Weight Loss Pills: A Guide to Oral Obesity Medications
Weight ManagementWeight Loss

A Guide to Weight Loss Pills: Benefits, Risks, and More

A Guide to Weight Loss Pills: Benefits, Risks, and More
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Updated on January 30, 2026
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If you have obesity and are curious whether a weight loss medication could help you improve your health, there are a number of weight loss pills on the market to consider, both old and new.

“Recommending an appropriate anti-obesity medication requires collecting a thorough history from each patient, including an understanding of their weight loss goals and expectations,” says Kyle J. Thompson, MD, a bariatric and weight loss surgeon at Intermountain Health in Denver. Ultimately, finding the right fit for you requires accounting for these details, considering your lifestyle, and weighing the benefits and risks of each medication with your doctor.

Prescription Weight Loss Pills

Drug
Weight Loss (% of Body Weight)
Common Side Effects
Dose
Semaglutide (Wegovy)
13–16%
Nausea (44%), diarrhea (30%), vomiting (24%)
Once daily on empty stomach
Phentermine/topiramate (Qsymia)
8–10%
Numbness or tingling (20%), dry mouth (19%), constipation (16%)
Once daily
Naltrexone/bupropion (Contrave)
5–6%
Nausea (33%), constipation (19%), headache (18%)
Twice daily with water
Orlistat (Xenical)
5–6%
Oily spotting (27%), flatus with discharge (24%), fecal urgency (22%)
Three times daily with meals containing fat

Oral Semaglutide (Wegovy)

Oral semaglutide (Wegovy) was approved by the U.S. Food and Drug Administration (FDA) in December 2025 as a treatment for weight loss in people with obesity and at least one related health condition.

 In clinical trials, oral semaglutide helped participants lose an average of 13.6 percent of their total body weight over about 15 months. For someone with a starting weight of 235 lbs, that translates to about 33 lbs of weight loss.

Oral semaglutide is a prescription medication that’s intended to be used in conjunction with a reduced calorie diet and regular physical activity to help adults with obesity and related health problems lose weight. It’s also used to help lower the risk of major cardiovascular events like heart attack and stroke in adults who are overweight or have obesity and also have heart disease.

 Wegovy is the first oral glucagon-like peptide-1 (GLP-1) agonist approved for these purposes.

GLP-1 drugs (including semaglutide) work by mimicking GLP-1, a hormone made by the small intestine, increasing satiety by affecting areas of the brain that process hunger and slowing stomach emptying.

Side Effects and Warnings

The most common side effects of Wegovy include gastrointestinal issues like nausea (the most frequently reported symptom), constipation, diarrhea, stomach pain, and vomiting. Other side effects may include dizziness, fatigue, headache, heartburn, and runny nose or sore throat.

Available in a dose of up to 25 milligrams (mg), the Wegovy pill is taken daily in the morning when you first wake up, on an empty stomach and with no more than 4 ounces (oz) of water. You must then wait 30 minutes before eating, drinking, or taking any other oral medications.

This regimen may be a limiting factor for some: Even once-daily medications can fail if they don’t fit naturally into a person’s routine, says Auda Auda, MD, a board-certified family medicine physician at Baker Health in New York City.

“Oral semaglutide often falls short outside of trials because adherence and side effects become limiting factors,” says Dr. Auda. “It’s the most challenging of these weight loss pills due to its strict fasting and timing requirements.”

Wegovy isn’t recommended for people who have a personal or family history of medullary thyroid cancer. (In rodent studies, Wegovy caused thyroid tumors, but it’s unclear how it may affect the human thyroid.) It’s also not recommended for those who have or have had problems with their pancreas or kidneys, type 2 diabetes and a history of diabetic retinopathy, or mental health issues. It shouldn’t be used by people scheduled for surgery that requires anesthesia, those who are pregnant or planning to become pregnant within two months, or people who are breastfeeding.

If none of these contraindications apply to you and you can adhere to its specific administration instructions, the Wegovy pill may be an option. “Oral semaglutide may work for highly disciplined patients who want to avoid injections,” says Auda.

Phentermine and Topiramate (Qsymia)

Phentermine and topiramate (Qsymia) is a combination of medications used alongside a lower-calorie diet and exercise for weight loss. It’s available as an extended-release capsule.

In clinical trials, participants who took the highest dose of Qysmia (15 mg of phentermine and 92 mg of topiramate) experienced an average weight loss of 9.8 percent of their total body weight after one year of treatment, compared with 1.2 percent in the placebo group.

Qysmia works by reducing appetite and hunger.

Side Effects and Warnings

Side effects may include back pain, change in taste, constipation, ear congestion, loss of voice, and mood changes.

