Written on June 25, 2023 by Theresa Vuskovich, DMD. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
Table of contents
- Phentermine
- Phentermine and Topiramate
- Naltrexone and Bupropion
- Liraglutide
- Semaglutide
- Weight Care+ with Everlywell
- Related Content
If you have type 2 diabetes, there are many medications available to help with weight loss. [1] The American Diabetes Association (ADA) recommends the medications presented in this article for people with type 2 diabetes who are trying to lose weight. Each medication carries risks and benefits. Weight loss medication is not appropriate for everyone with type 2 diabetes, so it is important to discuss your options with your healthcare provider.
The medications discussed in this article are considered adjuncts to lifestyle changes. For people with type 2 diabetes, there's no one best way to lose weight. The best option is to get an individualized care plan from a healthcare provider. This article discusses type 2 diabetes medication for weight loss.
Phentermine
Phentermine is one of the oldest weight loss medications for people with T2D, approved in 1959. [2] Phentermine is intended for short-term use (less than 12 weeks at a time). [1] Phentermine belongs to a class of drugs called anorectics, which are appetite suppressants. [1] The exact mechanism of phentermine is still unknown. [2] Phentermine is for individuals with obesity or who are overweight with at least one comorbidity, including T2D. [1,2]
On average, individuals taking 12 mg of phentermine once a day lost 6.1% of their baseline weight. [1] Clinically meaningful weight loss for individuals who are overweight is 5%. [1] A 5% weight loss for individuals with T2D is associated with improved glycemic control and a reduction in heart disease risks for some individuals. [1]
Lomaira™ is the brand name of phentermine. [2] Phentermine is not for individuals with a history of heart disease, hyperthyroidism, drug abuse, glaucoma, or an allergic reaction to sympathomimetic amines. [2] Phentermine is not suitable for pregnant or nursing women and those taking monoamine oxidase inhibitors (MAOI). [2] Common side effects of phentermine include dry mouth, trouble sleeping, irritability, dizziness, increased blood pressure, and an elevated heart rate. [1]
Phentermine and Topiramate
Phentermine is also available in combination with another medication, topiramate. [3] The combination of phentermine and topiramate is sold under the brand name Qsymia®. [3] Qsymia® is a once-daily pill that suppresses appetite and is indicated for long-term weight management treatment (greater than 12 weeks) for individuals with obesity or who are overweight with at least one comorbidity, including T2D. [3] On average, patients lost 9.8% of their baseline weight after one year of treatment. [3]
Qsymia® is not suitable for individuals with glaucoma, hyperthyroidism, or who are pregnant or nursing. [3] Common adverse side effects include tingling or numbness in the feet and hands, dizziness, altered taste, trouble sleeping, constipation, and dry mouth. [3] Discuss with your healthcare provider which phentermine option is right for you.
