Medical Weight Management for Overweight and Obese People

Chapter 1: Understanding Overweight and Obesity

It is more important than ever to understand the complexities of overweight and obesity, especially in the USA, where over 40% of adults are classified as obese, according to recent CDC data.

While both involve excess weight, obesity represents a more severe condition with a greater likelihood of serious health complications like type 2 diabetes, heart disease and nonalcoholic fatty liver disease. 

However, its causes are multifaceted, ranging from dietary imbalances and sedentary lifestyles to genetic predispositions, medical conditions, and even certain medications.

In this guide, we will cover all the aspects related to being overweight and obesity so that you can start your weight loss journey the right way. 

What is the difference between Overweight and Obese?

Overweight refers to a body weight greater than what’s considered healthy for a given height, while obesity is a condition characterized by excessive fat accumulation that poses a significant health risk.

Both indicate excess body fat, but obesity signifies a more severe level, with a greater risk of health complications. 

Let’s understand the difference in depth with this table:

What percentage of the US population is overweight and obese?

According to the latest data from the CDC, from August 2021 to August 2023, over 40.3% of U.S. adults were obese.

According to the 2017–2018 NHANES report, 30.3% of Americans were overweight, while 42.8% were obese. Among these, 9.6% were severely obese, which means they had a BMI at or above 40.0.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics 

These numbers are staggering and highlight the public health crisis we’re facing. This isn’t just about individual choices; it’s a societal challenge that requires comprehensive solutions. 

Are overweight and obese the same thing?

No. While they both involve excess weight, the degree of excess and the associated health risks differ significantly. Overweight is a precursor to obesity and early intervention can prevent progression.

How to calculate obesity and overweight?

We use the Body Mass Index, or BMI, as our primary tool to calculate obesity in adults. But other methods, like waist circumference and body fat percentage measurements, provide more detailed insights.

The BMI Formula

BMI = (weight in pounds / (height in inches x height in inches)) x 703

Let’s walk through an example:

Imagine someone who weighs 200 pounds and is 5 feet 10 inches tall (which is 70 inches).

1. Square the height: 70 inches x 70 inches = 4900 square inches
2. Divide the weight by the squared height: 200 pounds / 4900 square inches = 0.0408
3. Multiply by 703: 0.0408 x 703 = approximately 28.7

So, this person’s BMI would be around 28.7.

What BMI is considered overweight and obese?

A BMI of 25 to 29.9 is overweight, while a BMI of 30 or higher is obese.

There are 3 classes of obesity:

• Class 1: 30 to 34.9
• Class 2: 35 to 39.9
• Class 3 (Severe Obesity): 40 or higher.

How to Calculate Overweight and Obesity in Children

WHO recommends a different methodology to measure obesity and overweight in children between the ages of 0 and 19. This is because age has to be considered as a factor when measuring obesity in children.

For very young children (under 5 years old):

• Overweight – If their weight is much higher than the average for their height (specifically, more than 2 standard deviations above the average), they are considered overweight.
• Obese – If it’s even higher (more than 3 standard deviations above the average), they are considered obese.

For older children and teenagers (5 to 19 years old):

• Overweight – If their BMI is higher than the average for their age (more than 1 standard deviation above the average), they are considered overweight.
• Obese– If their BMI is significantly higher than the average for their age (more than 2 standard deviations above the average), they are considered obese.

What are the causes of obesity and being overweight?

First off, let’s dispel the myth that it’s just about laziness or lack of willpower. That’s a harmful oversimplification. Human biology is incredibly complex.

1. Dietary Imbalances

This isn’t just about eating too much. It’s about the type of calories we consume. For example highly processed foods which are loaded with refined sugars, unhealthy fats and artificial additives can wreak havoc on our metabolic systems.

They provide a massive dose of calories with minimal nutritional value and our bodies don’t register them the same way as solid food.

2. Sedentary Lifestyle

Sedentary behavior significantly increases with age, with young adults spending roughly 50-60% of their day inactive. Our bodies are designed for movement and when we don’t move, the energy we consume gets stored as fat.

3. Genetics

Genetics plays a significant role. Some individuals are genetically predisposed to store fat more easily or have a slower metabolism.

This study of twins, both those raised together and separately, demonstrated a strong genetic influence on BMI, with heritability estimates ranging from 66-74%, indicating that genes play a substantial role. Conversely, the shared childhood environment showed negligible impact on BMI similarity in later life.

However, genetics don’t determine destiny. They create a predisposition, which can be influenced by lifestyle choices.

4. Medical Conditions

Several medical conditions, such as hypothyroidism, Cushing’s disease, and even depression, can disrupt hormone balance or metabolic processes, leading to weight gain. 

Additionally, sleep disorders like insomnia and life stages like menopause can indirectly contribute to weight increase through hormonal changes and lifestyle shifts.

5. Prescription Medications

Many prescription medications, particularly those for diabetes, psychiatric conditions, and hypertension, can lead to significant weight gain by affecting appetite, metabolism, and hormone levels. This side effect is often accompanied by increased risks of metabolic disorders like type 2 diabetes and cardiovascular problems.

What are the health risks of being overweight and obesity?

1. Type 2 diabetes

The accumulation of excessive body fat disrupts normal metabolic processes. This leads to insulin resistance and impaired β-cell function, which are key factors in the development of type 2 diabetes.

2. Nonalcoholic fatty liver disease

The high amount of body fat leads to increased fatty acid delivery to the liver. This disrupts the balance of fat uptake and export, which results in the accumulation of triglycerides and the development of nonalcoholic fatty liver disease (NAFLD). This accumulation is further worsened by insulin resistance and inflammation, both of which are linked to obesity.

3. High blood pressure

When you put on excess weight, especially visceral fat, it compresses the kidneys. This activates the renin-angiotensin-aldosterone system and increases sympathetic nervous system activity, which leads to elevated blood pressure. Over time, this contributes to chronic kidney disease, which makes hypertension more difficult to manage.

4. Sleep Apnea

Fat deposits in the upper respiratory tract narrow the airway. This leads to breathing difficulties and recurrent pauses in breathing during sleep, which characterize obstructive sleep apnea (OSA). This results in decreased oxygen levels, causing sleep disturbances and associated health risks.

