Physician-supervised Weight-loss
(Overweight, Obesity and Severe Obesity)



The Initial Consult:


Overall, the physician management of obesity may include:

  • Behavior Modifications (diet and exercise)
  • Pre-packaged Meal Replacement Plans
  • Pharmacotherapy (weight-loss medications)

Behavior Modifications:



Physical Activity


Pre-packaged Meal Replacement Plans


How do they work?




Medical Weight Management:

Note: None of the obesity medications discussed in this brochure should be taken while pregnant or attempting to become pregnant. One medication, Qsymia®, has specific FDA warning label information around the use of birth control due as to a birth defect risk. If you have any questions regarding these medications, please contact a healthcare provider.

Who Qualifies for Obesity Medications?

The next tool that can be used to achieve weight-loss and health improvement is medication. Medical Weight Management may be offered to individuals affected by obesity who have failed to achieve weight-loss through diet and exercise alone.


  • orlistat (Xenical® or alli®)†
  • lorcaserin HCI (Belviq®)†
  • naltrexone HCI AND bupropion HCI (CONTRAVE®)†
  • phentermine- topiramate ER (Qsymia®)†
  • liraglutide injection (Saxenda®)†
  • *Approved for short term use
  • †Approved for chronic(long term) use


Phentermine (Adipex-P® or Suprenza®)

How does it work?
Phentermine is a medication available by prescription that works on chemicals in the brain to decrease your appetite. It also has a mild stimulant component that adds extra energy. Phentermine is a pill that is taken once a day in the morning time. Tolerance to this medication can develop, so it is often used for only several months at a time. Common side effects are dry mouth and sleeplessness.



Orlistat (Xenical® or alli®)

How does it work?

The average weight-loss is about 5 percent of your weight after one year. In a person who weighs 200 pounds, this would mean 10 pounds of weight-loss.



Lorcaserin HCI (Belviq®)

How does it work?



Naltrexone HCI AND Bupropion HCI (CONTRAVE®)

How does it work?
CONTRAVE®, approved in 2014 by the FDA, is a combination of two medications that have been approved for other medical problems. Naltrexone is a medication used for the treatment of narcotic and alcohol dependency. Bupropion is used as an antidepressant and for helping people stop smoking. When used in combination, these two medications work together in the brain to decrease appetite and control eating.

Among individuals who took the medication for one year, 65 percent of the study subjects lost at least 5 percent of their body weight. In a 200 pound person, this would mean a 10 pound weight-loss. Also, 39 percent lost at least 10 percent of their body weight. In a 200 pound person, this would mean a 20 pound weight-loss. Improvements in bad cholesterol, triglycerides and good cholesterol were also seen.

The common side effects are nausea, constipation, headache, dry mouth, vomiting and dizziness.

Phentermine-Topiramate ER (Qsymia®)

How does it work?
This combination medication was approved by the FDA in July 2012. Topiramate is a medication used in migraine prevention as well as seizure prophylaxis. It was found that a common side effect of this medication was weight-loss. Phentermine, as described in this brochure, helps to increase your energy and decrease your appetite.


The most common side effects were dry mouth, constipation and pins-and-needle feeling in extremities. Qsymia® should NOT be used in women of childbearing age who are not using at least one reliable form of contraception. Topiramate ER, a component of Qsymia®, has been known to cause birth defects.

Liraglutide injection (Saxenda®)

How does it work?
Liraglutide, approved in 2014 by the FDA, is an injectable medication that increases our natural production of insulin, which is needed to regulate the levels of sugar in the blood. It decreases the production of a hormone that opposes insulin called glucagon. It also slows down the emptying of the stomach. Lastly, it works in the brain to reduce the amount of food consumed. As such, it has been used for the management of diabetes for the last few years.

In four trials consisting of more than 5,000 individuals, participants received 3mg of liraglutide daily. The outcomes showed that among individuals who took the medication for one year, 73 percent of the study subjects lost at least 5 percent of their body weight. In a 200 pound person, this would mean a 10 pound weight-loss. Also, 41 percent lost at least 10 percent of their body weight. In a 200 pound person, this would mean a 20 pound weight-loss.

The most common side effects are nausea, vomiting, diarrhea, and constipation.

Follow-up Visits:

