Comparison of Medical Weight Loss Medications – The Unraveling

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Comparison of Medical Weight Loss Medications – The Unraveling

October 11, 2023


The journey towards weight loss is often a winding road, laden with numerous options, all claiming superiority. Among these weight loss avenues, medical weight loss medications have grown in popularity due to their potential benefits and effectiveness.

Navigating through the diverse array of medical weight loss medications can be both confusing and daunting. With numerous options on the market, finding the most appropriate one to achieve effective, safe, and sustainable weight loss can be a challenge. This post seeks to aid in this process by comparing five common medical weight loss medications: Phentermine, Qsymia, Contrave, the HCG diet, and Lipo/B12 injections.


Phentermine, a staple in the weight loss field since the 1950s, is the first on our list of medical weight loss medications. Approved by the Food and Drug Administration (FDA), Phentermine assists weight loss by suppressing appetite and increasing energy levels.

Phentermine works mainly by affecting the central nervous system, specifically the hypothalamus, reducing hunger perception. A 2009 study published in the International Journal of Obesity, showed that Phentermine can lead to an average weight loss of 5% in 12 weeks. While effective, Phentermine is not without its drawbacks. The most common side effects include dry mouth, insomnia, and palpitations. Furthermore, it is only designed for short-term use – typically no more than 12 weeks, owing to potential for dependence. The decision to opt for Phentermine should be made in careful consultation with a healthcare professional.

In conclusion, Phentermine is a powerful appetite suppressant that can yield significant weight reduction in the short-term. However, its long-term effectiveness is less established given that it’s primarily used as a short-term treatment, and its potential side effects should be carefully considered.

Remember, the goal when considering medical weight loss medications is not just short-term success, but long-term health and sustainable weight loss.


The second medical weight loss medication under discussion is Qsymia. A relatively newer addition to the weight loss field, Qsymia combines two FDA-approved medications, Phentermine (an appetite suppressant) and Topiramate (a medication typically used to control seizures or prevent migraines) to create a potent weight loss solution.

According to a 2012 study, Qsymia has shown a significant effect on weight loss. Participants in the study lost an average of 8.8kg (about 19.4 pounds) more than those in a placebo group over a year.

Despite promising results, Qsymia also has its drawbacks. The medication has several side effects such as dizziness, insomnia, and a taste change. More importantly, Qsymia may cause birth defects and so is not recommended for pregnant women or women planning to become pregnant.

In summary, Qsymia, like other medical weight loss medications, has shown significant weight loss potential, particularly in the long-term. However, its consideration should also factor in its potential side effects and contraindications, such as its unsuitability for pregnant women.

A consultation with a medical professional who understands your health history and needs remains crucial before beginning any medication.


Third on our list of medical weight loss medications is Contrave, another FDA-approved drug. Contrave combines two well-known drugs, naltrexone and bupropion, in its quest to aid weight loss.

Contrave operates on the dual principles of appetite suppression and increased energy expenditure. Specifically, bupropion helps in weight loss by increasing the patient’s metabolic rate, while naltrexone reduces food cravings by blocking the parts of the brain that make people feel good when they eat.

A 2013 study found that patients on Contrave lost approximately 4.1% more weight than those taking a placebo over one year.

However, Contrave also carries several side effects including nausea, constipation, and headaches. It might also increase the risk of suicidal thoughts, a common concern with bupropion. Therefore, it’s imperative to discuss these possible drawbacks with a healthcare provider before beginning this medication.

To wrap up, while Contrave might be an effective option among medical weight loss medications, side effects and potential risks must be taken into account. Like with all medications, a complete understanding of one’s health and history is crucial before starting the medication.

hCG Diet – A Closer Look

The hCG diet has been around for decades, gaining fame as a quick and effective method for weight loss. It operates on the principle of utilizing the hCG hormone to trigger the metabolism of body fat to compensate for calorie consumption.

However, the hCG diet is not without its controversies. Many experts express concern over the extreme low-calorie diet — typically 500 to 800 calories per day — that accompanies the regimen. Besides, the FDA has not approved hCG for over-the-counter use due to a lack of evidence supporting its effectiveness and safety.

While some individuals report significant weight loss from the hCG diet, it’s crucial to note that research does not conclusively credit the hCG hormone for this effect. Instead, many scientists attribute such drastic weight loss to the extreme calorie restriction rather than the hCG hormone’s role.