5. Osteoarthritis

Arthritis Foundation says, “Being just 10 pounds overweight puts an extra 15 to 50 pounds of pressure on your knees.” This leads to increased stress and accelerated cartilage breakdown. Obesity also contributes to systemic inflammation and hormonal imbalances, further exacerbating joint damage in osteoarthritis.

How to manage overweight and obesity?

One way is the dietary management of obesity, which primarily involves calorie restriction, with low-calorie (800-1500 kcal/day) or very low-calorie (<800 kcal/day) diets. 

A typical macronutrient distribution should be 55% carbohydrates, 10% proteins and 30% fats (with limited saturated fats). You can add regular exercise to your diet for faster and efficient results.

While the equation of “calories in versus calories out” seems simple, modern food environments and sedentary lifestyles can make it challenging. This is why medical weight management is often required to deal with obesity.

Chapter 2: Medical Weight Management – What Does It Mean?

Many people struggle with weight because they are not able to stick to their diets. You’ve probably tried a bunch of things, and maybe they worked for a bit, but then the weight came back. This is why Medical Weight Management is an important tool in many cases:

Medical weight management is a clinically supervised approach to helping individuals achieve and maintain a healthy weight that involves various therapies and medications along with proper diet and exercise.

It’s not a quick fix but a real plan that is guided by doctors and dietitians. They look at your whole picture and create a plan that fits you.

Importance of medically managed weight loss

The Obesity Medicine Association (OMA) emphasizes a comprehensive care model for obesity treatment built upon four fundamental pillars. These include Nutrition Therapy, Behavioral Modification, Physical Activity, and Medical Interventions.

This holistic plan showcases the importance of medical weight management, which can be summarized below:

1. Personalized and Individualized Plans: One of the primary advantages is the development of weight management plans that are highly personalized. These can be revised according to the individual’s unique health profile and weight loss goals. This individualized approach increases the likelihood of patient compliance and ultimately leads to more successful and sustainable results.
2. Medical Supervision and Safety: Healthcare professionals like doctors and dietitians can closely track the individual’s progress, monitor for any side effects from medications, and make timely adjustments to the treatment plan as needed. This medical oversight provides a level of safety for individuals with pre-existing chronic health conditions.
3. Improved Health Outcomes: The primary goal is not just to achieve weight loss but also to improve overall health and reduce the risk of obesity-related diseases. Therefore, participation in these programs can lead to significant improvements in conditions such as type 2 diabetes, high blood pressure, high cholesterol and sleep apnea.

Medical Weight Management – How Does It Work?

Medical weight management has an active involvement of healthcare professionals and is done under their supervision. The program usually has the following components:

1. Multidisciplinary Team: A cornerstone of effective medical weight management is the collaboration of a multidisciplinary team of experts. This team usually includes: 

• Obesity medicine physicians (MD, DO, PA, NP)
• Registered Dietitians (RD)
• Health psychologists and nurses
• Physical therapists, exercise specialists and coaches
• Bariatric surgeons (when necessary)

2. Initial Assessment and Evaluation: This involves a detailed review of the individual’s medical history, eating habits and exercise patterns. A physical examination is performed, including measurements of BMI, waist circumference, and blood pressure. Furthermore, laboratory tests, such as blood sugar levels, lipid profiles and thyroid function tests, may be ordered.
3. Personalized Treatment Plan Development: This plan takes into account the initial assessment. It incorporates:

• Tailored dietary recommendation
• Exercise guidelines
• Behavioral modification strategies
• Medical interventions such as prescription medications

4. Ongoing Monitoring and Support: Individuals with overweight or obesity were more successful in achieving significant weight loss (5% or 10%) when their doctor had informed them of their overweight status. Moreover, regular follow-up appointments help healthcare professionals to monitor the individual’s progress and make necessary adjustments to the treatment plan. 
5. Medical Interventions: In some cases, the possibility of lowering weight only with exercise and a diet plan is very low. This situation calls for the use of prescription weight loss medications. These medications work by targeting appetite and satiety. They slow digestion or interfere with fat absorption, which leads to reduced calorie intake and weight loss 

Medical Weight Management Programs: What It Is and How They Help You

Medical weight management programs offer lots of different options designed to fit the needs and preferences of people trying to get to a healthier weight. These programs are usually watched over by medical professionals and use proven strategies for weight loss and keeping it off.

1. Lifestyle Modification Programs

These programs are the backbone of medical weight management and focus on building daily habits you can stick with for long-term health and weight control. They often give you comprehensive guidance on nutrition, physical activity, and behavioral therapy, tailored to your specific situation and what you prefer. The goal is to teach you about making healthier food choices, getting regular exercise into your routine, and dealing with the psychological and emotional element that affects your eating behaviors.

2. Pre-Packaged Meal Replacement Plans

If you want something more structured, pre-packaged meal replacement plans offer a medically supervised option. These programs use specially made meal replacement products, like shakes, bars and soups, to give you a controlled and convenient way to cut calories while still getting enough nutrients. They’re typically combined with lifestyle changes and behavior change counseling to help you reach and maintain your weight loss. Some well-known pre-packaged meal replacement programs include OPTIFAST®, Health Management Resources (HMR), and Medi-Fast.

3. Pharmacological Programs

Many medical weight management programs include FDA-approved prescription weight-loss medications along with lifestyle changes. The choice of medication is carefully picked based on your health profile, medical history and any existing health conditions. These medications can work in different ways, like suppressing your appetite, making you feel fuller, or reducing how much fat your body absorbs.

4. Very Low-Calorie Diet (VLCD) Programs

Some specialized medical weight management programs, like the UCLA Medical Weight Management Program, offer very low-calorie diets (VLCDs) or modified VLCDs for quick initial weight loss. VLCDs typically involve using meal replacements along with a limited amount of vegetables, while modified VLCDs might include one small meal of regular food per day plus meal replacements. These programs are done under close medical supervision because of the significant calorie restriction and potential side effects.

