Young woman using telehealth to learn about type 2 diabetes medication for weight loss

Type 2 Diabetes Medication for Weight Loss: Key Points to Know

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.

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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.

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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.

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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.

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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

  1. 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
  2. LomairaTM. Phentermine Prescribing Information. https://www.lomaira.com/Prescribing_Information.pdf. Published December 26, 2016. Accessed June 12, 2023.
  3. Qsymia® Prescribing Information. Qsymia.com. https://qsymia.com/patient/include/media/pdf/prescribing-information.pdf. Accessed June 12, 2023.
  4. Contrave® Prescribing Information. Contrave.com. https://contrave.com/contrave-pi/. Accessed June 13, 2023.
  5. Saxenda® Prescribing Information. Novo-pi.com. Accessed June 6, 2023. https://www.novo-pi.com/saxenda.pdf
  6. Ozempic® Prescribing Information. Novo-pi.com. https://www.novo-pi.com/ozempic.pdf. Accessed June 12, 2023.
  7. Rybelsus® Prescribing Information. Novo-pi.com. https://www.novo-pi.com/rybelsus.pdf. Accessed June 12, 2023.
  8. Wegovy® Prescribing Information. Novo-pi.com. https://www.novo-pi.com/wegovy.pdf. Accessed June 12, 2023.
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