Lipo/B12 Injections – A Closer Look

Unlike the hCG diet, lipo/B12 injections do not come with a specific diet plan. They involve a concoction of compounds known to assist the body in breaking down fat. The major components include Vitamins B12 and B6, Methionine, Inositol, and Choline (MIC) — all crucial for fat metabolism.

Lipo/B12 injections aim to boost energy, metabolism and help with weight loss by enhancing the body’s ability to remove fat. However, similar to the hCG diet, the injection’s effectiveness in weight loss has been a topic of debate among health professionals.

medical weight loss medications

While some studies suggest potential benefits of lipo/B12 injections in promoting weight loss, they underscore the importance of combining these injections with a nutritious diet and regular exercise for optimal results. Furthermore, lipo/B12 injections, though generally safe, may have side effects including nausea, mild diarrhea, and upset stomach.

What Are They?

Among the tools healthcare professionals have to help individuals fight the battle against obesity are medical weight loss medications. These medications come in various forms and consist of different active ingredients, each with a unique mode of action. This post will compare Phentermine, Qsymia, Contrave, the HCG diet and Lipo/B12 injections.

Phentermine is a prescription medication that suppresses appetite. It belongs to a class of drugs known as sympathomimetic amines. Healthcare professionals often prescribe it as part of an overall weight management plan.

On the other hand, Qsymia is a combination drug containing phentermine and topiramate in an extended-release form. This combination provides dual-action – appetite suppression and some sensation of satiety or fullness.

Contrave is another combination drug that includes naltrexone and bupropion. These help curb hunger and food cravings, playing a significant role in weight management.

The HCG diet (Human Chorionic Gonadotropin) is a low-calorie diet accompanied by HCG hormone injections. The diet limits you to 500 calories a day for 8 weeks while taking HCG, either by getting a shot or by taking a homeopathic product.

Finally, Lipo/B12 injections, also known as lipotropic injections, are a combination of ingredients injected into the body to stimulate the metabolism and promote weight loss. These often include nutrients like choline, methionine, and inositol, as well as vitamin B12.

Each of these medical weight loss medications and treatments offers a different approach to aiding weight loss. Understanding their indications, contraindications, off-label use, clinical trials, protocols, and cost can assist in making an informed decision.


Medical weight loss medications are typically indicated for those with a Body Mass Index (BMI) higher than 30, or 27 if other health conditions like hypertension, diabetes, or dyslipidemia are present. However, specific indications vary for each medication.

Phentermine is recommended for short-term use to kick start the weight loss journey. It’s approved for people with a BMI greater than 30, or greater than 27 if they have at least one weight-related condition.

For Qsymia, the FDA approves it for adults with a BMI of 30 or more, and for those with a BMI of 27 or more who have at least one weight-related medical condition. This medication is designed for long-term use.

Contrave is prescribed for weight management in adults who have a BMI of 30 or more, and adults with a BMI of 27 or more who have at least one weight-related medical condition. Like Qsymia, it’s designed for long-term use.

The HCG diet has not been approved by the FDA for weight loss. The hormone is naturally produced during pregnancy and is approved for other medical uses, but not for weight loss.

Lipo/B12 injections don’t have a specific BMI indication. However, they are often utilized when diet and exercise are insufficient, or as part of a broader weight loss strategy.

As with any medication, all these treatments should be used under the supervision of a healthcare professional. Consulting with a healthcare provider will ensure the medication is suitable for the individual’s health status and weight loss goals.


In the context of medical weight loss medications, contraindications are conditions or factors that serve as a reason to withhold a certain medical treatment due to the harm it could cause the patient. Each medication in this review has its specific contraindications.

Phentermine is contraindicated in individuals with a history of cardiovascular diseases, including stroke, arrhythmias, congestive heart failure and coronary artery disease. It is also not suitable for those with a history of drug abuse, glaucoma, hyperthyroidism, or those who are pregnant, planning to become pregnant, or breastfeeding.

Qsymia shares similar contraindications with phentermine due to its component and should also not be used by patients with glaucoma or hyperthyroidism. Additionally, it is contraindicated in pregnancy due to topiramate, a component known to increase the risk of birth defects.

Contrave carries contraindications for individuals with uncontrolled hypertension, seizure disorders, or those with a known allergy to any of its components. It should not be used by those with chronic opioid use or who are undergoing an abrupt discontinuation of alcohol, benzodiazepines, and other sedatives.

HCG diet, not being FDA approved for weight loss, carries significant risk. The low calorie intake may lead to malnutrition and cause gallstone formation, an imbalance of the electrolytes that keep the body’s muscles and nerves functioning properly, and other health issues.

Lipo/B12 injections are contraindicated in patients with liver disease, as they can potentially cause further liver damage. They should also be avoided by those allergic to any of the injection ingredients.

It is vital to remember that this is not an exhaustive list of contraindications. Always consult with a healthcare provider before starting any medical weight loss medications, as they can thoroughly assess personal health histories and circumstances.

Using these medications outside of their intended use is considered off-label use. It’s important to discuss this with a healthcare provider, as it often comes with additional risks.

Off-Label Use

Off-label use refers to the practice of prescribing medical weight loss medications for a purpose not approved by the Food and Drug Administration (FDA). This type of use, while not common, is legal and sometimes necessary when other treatment options have failed. Here’s a look at how our discussed medications might be used off-label.

Phentermine, designed for short-term use, is sometimes used off-label for longer periods under strict medical supervision. Its strong appetite suppression effects can be beneficial to those struggling with overeating.

Qsymia, combining phentermine and topiramate, is primarily intended for long-term weight loss management. However, it might be prescribed off-label to assist with conditions like binge eating disorder and bulimia because of its appetite-suppressing qualities.

Contrave’s components—naltrexone and bupropion—were initially individually used for treating addiction and depression respectively. While now used in combination for weight management, Contrave may be employed off-label for managing addiction or mood disorders.

The HCG diet, though controversial and not FDA-approved for weight loss, is sometimes used off-label in conjunction with a very low-calorie diet to promote fast weight loss. However, this usage is generally discouraged because of potential adverse effects and lack of substantial evidence supporting its effectiveness.

Lipo/B12 injections are primarily used to enhance weight loss and boost energy. Some healthcare providers may recommend these injections off-label for non-weight related benefits, like improving mood, enhancing liver function, and aiding red blood cell production.

In all cases, it’s crucial for individuals to consult their healthcare provider before starting any off-label use of medical weight loss medications. The potential for adverse effects or unexpected interactions warrants caution and specialized guidance. Remember, off-label does not mean risk-free.

Clinical Trials

Clinical trials are crucial in the world of medical weight loss medications as they provide rigorous scientific evidence of a drug’s safety, efficacy, and adverse effects. Each of the medications and treatments in this discussion has been subjected to clinical trials before being made available to the public.

Phentermine was approved by the FDA back in 1959, making it one of the oldest weight loss medications available. Numerous trials have illustrated its effectiveness as a short-term weight loss aid, although long-term safety data is limited due to its short-term usage recommendation.

In the case of Qsymia, several large-scale clinical trials have been conducted. These trials found that more patients taking Qsymia achieved significant weight loss compared to those taking a placebo. However, like most medications, it’s not without side effects, and potential risks should be weighed against benefits.

Contrave underwent extensive clinical trials involving over 4500 patients. Trial results showed that when combined with diet and exercise, more patients using Contrave lost at least 5% and 10% of their body weight compared to those using a placebo. Nevertheless, the trials also elucidated its potential side effects like nausea, constipation, and headache.

Beneficial effects of the HCG diet in weight loss are mainly anecdotal, with clinical trials showing no difference in weight loss between those using HCG and a placebo. These trials, along with the diet’s potential safety risks, are why it’s not FDA-approved for weight loss.

Lipo/B12 injections have less clinical trial data compared to the other discussed medications. Commonly, their effectiveness is linked to the components they contain which are known to play a role in fat metabolism and energy production.

Remember that clinical trials are conducted under controlled conditions. Real-world results can vary and adverse effects may be more common. Always consult with a healthcare professional before starting any new medication or treatment regimen. They can discuss the findings of these clinical trials in a context that applies best to individual health circumstances.


Protocols for medical weight loss medications outline how they should be used, including dosage, duration, and how they should be combined with other weight loss strategies like diet and exercise.

The protocol for phentermine involves using it short-term, usually a few weeks, in combination with diet, exercise, and behavior changes. It’s taken once a day, and healthcare providers will typically start patients on a low dose and adjust it based on the response.