“In clinical experience, patients taking Qsymia seem to meet expectations for weight loss if they don't experience or are able to tolerate the side effects,” says Dr. Thompson. “Anxiety and insomnia are also common side effects of Qsymia.”

Qsymia is taken once daily in the morning, with or without food. It should be avoided in the evening to prevent sleep disturbances.

Qysmia isn’t recommended for people who are pregnant or may become pregnant. It’s also not safe for those who have used an MAO inhibitor antidepressant like Eldepryl, Marplan, Nardil, or Parnate in the past two weeks, as using these medications together can cause serious side effects. It’s also important to know that this medicine may be habit forming.

Naltrexone and Bupropion (Contrave)

Naltrexone and bupropion (Contrave) is a combination of medications used alongside a lower-calorie diet and exercise for weight loss. Like Qsymia, it’s available as an extended-release capsule.

In clinical trials, participants taking the maximum dose of Contrave (32 mg of naltrexone and 360 mg of bupropion) lost an average of about 6 percent of their total body weight after one year of treatment, compared with about 1.4 percent among participants in the placebo group.

Naltrexone and bupropion are thought to have an impact on long-term weight loss by affecting brain areas that control hunger, helping individuals feel fuller, eat less, and burn more calories.

Side Effects and Warnings

Common side effects include constipation, diarrhea, dizziness, dry mouth, headache, nausea, trouble sleeping, and vomiting.

The dosing of Contrave increases over time:

  • Week 1, one morning pill daily
  • Week 2, one morning pill and one evening pill daily
  • Week 3, two morning pills and one evening pill daily
  • Week 4 and beyond, two morning pills and two evening pills daily
Contrave should be taken with 8 oz of water, and it’s best to drink additional glasses of water throughout the day to both support weight loss and prevent constipation.

“Contrave’s eventual twice-daily dosing and gradual titration [can] lead to missed doses,” says Auda. However, he says that Contrave can be a good option for people who struggle with cravings or emotional eating if they can adhere to the regimen.

Conversely, it’s not recommended for those with certain conditions, like seizure risk or uncontrolled hypertension (high blood pressure). Contrave also shouldn’t be used by people who take other medications containing bupropion, have or have had anorexia or bulimia, are dependent on opioid pain medications, drink a lot of alcohol, or use sedatives or anti-seizure medications.

Orlistat

Available as both a nonprescription medication (Alli) and a prescription drug (Xenical), orlistat is a lipase inhibitor, meaning it prevents some fat in food from being absorbed in the intestines. It’s intended for people who are overweight and may also have high blood pressure, diabetes, high cholesterol, or heart disease. It can also be used to prevent weight regain after weight loss.

In clinical trials, participants who took prescription-strength orlistat (120 mg three times daily) lost an average of about 13 pounds (5 to 6 percent of their body weight) after four years, compared with an average of about 6.5 pounds of weight loss in the placebo group.

Side Effects and Warnings

The most common side effect of orlistat is changes in bowel movements, including an increased number of bowel movements, loose stools, oily spotting on underwear, and stomach pain.

“Orlistat is poorly tolerated by many patients due to the gastrointestinal effects, and patients often find that the benefits do not outweigh the side effects,” says Thompson.

Orlistat must be taken three times daily with a meal that contains fat (or up to one hour after eating).

 To prevent vitamin deficiency, a multivitamin must also be taken but at a different time than when orlistat is taken.
Orlistat shouldn’t be used by people who are pregnant or may become pregnant, are breastfeeding, take certain medications (including Apixaban or Enoxaparin), take supplements (including linoleic acid and vitamin E), or have certain medical issues. Tell your doctor if you have diabetes, hypothyroidism, kidney failure, or liver disease before taking orlistat.

Prescription Appetite Suppressants

Short-term appetite suppressants can also support weight loss by helping you feel full faster, but they require caution due to potential severe side effects and addiction risk.

Prescription appetite suppressants for short-term use (usually a maximum of three months) include these options:

  • benzphetamine (Didrex, Regimex)
  • diethylpropion (Tenuate, Tenuate Dospan)
  • phendimetrazine (Prelu-2)
  • phentermine (Atti-Plex P, Dipex-P, Pro-Fast, and others)

Side Effects and Warnings

The side effects of short-term prescription appetite suppressants include abdominal pain, dizziness, dry mouth, headache, insomnia, mood changes like agitation or irritability, nausea, rapid or irregular heartbeat, and vomiting.

Those who are most likely to benefit most from an appetite suppressant already have an established food and exercise plan in place.

“Short-term appetite suppressants like phentermine reliably reduce appetite, but the challenge is maintaining results after stopping,” says Auda.