Top Medical Weight Management Programs

1. UCLA Medical Weight Management Program

The UCLA Medical Weight Management Program, which used to be called the Risk Factor Obesity Clinic (RFO), has over 45 years of experience in helping people lose weight. They were among the first to study very low-calorie diets (VLCDs) for obesity. Their approach combines tailored dietary, physical activity, and behavioral lifestyle changes. The main part of their nutrition therapy is individualized protein intake, often using meal replacements like shakes and bars to achieve low-calorie intake with enough protein.

2. Mayo Clinic Diet

The Mayo Clinic Diet is designed to help you reshape your lifestyle by adopting healthy habits and breaking unhealthy ones for long-term weight management. It focuses on simple, enjoyable changes like eating more fruits and vegetables and adding daily physical activity. The diet has two phases: “Lose It!”, a two-week phase to jumpstart weight loss, and “Live It!”, a phase for continued weight loss and lifelong maintenance. It lets you eat unlimited fruits and vegetables and suggests at least 30 minutes of daily physical activity. The program is based on behavior-change science, focusing on motivation, goal setting, and managing setbacks to help you stick with it long-term.

3. Calibrate

Calibrate is an online medical weight management program that combines lifestyle changes with medication support for eligible people. This program focuses on combining proven methods for sustainable weight loss, including personalized coaching and curriculum, with access to GLP-1 receptor agonist medications when clinically appropriate. Calibrate aims to address the biological, psychological, and behavioral factors that contribute to weight, offering a comprehensive approach delivered through a virtual platform.

4. Noom Med

Noom Med is an extension of the popular Noom app. If you join Noom Med, you’ll get personalized support from healthcare providers who can prescribe medications if needed, alongside the app’s features that focus on psychology-based strategies for healthier eating and lifestyle habits. This program makes use of Noom’s behavior change expertise and integrates it with medical interventions. The program aims to empower you to make sustainable changes while also having the option of medical assistance.

Chapter 3: Medical Treatments for Obesity/Weight Loss

Weight loss medications have become a big help in managing chronic weight issues, especially if you meet certain criteria based on your BMI (that’s body mass index) and if you have other health problems related to your weight. Doctors typically consider these medications for adults with a BMI of 30 or higher, or for those with a BMI of 27 or higher who also have conditions like high blood pressure, type 2 diabetes or problems with their cholesterol levels. 

This is why it’s really important to understand what medical treatments are available for obesity and weight loss. We’ll cover FDA-approved pills and shots, how they work, and their possible side effects. We’ll also talk about diabetes medications that are used off-label for weight loss and take a peek at future weight loss drugs under clinical trials.

FDA-Approved Weight Loss Medications For Chronic Weight Management 

The U.S. Food and Drug Administration (FDA) has approved several medications, available as both pills and injectables, for the long-term management of chronic weight issues in adults and, in some cases, adolescents. These work through various mechanisms like appetite suppression and mimicking natural hormones. 

Additionally, some medications approved for other conditions, notably diabetes drugs like certain GLP-1 receptor agonists, are increasingly being used “off-label” for their significant weight loss effects, alongside other appetite suppressant medicines.

FDA-Approved Oral Weight Loss Medications

There are several pills that have gotten the green light from the FDA for long-term weight management. These medications work in different ways to help you lose weight and prove to be most effective when combined with lifestyle modifications.

1. Orlistat (Xenical, Alli)

Orlistat first got FDA approval back in 1999, making it one of the early players in the weight loss medication game. You can also get a lower-strength version (60 mg) over-the-counter called Alli.

Orlistat works by blocking fat-digesting enzymes in your gut. It’s pretty good at its job – it can reduce the amount of dietary fat your body absorbs by about 30%. 

Studies suggest it works better at blocking fat from solid foods than from liquids. What makes orlistat different from many other weight loss medications is that it works in your digestive system rather than affecting your brain’s appetite control.

In rare cases, orlistat has been linked to serious liver injury and it might increase your risk of kidney stones.

You shouldn’t take it if you’re pregnant or breastfeeding, or if you have certain digestive disorders.

As for how well it works, orlistat typically leads to modest weight loss compared to placebo. Therefore, it might not work as well as newer medications like liraglutide and semaglutide.

2. Phentermine (Adipex-P, Lomaira)

Phentermine is one of the oldest and most widely used weight loss medications, having been approved by the FDA in 1959. Initially used as a short-term medication to jump-start weight loss, newer guidelines have added it to long-term therapy. 

Phentermine helps with weight loss by increasing the release of norepinephrine in your brain, which helps suppress your appetite. It also boosts your energy expenditure as it acts as an adrenergic agonist.

Interactions may occur during or within 14 days following the use of monoamine oxidase (MAO) inhibitors, sympathomimetics, alcohol, adrenergic neuron-blocking drugs, and possibly some anesthetic agents.

Phentermine is contraindicated in individuals with hyperthyroidism, glaucoma, or heart disease, or who have had a stroke. It is also contraindicated during pregnancy. Some patients may lose about 5% of their body weight by taking phentermine.

3. Phentermine-Topiramate (Qsymia)

Phentermine-topiramate is a combo medication that got FDA approval in 2012. It combines two drugs that work together: phentermine and topiramate.

Topiramate, which is also used to treat epilepsy and prevent migraines, helps with weight loss by making food less appealing and potentially making you feel fuller. This combo approach targets different pathways involved in controlling appetite and feeling satisfied.

You shouldn’t take it if you’re pregnant, or if you have glaucoma, hyperthyroidism or if you’ve taken certain antidepressants (MAOIs) in the past 14 days.

It’s been linked to an increased risk of cleft lip and palate in babies if taken during early pregnancy. Because of the birth defect risk, there’s a special program in place to educate about prescribing information and monitor during treatment.

4. Naltrexone-Bupropion (Contrave)

Naltrexone-bupropion is another combo pill approved by the FDA in 2014 for chronic weight management. It’s not currently available in the VA formulary.

This medication combines naltrexone, which is mainly used to treat alcohol and opioid dependence, and bupropion, an antidepressant that affects certain brain chemicals. This combo is thought to target both the system in your brain that regulates appetite and the pathways involved in food cravings.

There’s a risk of suicidal thoughts and behaviors associated with bupropion, so doctors need to monitor patients carefully.