Qsymia protocol involves a tiered approach, starting with a lower dosage and gradually increasing it until the desired effect is reached. This method helps to minimize potential side effects. The medication is taken once daily, usually in the morning.

Contrave usage in weight management follows a protocol of gradual dose escalation. Patients start with one tablet a day in the first week, and by week 4, they reach the maintenance dose of two tablets taken twice daily. This step-wise approach helps mitigate the impact of side effects.

The HCG diet protocol involves daily injections of HCG while maintaining a very low-calorie diet. The protocol is stringent and requires strict adherence. However, this method is not approved by the FDA for weight loss due to potential health risks and lack of evidence of effectiveness.

Lipo/B12 injection protocols may vary based on the healthcare provider’s assessment. Some individuals may receive injections weekly, bi-weekly, or monthly. The injections are often a component of a broader weight loss program that includes dietary adjustments and physical activity.

It’s essential to follow these protocols precisely when using medical weight loss medications. They’re designed to balance effectiveness with safety and are based on thorough clinical trials and research. Always consult a healthcare provider to ensure the correct protocol is followed for each medication.

Normal Cost/Packages of Medical Weight Loss Medications

The cost of medical weight loss medications can vary widely based on several factors, including the specific medication, dosage, location, and whether it’s covered by insurance. It’s critical to factor in the cost when considering weight loss treatment options.

Phentermine is usually the least expensive option, with monthly costs typically under $50, depending on the pharmacy and dosage. Some healthcare providers may offer a package that includes consultation fees, a month’s supply of the medication, and follow-up appointments.

Qsymia is more expensive than phentermine, often costing over $200 per month. Some patients may qualify for a savings program through the manufacturer that can help reduce out-of-pocket costs.

Contrave, similar to Qsymia, can cost over $200 per month. However, the manufacturer provides a savings card that can lower costs considerably for eligible patients.

The HCG diet can be costly, with the price often exceeding $1,000 for a course of treatment. This cost includes the HCG injections and necessary medical consultations, but given the risks associated with this diet, potential users should consider if the costs outweigh the benefits.

Lipo/B12 injections can vary in price. Some providers may charge around $20 per injection, while others may offer packages that include multiple injections, consultation, and other services, which can cost several hundred dollars.

When considering the cost of medical weight loss medications, it’s important to note that these are often part of a more extensive weight loss program that includes dietary changes, physical activity, and behavioral therapy. Therefore, the total cost of managing weight can be higher.

Remember, cost should not be the only factor when selecting a weight loss approach. The most successful programs are those that can be maintained in the long term and contribute to overall health and well-being. Consulting with a healthcare provider can help in making an informed decision that balances cost with personal health goals and safety.


Weight loss journeys are deeply personal and vary greatly from person to person. Medical weight loss medications like the hCG diet and lipo/B12 injections are just tools that may assist in this journey. Both have their merits and downsides, and the choice between the two should be made with careful consideration and professional medical advice.

While the debate surrounding these methods continues, it’s clear that these medical weight loss medications are not magic solutions. They work best when combined with a balanced diet, regular exercise, and a sustained commitment to a healthier lifestyle. Remember, your health is a precious resource; treat it with the care it deserves.

A Note From Replenish Aesthetics and Wellness

At Replenish Aesthetics and Wellness, the focus is always on a holistic approach to health and wellness. Medical weight loss medications, such as the ones mentioned above, are tools that may aid in the weight loss journey. But it is important to acknowledge that they are not standalone solutions.

Both of these methods have shown to be successful for some, but the effectiveness varies from person to person. They are not without potential side effects and, in some cases, may pose health risks.

Before embarking on any weight loss plan involving these medical weight loss medications, it is imperative to consult with a healthcare professional. They can provide a balanced perspective, taking into account individual medical histories, and overall health goals.

At Replenish Aesthetics and Wellness, the commitment is to guide each individual on their journey to wellness, offering tailored advice and solutions. Remember, weight loss is a journey, not a destination. It requires a commitment to lifestyle changes, encompassing a balanced diet and regular physical activity.

Healthy living is more than just losing weight. It involves nurturing your body, mind, and spirit. At Replenish Aesthetics and Wellness, the goal is to help you usher in a lifestyle of wellness, where weight loss is just one facet of the journey towards comprehensive well-being.

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