FDA-Approved Weight Loss Medications

Indications for Pharmacotherapy

The American Diabetes Association recommends prescribing weight loss medications for patients with a BMI ≥30 kg/m² (obesity), or a BMI ≥27 kg/m² with weight-related comorbidities including type 2 diabetes, hypertension, dyslipidemia, or obstructive sleep apnea 2, 1

The American College of Cardiology recommends semaglutide 2.4 mg or tirzepatide as first-line agents for most patients due to superior efficacy and cardiovascular benefits 1
Liraglutide 3.0 mg (Saxenda) has a mean weight loss of 5.4% at 56 weeks, and requires dose escalation starting at 0.6 mg daily, increasing by 0.6 mg weekly up to 3.0 mg 1
Phentermine/Topiramate ER (Qsymia) has a mean weight loss of 6.6-9.8% at 1 year, and is a fixed-dose combination targeting multiple pathways (sympathomimetic + GABA modulation) 3, 1
Orlistat (Xenical 120 mg/Alli 60 mg OTC) has a mean weight loss of 2.9-3.1% at 1 year, and blocks ~30% of dietary fat absorption via pancreatic/gastric lipase inhibition 2, 1

The American Heart Association recommends assessing for contraindications, such as cardiovascular disease, pregnancy, and glaucoma, before selecting a weight loss medication 1, 3, 2
The Endocrine Society recommends discontinuing or switching medication if <5% weight loss is achieved after 3 months at therapeutic dose 2, 1

The American College of Cardiology recommends monitoring blood pressure and heart rate regularly in patients taking phentermine, and assessing for signs of pulmonary hypertension (dyspnea, angina, syncope, edema) 1
The National Lipid Association recommends monitoring fat-soluble vitamin levels and ensuring multivitamin compliance in patients taking orlistat 3, 1