You shouldn’t take it if you have uncontrolled high blood pressure, seizure disorders, eating disorders like anorexia or bulimia, if you’re using opioids, or if you’re taking certain antidepressants. This highlights why it’s important for your doctor to know your full medical history before prescribing this medication.

While it might not be as powerful for weight loss as some other options, it may be particularly helpful for controlling food cravings.

FDA-Approved Injectable Weight Loss Medication

Besides pills, there are several injectable medications approved by the FDA for long-term weight management. These medications, mostly GLP-1 receptor agonists (a fancy term for drugs that mimic a natural hormone in your body), have shown they can be really effective for weight loss.

1. Liraglutide (Saxenda)

Liraglutide, sold under the brand name Saxenda, was approved by the FDA in 2014 for chronic weight management. It’s also approved for teenagers aged 12 to 17 years.

Liraglutide is a GLP-1 receptor agonist, which means it mimics the effects of a hormone your body naturally produces. This hormone helps regulate appetite, makes you feel fuller and slows down how quickly food empties from your stomach.

It’s also approved for kids aged 12 to 17 with obesity (BMI at or above the 95th percentile for their age and sex) and who weigh more than 60 kg, when used along with a reduced-calorie diet and increased physical activity. 

You shouldn’t take it if you or your family have a history of certain types of thyroid cancer or a condition called MEN 2.

However, studies suggest it might not work as well for weight loss as semaglutide and tirzepatide.

2. Semaglutide (Wegovy)

Semaglutide, sold as Wegovy, got FDA approval for chronic weight management in 2021. It’s also approved for teenagers aged 12 years and older. Plus, Wegovy is approved to reduce the risk of major heart problems, like heart attack or stroke, in adults with established heart disease who are also obese or overweight. 

Semaglutide also comes in a pill form (Rybelsus) which is approved for type 2 diabetes but is being studied for weight loss. As an injectable, semaglutide is a GLP-1 receptor agonist, similar to liraglutide, but it lasts longer in your body, so you only need to take it once a week.

Like liraglutide, you shouldn’t take it if you or your family have a history of certain types of thyroid cancer or MEN 2.

It’s been shown to work better than liraglutide for weight loss. However, some studies suggest that tirzepatide might lead to even more weight loss compared to semaglutide.

3. Tirzepatide (Zepbound)

Tirzepatide, sold as Zepbound, is the newest FDA-approved injectable medication for chronic weight management, getting approval in 2023. It’s also approved for treating moderate-to-severe sleep apnea in adults with obesity. 

Tirzepatide stands out because it’s the first medication that works on two different receptors – both the GLP-1 and GIP receptors. This dual action helps reduce appetite and food intake, slow down how quickly your stomach empties, increase insulin release, and lower glucagon (another hormone) secretion.

Clinical trials have shown that tirzepatide leads to significant weight loss compared to placebo and semaglutide (Wegovy). This makes tirzepatide one of the most effective medications currently available for weight loss.

4. Setmelanotide (Imcivree)

Setmelanotide is a newer medication, approved by the FDA in 2020. It works by activating a receptor in your brain called the melanocortin-4 receptor (MC4R). When this receptor is activated, it helps regulate appetite and energy expenditure, which leads to decreased hunger and increased calorie burning.

The criteria for prescribing setmelanotide are very specific. It’s only for people age 6 and older who have obesity due to certain rare genetic conditions, including POMC deficiency, PCSK1 deficiency, or LEPR deficiency, which must be confirmed through genetic testing. This very specific patient group reflects how targeted this drug is.

In people with these rare genetic conditions, setmelanotide has shown significant weight loss. This shows how effective it can be for this very specific genetic subset of people with obesity.

List of Off-Label Drugs for Weight Loss

Off-label use means using a medication for a condition or in a way that isn’t approved by the FDA.

Several medications approved for treating type 2 diabetes have been found to cause weight loss as a side effect and are sometimes used off-label for this purpose.

1. GLP-1 Receptor Agonists (Ozempic, Rybelsus)

GLP-1 receptor agonists, such as semaglutide (Ozempic, Rybelsus), liraglutide (Victoza), dulaglutide (Trulicity), and exenatide (Byetta/Bydureon), are mainly approved for lowering blood sugar in people with type 2 diabetes. 

These medications slow down how quickly your stomach empties and reduce your appetite. A significant benefit seen with these drugs is weight loss. 

In fact, Ozempic contains the same active ingredient (semaglutide) as Wegovy, which are approved for weight loss, but at lower doses.

Rybelsus, which is an oral form of semaglutide, is approved for type 2 diabetes but has shown weight loss comparable to Wegovy in higher doses studied in clinical trials. The manufacturer has indicated plans to seek FDA approval for its use in weight management.

However, the off-label use of these diabetes medications for weight loss has raised concerns about potential shortages for patients with diabetes who rely on them for blood sugar control. Additionally, the risks associated with these medications when used for weight loss are generally similar to those seen with the weight loss formulations.

2. Dual Gip And Glp-1 Receptor Agonist (Mounjaro)

Mounjaro, which contains the same active ingredient (tirzepatide) as the weight loss drug Zepbound, is approved for type 2 diabetes and has been observed to cause significant weight loss, leading to its off-label use for obesity.

Clinical trials showed an average weight loss of 34 pounds over 72 weeks with Mounjaro. The side effects of Mounjaro when used off-label for weight loss are expected to be similar to those of Zepbound, including nausea, diarrhea, and vomiting.

3. SGLT2 Inhibitors

SGLT2 inhibitors, including canagliflozin (Invokana), empagliflozin (Jardiance), and dapagliflozin (Farxiga), are another class of diabetes medications that have shown some weight loss benefits. 

These oral medications work by increasing the amount of glucose you pee out, leading to a modest loss of calories. While they mainly target blood sugar control, they’ve been linked to a modest weight loss of about 3 to 5 pounds over 6 months.

The potential risks of SGLT2 inhibitors include an increased risk of urinary tract and genital infections, dehydration, and a condition called ketoacidosis. The weight loss seen with SGLT2 inhibitors is generally less than with GLP-1 agonists, and they have different potential side effects.