Over-the-Counter Weight Loss Pills and Supplements

You may also find over-the-counter supplements that claim to support weight loss. Such supplements include these products:

  • Botanicals and Herbs African mango, bitter orange, hoodia, and more purportedly support weight loss, energy expenditure, and metabolic health.
  • Stimulants Caffeine pills are often marketed for increasing calorie burn and fat loss.
  • Tea Extracts Options like green tea extract (with or without caffeine) are suggested to increase calorie and fat burn, as well as decrease the body’s ability to store fat.

However, both Thompson and Auda caution against using most over-the-counter products that claim to drive weight loss.

“Most contain undisclosed stimulants or ingredients with no proven benefit,” says Auda. “If I suggest anything over the counter, it’s evidence-based support like protein, fiber, hydration, or electrolytes — tools that support metabolism rather than promise rapid weight loss.”

The Takeaway

  • Several FDA-approved oral medications, including Wegovy (oral semaglutide), Qsymia, Contrave, and Orlistat, offer weight loss benefits when paired with diet and exercise.
  • These drugs work in different ways, such as mimicking hormones to increase satiety, suppressing appetite, or blocking fat absorption; however, they frequently cause gastrointestinal issues, mood changes, and other uncomfortable side effects.
  • The effectiveness of these weight loss pills often depends on strict dosing schedules, which can make real-world results less consistent than clinical trials.
  • Experts warn against over-the-counter weight loss supplements and herbs, noting that they often lack proven benefits.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. FDA Approves Oral Semaglutide as First GLP-1 Pill for Weight Loss. The American Journal of Managed Care. December 23, 2025.
  2. Wharton S et al. Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity. The New England Journal of Medicine. September 17, 2025.
  3. Is Wegovy Pill Right for Me? Wegovy.
  4. Gilden AH et al. Obesity. Annals of Internal Medicine. May 14, 2024.
  5. GLP-1 Agonists. Cleveland Clinic. July 3, 2023.
  6. What You Might Expect With Wegovy. Wegovy.
  7. Your Complete Guide to Wegovy Pill. Wegovy.
  8. Phentermine and Topiramate (Oral Route). Mayo Clinic. January 1, 2026.
  9. Gadde KM et al. Effects of Low-Dose, Controlled-Release Phentermine Plus Topiramate Combination on Weight and Associated Comorbidities in Overweight and Obese Adults (CONQUER): A Randomised, Placebo-Controlled, Phase 3 Trial. The Lancet. April 16, 2011.
  10. Phentermine; Topiramate Extended-Release Capsules. Cleveland Clinic.
  11. Naltrexone and Bupropion (Oral Route). Mayo Clinic. January 1, 2026.
  12. Sherman MM et al. Naltrexone/Bupropion ER (Contrave). Pharmacy and Therapeutics. March 2016.
  13. What to Expect. Contrave.
  14. Orlistat. MedlinePlus. July 20, 2024.
  15. Torgerson JS et al. XENical in the Prevention of Diabetes in Obese Subjects (XENDOS) Study: A Randomized Study of Orlistat as an Adjunct to Lifestyle Changes for the Prevention of Type 2 Diabetes in Obese Patients. Diabetes Care. January 2004.
  16. Orlistat (Oral Route). Mayo Clinic. October 1, 2025.
  17. Appetite Suppressants. Cleveland Clinic. November 20, 2023.
  18. Shah M et al. When Should I Consider Using a Medication to Assist With Weight Loss? Mayo Clinic. June 5, 2024.
  19. Dietary Supplements for Weight Loss. National Institutes of Health Office of Dietary Supplements. May 18, 2022.
Additional Sources

Annals of Internal Medicine. Obesity. Gilden AH et al. May 14, 2024.

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Adam Gilden, MD, MSCE

Medical Reviewer
Diplomate of American Board of Obesity Medicine Foundation

Adam Gilden, MD, MSCE, is an associate director of the Obesity Medicine Fellowship at University of Colorado School of Medicine and associate director of the Colorado University Medicine Weight Management and Wellness Clinic in Aurora. Dr. Gilden works in a multidisciplinary academic center with other physicians, nurse practitioners, registered dietitians, and a psychologist, and collaborates closely with bariatric surgeons.

Gilden is very involved in education in obesity medicine, lecturing in one of the obesity medicine board review courses and serving as the lead author on the Annals of Internal Medicine article "In the Clinic" on obesity.

He lives in Denver, where he enjoys spending time with family, and playing tennis.

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Kelsey Kloss

Author

Kelsey Kloss is a health and wellness journalist with over a decade of experience. She started her career as an in-house editor for brands including Reader’s Digest, Elle Decor, Good Housekeeping, Prevention, Woman's Day, and Redbook, and her work has been featured in over 50 publications.

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