Weight loss lowers the risk of diabetes, and in those who already have diabetes weight loss can reduce blood glucose—also called blood sugar. Besides improving blood sugar control, modest weight loss of 5% to 10% can decrease blood pressure, cholesterol, and reduce the risk of other chronic diseases related to diabetes.
There are a number of treatment options available for the management of obesity, including lifestyle behavior change, very low-calorie diets, bariatric surgery and medication. There’s no single weight loss approach that works for everyone. Medication is considered only if a person has not lost 1 lb per week after six months of combined lifestyle behavior therapy, including a low-calorie diet and increased physical activity.
Medication for weight loss isn’t a new phenomenon. However, many of the available medications over the past decade were taken off the market due to serious side effects such as psychiatric problems, cardiovascular risks, stroke, heart damage, and pulmonary hypertension. But over the last four years, there has been a rapid increase in approved obesity drugs with fewer side effects.
Here’s the list of weight loss drugs for people with diabetes and what you need to know about how they work.
Brand name: Belviq
Generic name: Lorcaserin
How it works: Lorcaserin is in a class of medications called serotonin receptor agonists. It works by increasing feelings of fullness so that less food is eaten.
Who should not take it? Women who are pregnant or who are trying to become pregnant
Brand name: Qsymia
Generic name: Phentermine/topiramate
How it works: Phentermine is in a class of medications called anorectics. It works by decreasing appetite.
Who should not take it? This drug should not be taken by women who are pregnant or who are trying to become pregnant, in patients with glaucoma or hyperthyroidism.
Brand name: Contrave
Generic name: Naltrexone/bupropion
How it works: Naltrexone is approved to treat alcohol and opioid dependence. Bupropion is approved to treat depression and seasonal affective disorder and aid in smoking cessation. Together these two drugs block opioid stimulation and suppress appetite.
Who should not take it? Naltrexone/bupropion should not be taken by people who have seizure disorders, women who are pregnant or who are trying to become pregnant, people using opioids, or individuals with eating disorders. Naltrexone/bupropion can also raise blood pressure and heart rate and must not be used by people with uncontrolled high blood pressure.
Brand name: Saxenda
Generic name: Liraglutide
How it works. Liraglutide (Victoza) was initially used with diet and exercise to control blood sugar in people with diabetes. One of the side effects observed was weight loss. As a result, researchers developed a form of Liraglutide (Saxenda) specifically for weight loss. Unlike other weight loss drugs, Liraglutide is given by injection. It slows the emptying of the stomach which decreases appetite and causes weight loss.
Who should not take it? Saxenda should not be used in patients with a personal or family history of medullary thyroid carcinoma (MTC), or in patients taking Victoza for the management of diabetes. Saxenda and Victoza have the same active ingredient, liraglutide, therefore they should not be used together.
As always, speak with your doctor about the best medications for you.
Constance Brown-Riggs, MSEd, RD, CDE, CDN is a registered dietitian, certified diabetes educator, national speaker and author of The African American Guide to Living Well with Diabetes. She is Dannon One Yogurt Every Day Nutrition Advisor.
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