4. Metformin

Metformin is a widely used oral medication for type 2 diabetes that works by reducing how much glucose your liver produces, increasing your body’s sensitivity to insulin, and may also affect your appetite and gut bacteria. Along with its blood sugar-lowering effects, metformin has been shown to cause modest weight loss, with some studies reporting an average loss of over 12 pounds in 6 months.

The main risks with metformin are digestive side effects, such as diarrhea and nausea. Metformin is a well-established and generally safe medication, and its modest weight loss benefit can be an extra advantage for overweight or obese people with type 2 diabetes.

Chapter 4: Clinical Trials for Weight Loss Drugs

The field of obesity pharmacotherapy is pretty busy these days, with scientists working hard to make treatments that work better and don’t cause as many side effects. There are several promising medications going through clinical trials right now that might really change how we handle weight loss in the future.

What Are Clinical Trials For Overweight And Obesity?

Clinical trials for overweight and obesity are research studies that aim to find new ways to prevent, detect, or treat these conditions and improve the quality of life for affected individuals. These trials involve volunteers who participate under the guidance of healthcare professionals and researchers.

Clinical trials for overweight and obesity follow these main steps:

Pre-clinical: Lab and animal testing to assess safety and potential.

Phase 1: Small group (20-100) to check safety and side effects.

Phase 2: Larger group (up to a few hundred) to test effectiveness and further assess safety.

Phase 3: Large, diverse group (up to thousands) to confirm effectiveness, monitor side effects, and compare to existing treatments. Successful Phase 3 leads to potential approval.

Phase 4: Post-market monitoring for long-term safety and effectiveness in real-world use.

Registered Clinical Trials for Weight Loss Drugs

Phase 3 Trials

Phase 3 trials are the final testing stage before medications can be approved. Your doctor might be excited about several drugs that are almost ready:

1. Cagrilintide and Semaglutide (CagriSema)

This is a combo treatment from Novo Nordisk that puts together semaglutide, which works on something called GLP-1 receptors, with cagrilintide, which mimics a hormone called amylin. You’d get it as a once-weekly shot under your skin. In Phase 3 testing, people lost around 22.7% of their weight on average. We might see CagriSema approved around late 2025.

2. Orforglipron (LY3502970)

Eli Lilly makes this one. It’s a daily pill that works on GLP-1 receptors, but it’s not a protein like other similar drugs – it’s a smaller molecule. Right now it’s in Phase 3 trials in what they call the ATTAIN program. Earlier studies showed people might lose up to 15% of their weight, and it could be approved in early 2026.

3. Retatrutide (LY3437943)

Another one from Eli Lilly, retatrutide is special because it works on three different receptors at once – GIP, GLP-1, and glucagon. You’d take it as a once-weekly shot, and it’s being tested in the TRIUMPH program. Earlier data showed people lost up to 24% of their weight over 48 weeks – that’s pretty significant. It might be approved by 2027.

4. Survodutide (BI 456906)

Two companies, Boehringer Ingelheim and Zealand Pharma, are working on this one together. It works on both GLP-1 and glucagon receptors. You’d get it once a week as a shot under your skin, and it’s in Phase 3 trials in the SYNCHRONIZE program. Earlier results showed nearly 19% weight loss after 46 weeks, and it might be available in 2027.

5. Mazdutide

This one’s made by Innovent Biologics, and like survodutide, it works on both GLP-1 and glucagon receptors. You’d get it as a shot under your skin, and it’s currently in Phase 3 trials.

6. Oral Semaglutide (higher doses)

Novo Nordisk is testing stronger versions (25mg and 50mg) of oral semaglutide, which is already approved as Rybelsus for type 2 diabetes. A Phase 3 study (they call it the OASIS program) showed weight loss of up to 15% with these higher doses, and it might be available in 2026.

Phase 2 Trials

There are other promising weight loss medications that aren’t quite as far along. They’re in Phase 2 clinical trials right now:

1. Amycretin (NN9487)

Novo Nordisk is making this drug that works on GLP-1 and amylin receptors. They’re developing it both as a daily pill and as a shot. Early trials of the pill showed about 13% weight loss over just 12 weeks. They’re also testing the shot version, and we’ll hear more about mid-stage trial results in early 2026.

2. MariTide (maridebart cafraglutide, AMG 133)

Amgen’s MariTide is a pretty special drug that both activates GLP-1 receptors and blocks GIP receptors. You’d get it as a shot, maybe just once a month or even less often. Phase 2 studies showed up to 20% average weight loss after a year, and they’re planning bigger Phase 3 trials now.

3. Danuglipron (PF-06882961)

Pfizer’s danuglipron is a daily pill that works on GLP-1 receptors. Earlier tests with twice-a-day dosing showed good weight loss, but lots of people dropped out. Now they’re focusing on a once-daily version that might work better, and they’re still figuring out the right dose.

4. VK2735

Viking Therapeutics is working on VK2735, which targets both GLP-1 and GIP receptors. They’re making both a shot and a pill form. Phase 2 results for the shot showed up to 13.1% more weight loss than placebo, and early testing of the pill form also shows it helps with weight loss.

5. Pemvidutide

Altimmune’s pemvidutide works on both GLP-1 and Glucagon receptors and is given as a shot under your skin. Phase 2 trials should be wrapping up soon.

6. Bimagrumab

Eli Lilly’s bimagrumab is a different kind of treatment – it’s an antibody that attaches to activin receptors. You’d get it through an IV once a month. It’s in Phase 2 trials and might help improve your body composition while you’re losing weight.

7. ARD-101 (Denatonium Acetate)

Aardvark Therapeutics is studying ARD-101, which is interesting because it activates bitter taste receptors in your digestive tract. This makes your body produce hormones that help control appetite. Right now it’s in Phase 2 trials for a condition called Prader-Willi syndrome and is also being studied for obesity caused by hypothalamic problems.

8. GSBR-1290

Structure Therapeutics is testing GSBR-1290, which is a small molecule pill that works on GLP-1 receptors. It’s in Phase 2b studies right now, and we should hear results in late 2025.

