most of the studies conducted on peptides like sermorelin include animal studies. In one study conducted evaluating the literature on anti-obesity peptides, the author discussed a handful of studies done on peptides and their efficacy in controlling weight. However most of these studies were small and non-generalizable to a larger, human population.

Although one small study showed the effects of glycine increasing serum human growth hormone, the outcomes of the study were not specific to its role in weight management. Furthermore the sample size was small and did not include overweight or obese individuals.

Sermorelin/Glycine efficacy is primarily relied on anecdotal evidence from individuals who claim it works and the providers who have had success in their off-label use for weight management. As Sermorelin/Glycine is considered a supplement, it does not have FDA approval for use in weight management. This product is generally well-tolerated in healthy individuals. Those with naturally lower IGF-1, such as older adults typically gain the most benefit from this product in improving weight control and anti-aging effects. Sermorelin, specifically, has side effects that are mainly gastrointestinal in nature. Those who have uncontrolled diabetes, history of pituitary or other cancers, and pregnant women should not use this product.

Increasing Insulin Sensitivity:

Semaglutide

Class: GLP-1 Agonists

Mechanism of Action: Known by more popular brand names, such as Wegovy, Semaglutide is a glucagon-like peptide (GLP-1) agonist that works in various ways to improve glycemic control in those with type 2 diabetes and treat weight gain in those who are classified as being overweight and obese. Specifically it works by enhancing the growth of beta cells in the pancreas, increasing insulin sensitivity of tissues, thus lowering blood sugar. Semaglutide also delays gastric-emptying by reducing glucagon secretion, thus reducing appetite, improving control of eating, and reducing food intake, all of which can lower HbA1c levels and produce significant weight loss.

Risks vs. Benefits: One of the main benefits of Semaglutide is that it has recently received FDA approval for use in chronic weight management alongside continued dietary and physical activity for overweight and obese adult patients. In the New England Journal of Medicine’s publication of the STEP Trial, the study revealed that 50% of trial participants lost 15 percent of their body weight, and between 33 – 40% of participants lost 20 percent of their body weight, which is a major improvement from the placebo group of just 2.4% loss in body weight.

Semaglutide requires that an adult meet criteria for use. One of the main requirements is having a BMI of 30 or above, or an BMI of at least 27 with one or more weight-related problems, such as high cholesterol, high blood sugar, and hypertension. Common side effects of Semaglutide include gastrointestinal problems, mainly nausea and vomiting. For this reason, this medication is typically paired with Vitamin B12 for better tolerability. Semaglutide is a once a week injectable, which is a benefit for many individuals looking for easy and discreetness, although may pose as a con for those who do not like injectables. The dose is increased per month until the target dose of 2.4mg/week is achieved, and/or one’s target weight is reached.

Other risks include irritation at the injection site, particularly if injected in the same area. Those who are pregnant, have a personal or family history of medullary thyroid carcinoma (MTC) history, or a history of multiple endocrine neoplasia syndrome (MEN 2) should not use this product.

Decreasing Appetite:

Oxytocin

Class: Neuropeptide hormone

Mechanism of Action: Not be be confused with OxyContin ( an opiate used for pain control), Oxytocin is a neuropeptide hormone that is most infamously known as the “love drug”, as it produces endorphin-like pleasurable chemicals during sex and orgasm, as well as promote love and bonding in relationships. Oxytocin is also produced in the brain to help reduce pain during labor, childbirth, and breastfeeding. For weight management, supplemental use of oxytocin has been shown to decrease overall weight through reduced caloric consumptions in both human and animal studies. Specifically, this is done by activation of the area of the brain in the hypothalamus that regulates food cravings. Activation and stimulation of the oxytocin receptors of this area of the brain is thought to lead to a downstream effect of decreasing food desire and appetite.

Risks vs. Benefits:

One benefit of oxytocin is that it is generally well tolerated by those who use it. As the body produces endogenous (natural) oxytocin, the body may be able to better recognize and use appropriate amounts of exogenous (medicinal) oxytocin supplementation. Some studies show promising effects of controlling reward-related food pathways in the brain. One such study by Marenhi et al. (2017) conducted a randomized, double-blinded, placebo-controlled study on overweight and obese males with a single dose of oxytocin 24 IU intranasally, and found reduction in food motivation and cravings for high-calorie foods upon brain imaging.