Naltrexone and Bupropion
Contrave® is a medication containing two active pharmaceutical ingredients — naltrexone and bupropion. [4] Contrave® is indicated for long-term weight management for individuals with obesity or those who are overweight with at least one comorbidity, including T2D. [4] Similar to phentermine, Contrave® works by suppressing your appetite, and the exact mechanism of how it works remains unknown. [4]
Individuals with obesity or who are overweight with T2D lost, on average, 3.7% of their baseline weight during a 56-week clinical trial. [4] The most common adverse reactions of Contrave® include nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, and diarrhea. [4] Contrave® is not for individuals with a history of anorexia or bulimia, seizure disorders, uncontrolled high blood pressure, or chronic opioid use. [4]
Liraglutide
Liraglutide is a glucagon-like peptide-1 (GLP-1) agonist designed to regulate your appetite and lead to eating fewer calories. [5] Liraglutide is sold under the brand name Saxenda®. [5] Saxenda® is a once-daily injectable medication for individuals who have obesity or overweight with at least one comorbidity. [5]
Individuals with obesity or who are overweight with T2D lost, on average, 5.4% of their body weight during a 56-week phase 2 clinical trial. [5] Saxenda® is not for individuals with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2. [5] If you are pregnant or trying to get pregnant, Saxenda® is not appropriate for you. [5] Common side effects of Saxenda® include nausea, diarrhea, constipation, vomiting, headache, low blood sugar, fatigue, dizziness, and abdominal pain. [5]
Semaglutide
Semaglutide is also a GLP-1 designed to regulate appetite. [6-8]. Semaglutde is available under three brand names — Ozempic®, Rybelsus®, and Wegovy®. [6-8] Ozempic® and Wegovy® are once-weekly injections while Rybelsus® is a once-daily pill. [6-8] Even though Ozempic®, Rybelsus®, and Wegovy® contain semaglutide as the active pharmaceutical ingredient, the FDA approved each medication for different indications. [6-8]
Ozempic® and Rybelsus® are FDA-approved for individuals with T2D to assist with blood sugar control. [6,7] During clinical trials, researchers found that patients were also losing weight as a result of taking semaglutide. [6,7] Further clinical trials confirmed the efficacy of semaglutide as a weight loss medication in combination with physical activity and a healthy diet. [8]
As a result, Wegovy® was approved by the FDA as a weight management medication for individuals with obesity or overweight with at least one comorbid condition. [8] Nevertheless, Ozempic® and Rybelsus® are prescribed off-label by healthcare providers for weight management.
Semaglutide is not for individuals with a personal or family history of medullary thyroid carcinoma or in patients with Multiple Endocrine Neoplasia syndrome type 2. [6-8] Common side effects of semaglutide include nausea, vomiting, diarrhea, elevated heart rate, and low blood sugar. [1,6-8] Taking semaglutide carries the risk of thyroid C-cell tumors. [1,6-8]
Consult your healthcare provider to discuss the best weight management medications for you.
Weight Care+ with Everlywell
Weight Care+ with Everlywell is a weight management program designed to help you reach your weight loss goals. The program entails virtual care visits with a licensed nurse practitioner who will recommend tests, lifestyle modifications, and medications if needed. The Weight Care+ program provides the right tools to monitor and treat weight-related conditions.
Related Content
Ozempic® for Type 2 Diabetes: What You Need to Know
Weekly Injection for Diabetes and Weight Loss: How It Works
Can Diabetes Be Reversed with Weight Loss?
References
- ElSayed NA, Aleppo G, Aroda VR, et al. 8. Obesity and weight management for the prevention and treatment of type 2 diabetes: Standards of care in diabetes-2023. Diabetes Care. 2023;46(Suppl 1):S128-S139. doi:10.2337/dc23-S008. https://diabetesjournals.org/care/article/46/Supplement_1/S128/148043/8-Obesity-and-Weight-Management-for-the-Prevention
- LomairaTM. Phentermine Prescribing Information. https://www.lomaira.com/Prescribing_Information.pdf. Published December 26, 2016. Accessed June 12, 2023.
- Qsymia® Prescribing Information. Qsymia.com. https://qsymia.com/patient/include/media/pdf/prescribing-information.pdf. Accessed June 12, 2023.
- Contrave® Prescribing Information. Contrave.com. https://contrave.com/contrave-pi/. Accessed June 13, 2023.
- Saxenda® Prescribing Information. Novo-pi.com. Accessed June 6, 2023. https://www.novo-pi.com/saxenda.pdf
- Ozempic® Prescribing Information. Novo-pi.com. https://www.novo-pi.com/ozempic.pdf. Accessed June 12, 2023.
- Rybelsus® Prescribing Information. Novo-pi.com. https://www.novo-pi.com/rybelsus.pdf. Accessed June 12, 2023.
- Wegovy® Prescribing Information. Novo-pi.com. https://www.novo-pi.com/wegovy.pdf. Accessed June 12, 2023.
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