Chapter 5: Weight Loss Drugs Success Stories

The widespread use of glucagon-like peptide-1 (GLP-1) receptor agonists has drastically affected the weight loss segment. But this has not taken place in a vacuum as it is a result of numerous success stories that have motivated a lot of people to try these drugs.

Some of the drugs such as Ozempic, Mounjaro, and Rybelsus are some of the drugs that have been approved for Type-2 diabetes but are quite famous because of the amazing results that people have achieved and showcased over the internet. We will share some of these stories with you that might help you better decide which course you should take.

Ozempic (Semaglutide)

Ozempic is a shot you take once a week that contains semaglutide. It first became popular because it works really well for type 2 diabetes by helping control blood sugar (A1C levels) and might lower heart disease risks in some folks. Big studies like the SUSTAIN program showed these good results. But here’s the thing – doctors kept noticing patients were losing weight while taking it. With more data from the STEP program (which looked at higher doses, like what’s in Wegovy, specifically for weight problems), lots of people started using it “off-label” just to lose weight.

Susan & Michael Dixon: This couple’s story shows how people use it both ways. Susan, who had prediabetes, dropped 14 pounds in just six weeks using Ozempic off-label. She found it worked way better for her weight than stuff she’d tried before, like Weight Watchers or phentermine. Food just didn’t interest her as much anymore; she got full really fast, and she even stopped wanting alcohol. Michael, who took Ozempic for his actual type 2 diabetes, saw his A1C drop from too high to just 5 in about four months. He wasn’t even trying to lose weight, but still lost 15 pounds simply because the medicine made him feel full super quickly, making him eat about half what he used to. Their story shows how the drug cuts your appetite, but also some real-world problems. Susan had trouble during the 2022 Ozempic shortage and gained back 10-12 pounds when she couldn’t get her prescription filled for over two months.

Susanne Brown: Doctors prescribed Ozempic off-label for Susanne’s obesity after she gained back weight following stomach surgery. It completely changed her life. She lost tons of weight (going from 280 lbs to 140 lbs, though some of that was from her earlier surgery) and became super active, even climbing mountains and running. But at first, she had really bad side effects. The appetite control was so extreme she called it “doctor-approved anorexia,” eating tiny amounts like “two pieces of cauliflower” and needing caffeine supplements just to have energy to exercise. This led to not getting enough nutrients, causing anemia and hair loss. The important part is that she eventually got professional help, working with a therapist and personal trainer to build a healthier relationship with food, track her nutrients, and build muscle while still losing fat.

Holly Figueroa O’Reilly: After having trouble with two stomach surgeries and lots of diets, Holly finally found success with Ozempic in 2023. She lost 105 pounds and got down to a healthy weight of 145 pounds. For her, the medicine helped her develop a better relationship with food. She made sure to combine Ozempic with weightlifting and eating lots of protein. While she felt sick to her stomach and had diarrhea at first, these problems went away after a few weeks. Her story shows how Ozempic can be a helpful tool that makes big lifestyle changes possible even when other serious methods didn’t work.

Barbie Jackson-Williams: Using Ozempic mainly for her type 2 diabetes starting in early 2021, Barbie achieved an amazing 180-pound weight loss. Her blood sugar levels got much better, dropping to pre-diabetic levels. Like Holly, Barbie emphasized that the medicine wasn’t a magic fix: “People think they can just take it and get skinny, but it’s not true. You have to do the work.” She found Ozempic helped her make better food choices, but regular exercise and discipline were super important parts of her success, helping her feel more active and fit.

Other Notable Experiences: Several other people have shared big results. Pepper Schwartz lost around 30 lbs off-label and found it permanently changed her eating habits by reducing her appetite and helping her focus more on portion control and health.

Mounjaro (Tirzepatide)

Tirzepatide, sold as Mounjaro for type 2 diabetes and Zepbound for long-term weight management, is a newer kind of medicine that works on both GLP-1 and GIP receptors in your body.1 While Mounjaro is approved for diabetes 1, it’s really good at helping people lose weight, so many folks used it off-label for obesity before Zepbound was specifically approved for that.

Natalie Wilgus: As a fitness trainer, Natalie’s story gives us a pretty unique perspective. She had amazing weight loss, dropping 55 pounds (from 235 lbs to 180 lbs) in just six months while using Mounjaro along with her regular strength and cardio workouts. But surprisingly, she decided to stop taking the medicine, not because it wasn’t working for her body, but because of how it affected her mind and emotions. She felt the rapid weight loss wasn’t something she could keep up long-term and noticed she was focusing too much on the scale numbers instead of overall health. Her experience really shows that success isn’t just about physical changes; mental well-being, sustainability, and feeling like yourself are super important too. She stressed the need for “mental work,” like mindfulness and self-acceptance, alongside any physical changes.

Sharon Schwartz, a 61-year-old nurse anesthetist, finally lost 75 pounds after fighting with her weight her whole life, made worse when doctors removed her thyroid 25 years ago. When she got diagnosed with prediabetes in 2022 and worried about diabetes complications that ran in her family, she knew she had to do something. At 5-feet-2-inches and 200 pounds, even walking seven miles every day wasn’t helping anymore.

After talking with Hello Alpha, a doctor service online, she got prescribed Mounjaro, a GLP-1 medicine. This, plus eating a low-carb diet with mostly fish and vegetables and keeping up her walking, led to an amazing 10-pound weight loss in the very first week. Sharon now weighs 112 pounds and enjoys a more active, “more joyful” life, including going boating with her husband. She really wants people to know that “obesity is a disease” and encourages others struggling with weight to get help, pointing out that even with all her medical knowledge, she needed support too.

Alix Harvey, a 35-year-old marine biologist, had her life completely transformed by Mounjaro. After gaining weight following the birth of her two children, she worried she might become morbidly obese. Starting Mounjaro in May, Alix saw her BMI drop from 32 to 22 in just six months, losing 25% of her body weight.

The drug really changed her relationship with food and got her motivated to exercise, even leading her to start weightlifting. While she didn’t want to eat much at all when she first started, this effect got less intense over time. Alix found that what she paid monthly for the drug was balanced out by spending less on food. She feels Mounjaro has “completely changed” her life and stresses how important it is to have a plan for after you stop taking the medicine, emphasizing it’s “not a quick fix.”