Despite some promising evidence, the research regarding oxytocin use as an appetite suppressant for weight management is very limited. Only a handful of studies exists and they are of small sample sizes and mainly male participants. More generalizable, larger-scale studies need to be conducted to better understand its effects as an effective weight management medication. Nevertheless, many anecdotal findings suggests its effects in curbing appetite.

Most people who use oxytocin for weight management tolerate the medication well. It comes in various formulations, including a nasal spray, sublingual (tongue) drops, and troches. Common side effects include nausea and vomiting which are time-limited and typically go away with continued use. Oxytocin for weight management should not be used in pregnancy. Those with uncontrolled hypertension should also not use this product.

Increase Utilization of Fat:

MIC B12 + L Carnitine

Class: Dietary supplements (combination of B vitamins and amino acids)

Mechanism of Action: Also known as the “Lipo shot”, this combination of essential amino acids and B vitamins have shown to help utilize and break down fats for more efficient use, and thus may aid in weight management control in some individuals.

Methionine, an essential amino acid, helps the liver breakdown fats, lowers cholesterol, relieves fatigue and helps allergies by lowering histamine release. Inositol, a B vitamin, helps the breakdown of fats, lowers cholesterol, and helps control mood and appetite. Choline, an essential nutrient, helps the liver breakdown fats and excrete toxins. B12, a vitamin that boosts energy and overall metabolic rate, assists in the burning of stored body fat, helps detox, and helps regulate sleep, mood, and appetite. The addition of L-Carnitine will assist in converting body fat to fuel and elevate certain enzymes needed to metabolize sugars, starches, and other carbohydrates. It is used to facilitate fatty acid oxidation, aiding in the reduction of body fat, both systemically and site specifically.

Risks vs. Benefits: As this combination blend of amino acids and B vitamins are typically made at a compounding pharmacy, studies regarding this specific formulation for weight management do not exist. However, individually, some studies suggests an effect on improving blood sugar and weight control. One such study conducted by Donne et al. (2019) studied the effects of inositol, a B vitamin, on body composition, BMI, and weight among 43 polycystic ovarian syndrome (PCOS) overweight/obese women. They found significant decrease in body weight, BMI, and waist/hip circumference in those who took inositol and maintained a healthy diet.

Another study looked at the effects of choline, a B vitamin naturally used by the body to burn fat, to understand its role as a dietary supplement in rapid weight loss among athletes. The study found that choline supplementation was associated with decrease in body fat and BMI, compared to placebo.

MIC B12 + L Carnitine is generally well tolerate and popular among those looking for weight loss, improved mood, and energy levels. Common side effects include pain/redness/swelling at the injection site, nausea and vomiting. Though rare, low potassium levels can occur with Vitamin B12, as well as an acute allergic reaction (anaphylaxis) requiring hospitalization.

Fat Loss Cream (Aminophylline/Glycyrrhetinic Acid)

Class: Supplement

Mechanism of Action: Another weight loss product in the “utilization of fat” category is the Fat Loss Cream. This product contains the active ingredients of aminophylline and glycyrrhetinic acid, and is applied topically on the abdominal area to aid in lipolysis (fat loss). Aminophylline and glycyrrhetinic acid work by preventing the breakdown of cAMP, which allows for continued regulation of glycogen (stored sugar) and lipid metabolism.

Risks vs. Benefits: Aminophylline/glycyrrhetinic acid transdermal fat loss cream appear to show promise in budding research. According to one study conducted on obese men and women who were prescribed the product for 12 weeks, participants on average lost 11 cm in waist circumference. Studies however are limited and therefore more larger-scale studies will need to be conducted to better understand its effects on weight loss.

Side effects of this product include gastrointestinal issues of nausea and vomiting in some people. This product can also be a bit stimulating and may cause irregular heartbeats, nervousness, and anxiety in some individuals. Caution should be advised for anyone with a medical history of cardiac disease, including coronary heart disease or hypertension as this product can worsen these health problems. Those with a seizure disorder and pregnant women should not use this product.

Weight management is an important first step in addressing one’s physical health and wellbeing. If you are overweight or obese, talk to your healthcare practitioner about your options for managing your weight. If you are contemplating the use of weight loss medications or supplements, discuss the risk vs. benefits with your healthcare practitioner in order to determine which option is best for you. Weight loss medications and supplements should always be used in conjunction with physical activity and dietary changes for best results.

To learn more about our holistic-centered approach to medical weight loss and supplementation, contact us at the Weight Loss & Health Clinic by Embodied Wellness to set up your free consultation.