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Weight loss medications are used in combination with lifestyle modification to help promote healthy weight.
Weight loss medication can be used as an alternative or in combination with bariatric surgery optimize a person's weight and reduce risks associated with dangerous weight related diseases and conditions.
To qualify for weight loss medication, individuals should be already committed to a healthy lifestyle including diet and exercise. A BMI of 30 or higher, or a BMI of 27 or higher with weight-related health conditions is required. Weight related comorbidities include: Heart disease, diabetes, high cholesterol, high blood pressure, sleep apnea.
Weight loss medications are not always covered by health insurance, and a patient needs to verify coverage. Prior authorizations can take several weeks and require your active participation in a healthy lifestyle for coverage.
INJECTABLE WEIGHT LOSS MEDICATION
Class: GLP-1 receptor agonist
Mechanism of Action:
Wegovy is a shot you take once a week.
It helps you feel full sooner and less hungry.
It works by copying a natural hormone in your body called GLP-1, which helps control appetite and blood sugar.
FDA-approved Indications:
Chronic weight management in adults and adolescents (12+)
BMI ≥30 kg/m² (obesity) or ≥27 kg/m² (overweight) with at least one weight-related condition (e.g., high blood pressure, Type 2 Diabetes, High Cholesterol, Sleep Apnea)
Efficacy:
Average weight loss: ~15% of baseline body weight in clinical trials (STEP program)
Contraindications:
Personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia, type 2 (MEN 2)
Pregnancy
History of pancreatitis (caution)
Class: Dual GIP and GLP-1 receptor agonist
Mechanism of Action:
Zepbound is also a weekly shot.
It works in two ways: it copies two natural hormones, called GLP-1 and GIP.
These hormones help you feel full and control your blood sugar.
Zepbound may help some people lose even more weight than Wegovy.
FDA-approved Indications:
Chronic weight management in adults with obesity (BMI ≥30) or overweight (BMI ≥27) with at least one weight-related condition
Also approved under the name Mounjaro for type 2 diabetes
Efficacy:
Average weight loss: ~22.5% of baseline body weight in SURMOUNT trials — greater than semaglutide
Some participants achieved >25% weight loss
Contraindications:
Personal or family history of MTC or MEN2
Pregnancy
History of pancreatitis (caution)
ORAL WEIGHT LOSS MEDICATIONS
Mechanism of Action:
Sympathomimetic amine → increases norepinephrine release in CNS → suppresses appetite.
Contraindications:
Cardiovascular disease (Heart attack or stroke history, arrhythmias, uncontrolled high blood pressure)
Hyperthyroidism
Glaucoma
History of drug abuse
Pregnancy or breastfeeding
Concurrent use with MAOIs (risk of hypertensive crisis)
Mechanism of Action:
Phentermine: appetite suppression via adrenergic stimulation
Topiramate: anticonvulsant; mechanism unclear, may enhance satiety and reduce cravings.
Contraindications:
Pregnancy (teratogenic → cleft lip/palate risk)
Glaucoma
Hyperthyroidism
Within 14 days of MAOI use
Mechanism of Action:
Bupropion: dopamine/norepinephrine reuptake inhibitor → reduces appetite.
Naltrexone: opioid receptor antagonist → modulates reward pathways (cravings).
Contraindications:
Uncontrolled hypertension
Seizure disorders or history of seizures
Chronic opioid use or withdrawal
Eating disorders (e.g., bulimia, anorexia)
Pregnancy
Abrupt discontinuation of alcohol, benzodiazepines, or barbiturates (seizure risk)
BARIATRIC SURGERY VS. WEIGHT LOSS MEDICATIONS
All medications are prescribed based on medical evaluation and patient needs
WHAT IF MEDICATIONS ARE
DENIED OR NOT COVERED?
Compounded Weight Loss Medications
Compounded Weight Loss Medications
Compounded medications are created by compounding pharmacies if drug shortages exist or if specialty formulations or doses of medications are required.
Insuranace companies do not cover compounded drugs and compounded drugs are not FDA-approved.
Laws and regulations regarding insurance coverage for weight-loss medications are constantly evolving. It's crucial to stay informed about the latest developments and advocate for yourself.
Appeal the denial: If your request is denied, you have the right to appeal the decision. Start with an internal appeal, which requires your insurer to review its decision, notes HealthCare.gov. If the internal appeal is unsuccessful, you can file an external appeal where an independent third party reviews your claim.
Write a letter of advocacy: Visit the Obesity Action Coalition to learn how to advocate for insurance coverage and obesity management.
Explore cost-saving options: If your appeals are unsuccessful or you need to pay out-of-pocket, consider these strategies:
GoodRx coupons and discount programs: These can significantly reduce the cost of weight-loss medications, potentially bringing monthly costs down to several hundred dollars.
Manufacturer savings cards: Many drug manufacturers offer savings cards or patient assistance programs that can help offset the cost of their medications.
Utilize HSA/FSA: You can use your Health Savings Account or Flexible Spending Account to pay for eligible prescription medications, including those for weight loss.
We can not wait to meet you and help you with your journey to better health.
Fill out this form and we will contact you.
You can also email us at info@drbriangluck.com or call 231-246-1123 to speak with a team member.
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