Wegovy (Semaglutide)

Wegovy has the same active ingredient as Ozempic (semaglutide) but comes in higher doses and is specifically approved by the FDA for long-term weight management in people with obesity or those who are overweight with related health problems.

Dustin Gee: Dustin looked for help after gaining 50 pounds, reaching 225 pounds. Starting Wegovy in early 2023, he lost 45 pounds in the first nine months. When his weight loss slowed down, he took action by joining the Mayo Clinic Diet program, which is specially designed for people on GLP-1 medicines, to build habits he could keep up long-term after eventually stopping Wegovy. This combined approach helped him lose another 6 pounds, reaching his goal weight of 175 pounds. He focused on learning more about nutrition and dealing with emotional eating. Dustin said he had very few side effects, even at the highest Wegovy dose. His journey shows how important it is to combine behavior programs with medicine, especially if you want to avoid gaining weight back after treatment.

Lisa (Patient Ambassador for Novo Nordisk): Lisa used Wegovy for 20 months, losing 26 pounds (about 11% of her starting weight). She combined the medicine with eating fewer calories and being more physically active. She reported experiencing the typical changes in appetite, feeling full sooner, and having less “food noise” in her head. While we don’t know her specific side effects, general Wegovy safety information was provided. Her story shows steady, maybe more moderate, weight loss over a longer time compared to some of the rapid weight loss stories. (It’s worth noting she is a paid ambassador.)

On Reddit, user “Fiveminutes26,” who had switched from Zepbound to Wegovy because of shortages, reported losing 37.6 pounds over 5.5 months (about 1.8 pounds per week, or 12.45% of body weight). They found side effects like heartburn and sulfur burps manageable and noted the medicine helped them eat less and better understand their hunger signals.

Saxenda (Liraglutide)

Saxenda, which contains liraglutide, is another GLP-1 receptor medicine approved by the FDA for long-term weight management. Longer studies suggest that about half of the people who initially respond well maintain significant weight loss at three years if they keep using it and maintain lifestyle changes.

Lizz Adair, from Market Weighton, describes her experience with the weight-loss drug Saxenda as “life-changing.” Having been overweight for most of her life, she decided to try the daily shot after seeing a friend lose a ton of weight. Lizz bought Saxenda from an online pharmacy and dropped 10 stone (63.5kg).

The change has dramatically improved what she can do physically. She says, “Now I can walk miles and miles and my feet aren’t aching the next day, I’m not laid up in bed.” While Lizz found success buying it online, doctors warn that Saxenda, which suppresses your appetite, should only be used after talking to your GP because it can have serious side effects, and buying it online can be dangerous.

Reddit user “PizzaReheat” reported losing 20 kg (about 44 pounds) over about a year on Saxenda and kept the weight off for over a year, noting that it helped kickstart important lifestyle changes.

Rybelsus (Oral Semaglutide)

Rybelsus is special because it’s the only semaglutide you can take as a pill instead of a shot. While it’s not approved for weight loss, it often leads to modest weight reduction as a side effect, due to the same GLP-1 effects that suppress appetite and slow down how fast your stomach empties.

darragh_johnston: This user switched to Rybelsus from Trulicity because they couldn’t get Trulicity anymore. They noticed their appetite went down within the first two weeks, felt full faster by weeks 3-4, and had fewer cravings for sweets and fried foods. They started taking daily walks between weeks 5 and 8 and found it easier to choose healthier foods. By the second month, they had lost 24 pounds, describing the weight loss as gradual but steady. Importantly, their blood sugar levels also got much better throughout the five months of use. They saw Rybelsus as a helpful tool that made gradual, positive changes in both weight and diabetes management possible.

Chapter 6: Growth of the Weight-Loss Drug Market

The weight-loss drug market around the world is getting bigger pretty fast, with different experts giving different numbers about how big it actually is. Some say it was worth about $3.83 billion in 2023, while others think it was as high as $26.3 billion. That’s a big difference! 

The market is expected to grow even more in 2024. Looking ahead, this market is likely to keep growing really quickly over the next 5 to 10 years. Some experts think it could grow at a rate of nearly 50% each year from 2024 to 2029, and might reach a whopping $104.9 billion by 2035.

This growth is happening because of some really effective new drugs called GLP-1 agonists and dual GIP/GLP-1 agonists, more money being put into research, and new approaches like personalized medicine and digital health tools.

Global Weight-Loss Drug Market Predictions

The weight-loss drug market isn’t growing the same way everywhere in the world. Let’s understand growth stats in main regions and what is causing this.

1. North America

North America was the biggest market in 2023, with the United States leading the pack. This region is expected to stay on top, with the U.S. market alone possibly reaching $23.60 billion by 2032. North America has lots of people with obesity and spends a lot on healthcare, which helps drive this growth. GLP-1 agonists are really popular there.

2. Europe

Europe is the second-biggest market for these drugs. It’s growing pretty fast too, with experts predicting growth of about 22% each year from 2024 to 2029. This is happening because obesity rates are going up and governments are trying to help tackle the problem. Germany is one of the biggest markets in Europe.

3. Asia Pacific region

The Asia Pacific region is expected to see big growth in weight-loss drugs. This is because more people are becoming obese, lifestyles are changing, and people have more money to spend. China and India offer great opportunities for growth, and Japan’s market is also expected to get much bigger.

Other parts of the world like Latin America and the Middle East & Africa are looking promising too. Latin America might see really fast growth of about 42% each year from 2024 to 2030, mostly because obesity is becoming more common there. The Middle East and Africa markets should also grow quite a bit in the coming years.

Key Factors Driving The Growth Of The Weight-Loss Drug Market

The main reason the weight-loss drug market is growing so fast is because obesity is becoming more common worldwide. In 2022, over one billion adults were living with obesity, and this number might reach 1.13 billion by 2030.

Other than this some major factors have supported this growth such as:

1. New Effective Weight Loss Drugs

The approval of new, really effective weight-loss drugs has also helped the market grow. Medications like semaglutide (sold as Wegovy and Ozempic) and tirzepatide (known as Mounjaro and Zepbound) have shown amazing weight loss results in clinical trials, much better than older treatments.

