Is Taking Appetite Suppressants a Good Idea? Here's What to Know.
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PEOPLE CAN'T STOP talking about drugs like Ozempic. Originally approved for diabetes management, they rose to fame for their weight loss effects. Celebrities and average joes have been taking them, and more than half of Americans say they think the drugs are good options for people with obesity.
Many of these medications work as appetite suppressants that influence how your body and brain react to feelings of hunger, according to the Cleveland Clinic.
“Sometimes people who have been dieting on and off for years feel very hopeless and helpless about the ability to change,” says Meghan Garcia-Webb, M.D., a triple board-certified physician in internal medicine, lifestyle medicine, and obesity medicine, and creator of the YouTube series “Weight Medicine with Dr. Meghan MD.”
“When they see themselves lose weight with these medications, these patients feel like change might actually be possible,” says Dr. Garcia-Webb, who prescribes appetite suppressants to men several times a week. “That can provide positive momentum for consistent lifestyle changes as well.”
Appetite suppressants have a checkered history—many people have taken over-the-counter, unregulated ones and experienced side effects. Newer weight loss meds are different (and are available by prescription, so they have been under FDA review). While these meds are effective, they actually work best when they’re used to supplement a healthy lifestyle that includes diet and exercise, says Paunel Vukasinov, M.D., an internal medicine physician at Medical Offices of Manhattan and contributor to LabFinder.
It’s always best to take any appetite suppressant or weight loss medication under the supervision of your doctor, who can work closely with you to monitor your health as you lose weight, he adds. Doctors typically don’t recommend over-the-counter appetite suppressants, Dr. Garcia-Webb says.
If you’re curious about appetite suppressants, doctors discuss a few different options, how they work, who should take them, and other things to know about the medications.
Types of Appetite Suppressants and How They Work
Basically, appetite suppressents make you feel less hungry or help you feel full more quickly, which results in consuming less food and losing weight, Dr. Garcia-Webb says.
Glucagon-like peptide-1 (GLP-1) agonists are a medication commonly used to treat type 2 diabetes, but they’re also appetite suppressants that have been used to help with weight loss.
GLP-1 agonists activate the GLP-1 hormone receptor, which is made in the small intestine and regulates how food moves through the stomach, Dr. Garcia-Webb explains. They also promote energy-burning pathways in the brain and lower energy-storing pathways, which she says helps the body adapt to a new, lower body weight.
“It also seems to work on the reward pathways in the brain, so someone may find that not only is his appetite lower, but they just don’t think of food as a reward or as entertainment anymore,” she explains.
The Food and Drug Administration has approved the use of some GLP-1s to treat obesity, including semaglutide (Wegovy and Ozempic) and liraglutide (Victoza and Saxenda). These medications are injections.
Tirzepatide (Zepbound) is a GLP-1 agonist injection medication that activates an additional pathway: the glucose-dependent insulinotropic polypeptide (GIP) hormone, Dr. Garcia-Webb says.
“Activating both the GLP-1 and GIP pathways together seems to cause a stronger weight loss effect,” she says.
There are also oral appetite suppressants, including phentermine, phentermine-topiramate, and bupropion/naltrexone. Dr. Garcia-Webb says these medications affect the brain’s energy-regulation pathway and suppress appetite as a byproduct.
Who’s a good candidate for appetite suppressants?
Prescription appetite suppressants are recommended by the FDA for people with a body mass index of 30 or higher, or a BMI of 27 or higher with at least one weight-related health condition, like type 2 diabetes, high blood pressure, high cholesterol, or sleep apnea, says Dr. Vukasinov.
The drugs are also recommended if you’ve tried and failed to lose weight over a six-month period with lifestyle modifications, he adds.
Doctors consider a patient’s individual circumstances, including health and medication history, before deciding which appetite suppressant to prescribe, Dr. Garcia-Webb says.
She says GLP-1 and GLP-1/GIP agonists work best for appetite impression and weight loss, with patients losing 15 to 20 percent of their body weight on average.
“Drug shortages and insurance issues aside, these will always be my first choices for patients if they don’t have any contraindications,” Dr. Garcia-Webb says.
However, these medications aren’t recommended for people with a history of pancreatitis, thyroid cancer, gastroparesis, or bowel obstructions.
Some patients can’t tolerate injectables and prefer oral appetite suppressants, but they’re not always as effective, Dr. Garcia-Webb says. Oral versions aren’t a good fit for patients with heart problems, high blood pressure, seizures, or glaucoma.
Should appetite suppressants be taken long-term?
Most prescription appetite suppressants are meant to be taken lifelong, Dr. Garcia-Webb says.
Research shows that they’re safe—and that when people stop taking them, many regain the weight they lost, Dr. Vukasinov says.
“None of the weight loss medications should be considered a short-term drug,” Dr. Garcia-Webb says. “So anyone interested in potentially taking a medication for weight loss should be comfortable taking it lifelong.”
Appetite Suppressant Side Effects
Appetite suppressants are safe for most people. But, depending on which medication you take, you could experience side effects, according to the Cleveland Clinic.
These include nausea, constipation, diarrhea, headache, abdominal pain, and indigestion. GLP-1s might also cause vomiting, dizziness, and an increased heart rate.
Why Lifestyle Changes Are Recommended Along With Medication
Appetite suppressants aren’t meant to work alone but in conjunction with a healthy diet and exercise plan, Dr. Garcia-Webb says.
That includes eating a mostly whole-foods, plant-based diet that limits ultra-processed foods and added sugar, she explains. And, each day, aim to get about five servings of produce and 1 to 1.2 grams of protein per kilogram of your ideal body weight (not your actual weight).
Strive to get at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity, along with strength training twice a week, the American Heart Association recommends.
“Also, remember to eat by your internal cues—eating when you’re hungry and stopping when you are satisfied,” Dr. Garcia-Webb says. “Almost no one does this, and it’s a game-changer.”
What about over-the-counter appetite suppressants?
Several over-the-counter supplements are out there and promise to curb your appetite, but Dr. Garcia-Webb and Dr. Vukasinov say they don’t recommend them.
They likely won’t work and could pose safety risks, depending on what ingredients they contain, they say. According to the Cleveland Clinic, some OTC appetite suppressants might contain ephedra, ephedrine, or caffeine, which are stimulants. In some cases, these substances could lead to heart attack, seizures, or stroke.
If you want to try an OTC supplement, talk to your doctor first, Dr. Garcia-Webb emphasizes.
“The best appetite suppressants are dietary, making sure your meals have healthy fats, fiber, and protein,” she says.
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