Weight Loss Medications: The Old and The New, A Brief History

With the latest craze over weight loss injectables, many have forgotten that weight loss medications have been around for years. Some have come and gone, (Remember the Fen-Phen craze) while others have been around for a while. This article will explore the many weight loss medications that have lasted the test of time as well as the ones that have not…..

The Statistics are staggering. In 2023, the prevalence of obesity in the United States reached 41.9%, affecting 1 in 5 children and adolescents. Over two-third of the US adults are overweight or obese. This number is projected to climb to fifty percent by 2030. Let’s face it, between the processed foods that make up the majority of the current North American diet, along with the sedentary lifestyles that have only worsened with more people now working from home, obesity IS the new pandemic.

While lifestyle modifications should be the mainstay of treatment, weight loss medications can help those at risk for comorbidities and other chronic conditions.

Let’s look at what weight loss medications we have had over the years and how they have worked.

Past:

● fenfluramine HCl: brand name Pondimin (in tablet form) or Ponderex (in capsule form), approved on June 14, 1973, by Wyeth, withdrawn in September 15, 1997

● dexfenfluramine: brand name Redux, by Indevus (formerly Interneuron and marketed by Wyeth-Ayerst), approved in 1996, withdrawn in September 15, 1997

● enfluramine/phentermine: brand name Fen-phen, in the 90s, by American Home Products (later known as Wyeth), approved in 1996, withdrawn in 1997

● dexfenfluramine and phentermine: brand name Dexfen-Phen, was not tested appropriately for safety and these medications were taken off the market in 1997. Due to concerns of heart valve issues and a condition called pulmonary hypertension that led to several patient deaths, this entire class of medications was recalled by the FDA in 1997.

● lorcaserin: brand name Belviq, approved in June 27, 2012, by Eisai, withdrawn in Feb 13, 2020 by the FDA due to increased risk of certain cancers including pancreatic, colon and lung cancers.

Present:

● orlistat: brand name Xenical, by Roche, approved in April 1999. Xenical is by prescription only.

● orlistat (OTC): brand name Alli, by GlaxoSmithKline, approved in Feb 2007. This medication is similar to Xenical but is half the dose (60mg) and sold over the counter. Both Xenical and Alli work by decreasing the amount of fat absorbed by the intestines.

● phentermine-topiramate: brand name Qsymia, by Vivus, approved in July 2012. It works as an appetite suppressant by increasing release of norepinephrine and dopamine.

● bupropion-naltrexone: brand name Contrave (ER tablet), by Orexigen Therapeutics, approved in September 2014. Works in a similar manner to Qsymia

● liraglutide injection: brand name Saxenda, by Novo Nordisk, approved in December 2014

● setmelanotide injection: brand name Imcivree, by Rhythm Pharmaceuticals, Inc., approved in November 2020

● semaglutide injection: brand name Wegovy, by Novo Nordisk, approved in June 2021

● tirzepatide injection: brand name Zepbound, by Eli Lilly, approved in November 2023

The GLP-1 medications all work by stimulation of GLP-1 receptors. This leads to enhanced insulin production and decrease in blood glucose levels while slowing down the transit of foods through the gut.

Antidiabetic medications that can cause weight changes but not approved for weight-loss

● liraglutide injection: brand name Victoza

● empagliflozin tablet: brand name Jardiance

● dulaglutide injection: brand name Trulicity

● semaglutide injection: Brand name Ozempic

● semaglutide tablet: brand name Rybelsus

● tirzepatide injection: brand name Mounjaro

● metformin tablet: brand name Glucophage, Glucophage XR, Fortamet, Glumetza, Riomet (oral solution).You can read more about these medications here Diabetes Drugs Are Being Used for Weight Loss. Are They a Safe Option?

With an estimated market value of $37.1 billion in 2031, the competition for the development of obesity medications is escalating. Here are some trials to keep a close eye on.

Future: (Drugs currently in trial)

● IcoSema

● danuglipron

● orforglipron

● cagrilintide and Semaglutide (CagriSema)

● retatrutide

● orforglipron (also known as OWL 833)

● APH-012

● ARD-101

● ecnoglutide

● mazdutide injection

● survodutide injection

● simagrumab injection

The following medications are available on https://www.canadapharmacyonline.com

(prices may vary, a prescription is required):

● Alli (Orlistat): $97.99 for 90 mg 90 tablets (OTC)

● Contrave (bupropion/naltrexone): $332.99 for 90 mg/8 mg 120 tablets

● Fortamet (metformin): $45.99 for 500 mg 84 tablets

● Glucophage (metformin): $61.99 for 500 mg 100 tablets

● Glucophage XR (metformin sustained release): $64.99 for 500 mg 84 tablets

● Glumetza (metformin extended release): $104.99 for 500 mg 100 tablets

● Jardiance (empagliflozin): $149.99 for 25 mg 30 tablets

● Riomet Oral Solution (metformin): $91.99 for 500 mg/5 ml oral solution

● Rybelsus (semaglutide): $325.99 for 3 mg 30 tablets

● Xenical (orlistat): $189.99 for 120 mg 84 tablets

Disclaimer:

Always discuss your health history with your doctor including physical activity habits, weight loss goals and strategies. It is also important to share the medications you take with your doctor or pharmacist so they can be aware of any side effects or drug interactions. Buying your medications from online pharmacies can be risky. It is safe and affordable to order weight-loss prescription medications from CIPA & IPABC Certified Canadian pharmacy online.

References:

• State of Obesity 2023: Better Policies for a Healthier America - TFAH

• Childhood and Adolescent Obesity in the United States: A Public Health Concern - PMC (nih.gov)

• Adult Obesity | Obesity Prevention Source | Harvard T.H. Chan School of Public Health

• News: By 2030, nearly half of all U.S.... (The Los Angeles Times) - Behind the headlines - NLM (nih.gov)

• Federal Register :: Determination That PONDIMIN (Fenfluramine Hydrochloride) Tablets, 20

• Milligrams and 60 Milligrams, and PONDEREX (Fenfluramine Hydrochloride) Capsules, 20 Milligrams Were Withdrawn From Sale for Reasons of Safety or Effectiveness.

• Fenfluramine/phentermine - Wikipedia

• Anti-obesity drugs: past, present and future - PMC.

• 10 Diabetes Medications That Cause Weight Loss (or Gain) - GoodRx

• How Fen-Phen, A Diet 'Miracle,' Rose and Fell - The New York Times

• Obesity market expected to reach $37.1bn across 7MM by 2031 (pharmaceutical-technology.com)

• Diabetes Drugs Are Being Used for Weight Loss. Are They a Safe Option?

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