A stock image of a series of pills wrapped in a fashion tape measurer, used to explain weight-loss drugs

With Ozempic scarce, here’s the skinny on other weight-loss drugs

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In today’s quest for weight loss, the allure of groundbreaking drugs like Ozempic and Wegovy has reshaped the landscape, with patients on the lookout for alternatives that are more available, from long-standing medications to pharmacy-made replicas.

While the demand for injectable medications like Ozempic soars, other options come with their own set of drawbacks. Those side effects may include nausea, upset stomach, constipation, or even diarrhea, says Nancy Georgekutty, MD, family and obesity medicine specialist on the medical staff at Methodist Mansfield Medical Center.

“If you already deal with GI problems, these won’t be the drugs for you,” says Dr. Georgekutty, whose Weight Loss and Wellness Center provides innovative solutions with a focus on quality care.

The surge in demand for drugs like Ozempic has prompted local pharmacies to craft compound drugs that mimic their effects.

“The challenge lies in determining the contents of these compounds, raising concerns about their safety and effectiveness,” Dr. Georgekutty says.

So let’s get the skinny from Dr. Georgekutty on everything from compounding to supplements and the older weight-loss medications that are often overshadowed by the popularity of the new drugs.

A bunch of red berries on a plant surrounded by leaves

SUPPLEMENTS: A MIXED BAG

Supplements offer a range of options for weight management, but they lack FDA regulation. Dr. Georgekutty introduces a few:

  • Berberine: Often called “nature’s Ozempic,” this natural chemical is found in plants and may cause side effects like nausea and diarrhea.
  • Chromium picolinate: This nutritional supplement enhances insulin response but may lead to gastrointestinal issues and can even throw off your balance and coordination.
  • Green coffee beans: These contain a high concentration of chlorogenic acid (CGA), a compound that helps reduce fat absorption in the body and increases metabolism. In high doses, this highly caffeinated supplement can raise the risk of heart palpitations, upset stomach, and diarrhea.
  • Raspberry ketones: This metabolism-boosting compound “helps reduce your appetite while also increasing your metabolism, and typically its side effects are very minimal,” Dr. Georgekutty says.

A medical professional in a white coat signing a prescription with a pill bottle in the foreground

WEIGHT-LOSS MEDICATIONS

Before the rise of Ozempic and Wegovy, other weight-loss medications were available. Here’s Dr. Georgekutty’s take on their benefits and possible side effects:

  • Phentermine HCL: This prescription medication, which has been around since the 1950s, stimulates the metabolism and suppresses appetite, but like other stimulants it may cause nervousness and sleeplessness.
  • Contrave: Also available only by prescription, this drug combines Wellbutrin and Naltrexone ingredients, with no known side effects on the heart or other organs.
  • Orlistat: Marketed under the brand name alli, this over-the-counter medication limits fat absorption, leading to oily and uncontrolled bowel movements, which can steer individuals toward healthier food choices.

A pharmacist preparing medications by weighing a substance on a scale and stirring with a spoon-like tool

RISKS OF COMPOUNDING

With shortages of drugs like Ozempic, Mounjaro, and Wegovy, some patients are turning to replica versions created in pharmacies, a process known as compounding.

However, compounding introduces risks as ingredients may differ from brand-name drugs, and side effects are often uncertain.

“You have to question, what exactly are they putting inside that compound?” Dr. Georgekutty warns, echoing the FDA’s warning about the lack of regulation in compounded drugs.

A person chopping fruit and vegetables at a cutting board while looking to instructions on their phone

SEEKING A DOCTOR’S ADVICE

With so many weight management options out there, Dr. Georgekutty advises consulting your primary care physician before starting any new medication, whether it’s a supplement or over-the-counter drug.

Collaborating with a trusted partner for lifestyle changes and behavioral health assessments can lead to more enduring results than relying solely on medication.

“It’s exhilarating to see patients feel at their best with the least amount of medications,” she says. “Lifestyle modifications and behavioral health assessments are also part of the plan, and those changes can be longer-lasting than drugs.”