In fact, studies show that tirzepatide works even better than semaglutide when they’re compared directly. Companies are also trying to make these drugs more accessible – for example, Eli Lilly launched something called LillyDirect to help people get Zepbound more easily.

2. Change in People’s Perspective

People’s views about medical weight loss are changing too. More people are okay with using drugs as part of their weight management plan, and many now prefer medication over just trying to change their lifestyle.

Many people believe prescription drugs can help them adopt healthier habits, and a lot of people say they’re interested in trying these medications. Social media is playing a big role in making people aware of and interested in these treatments.

3. Inactive Lifestyles And Unhealthy Eating Habits

Sedentary behavior, like sitting for long periods, is becoming more common, especially in developed countries. When you combine this with diets high in calories, processed foods, and sugary drinks, it’s easy to gain weight. This makes effective weight management strategies, including medications, even more important.

4. Rising Healthcare Costs

Obesity-related medical costs add up to billions of dollars each year in major markets like the U.S. and Europe. This huge financial burden highlights the need for treatments that can reduce these costs in the long run by preventing or managing the many health problems linked to excess weight.

Challenges Facing The Weight-Loss Drug Market

The weight-loss drug market has lots of potential, but it faces some tough challenges too. 

1. Expensive Medications

Many of these medications are really expensive, often more than $1000 per month, and insurance often doesn’t cover them unless you have other health problems besides just being overweight. This means a lot of people who could benefit from these drugs can’t afford them. 

2. Side Effects And Safety Concerns

While newer drugs are generally safer, common side effects like nausea and stomach issues can make it hard for patients to stick with treatment.

3. Long-Term Results

There’s also worry about whether these drugs work long-term and what happens when you stop taking them. Studies show that many people gain back the weight they lost once they stop medications like semaglutide and tirzepatide, which suggests you might need to keep taking them indefinitely.

4. Drug Approval Policies

On top of all this, regulatory hurdles from agencies like the FDA and EMA require tons of clinical data to prove these drugs work and are safe.

Major Pharmaceutical Companies And Other Key Players

Right now, the top four companies hold about 55% of the market, with Novo Nordisk and Eli Lilly together accounting for 68% of weight-loss drug sales. But the competitive landscape is changing fast, with predictions that 16 new drugs might be launched by 2029. 

Several big pharmaceutical companies are competing in the weight-loss drug market. 

1. Novo Nordisk is a major player, with popular drugs like Wegovy, Ozempic, and Saxenda. They’re investing heavily to make more of these drugs and are working on next-generation therapies like amycretin and UBT251. 
2. Eli Lilly has become a strong competitor with its drugs Mounjaro and Zepbound, which have shown even better weight loss results in clinical trials. Lilly is also developing weight-loss pills like orforglipron and retatrutide. 
3. Pfizer had some setbacks with its pill candidate danuglipron, but they’re still committed to staying in this market. 
4. Amgen is another important player, currently developing MariTide, which has shown good results in early trials. 
5. Roche entered the market by buying Carmot Therapeutics and partnering with Zealand Pharma. 
6. AstraZeneca is building its presence through early-stage development and collaborations. 
7. GlaxoSmithKline (GSK) has been in this market before with drugs like Orlistat (sold as Alli and Xenical).

Experts think Novo and Lilly will likely keep a significant market share, close to 70%, by 2031. Several smaller companies, including Viking Therapeutics, Altimmune, Structure Therapeutics, Metsera, and Zealand Pharma, are also developing promising therapies and might be acquired by larger players or form strategic alliances to enter the market.

Impact Of Growth On the Broader Healthcare Industry

Recent advances in weight-loss drug therapies are changing how we treat obesity. 

1. Development of GLP-1 Receptor Agonists

The emergence of glucagon-like peptide-1 (GLP-1) receptor agonists has been particularly important. These drugs mimic a hormone called GLP-1, which helps regulate blood sugar levels and reduces appetite. Drugs like semaglutide (Wegovy, Ozempic) and liraglutide (Saxenda) have shown they can help people lose a significant amount of weight. Pill forms of semaglutide are also being developed, which would be more convenient than injections.

2. Development of Dual GIP/GLP-1 Receptor Agonists

Dual agonists target both GLP-1 and another hormone called GIP. This represents another big step forward. Tirzepatide (Zepbound, Mounjaro) is one of these drugs, and it leads to even greater weight loss than GLP-1 agonists alone. Clinical trials have shown that tirzepatide works better than semaglutide.

3. Potential Development of Triple Agonists

Scientists are also developing triple agonists, which target GLP-1, GIP, and a third hormone called glucagon. Retatrutide is a good example, showing potential for even more substantial weight loss and metabolic benefits in clinical trials.

4. Potential Development of Amylin Analogs

Another approach involves amylin analogs, like cagrilintide, which help you feel full and slow down how quickly food leaves your stomach. Combination therapies involving amylin analogs and GLP-1 agonists, like cagrilintide combined with semaglutide (CagriSema), have shown promising results in achieving significant weight loss.

5. Shift Towards Weight-Loss Pills

The development of weight-loss pills is another key area of innovation. Oral GLP-1 receptor agonists, such as orforglipron, are in late-stage development and could offer a more convenient alternative to injections. While Pfizer has had some problems with its oral candidate danuglipron, the industry is still focused on developing weight-loss pills.

6. Development of Monthly Injections

Finally, better drug delivery methods are being developed, including less frequent dosing options, such as monthly injections like Amgen’s MariTide, which aim to make treatment more convenient and help patients stick with it.

Regulatory Landscape For Weight-Loss Drugs In Major Markets

The rules for approving weight-loss drugs vary in different parts of the world. 

In the United States, the Food and Drug Administration (FDA) oversees approvals, while in Europe, it’s the European Medicines Agency (EMA). Both agencies need extensive safety and efficacy data from clinical trials. The FDA tends to focus more on clinical endpoints, while the EMA requires a more in-depth review of human data.

FDA approval means that a drug’s benefits outweigh its known and potential risks for the intended users. The EMA is currently seeking feedback on the regulation of weight control medications for children, showing that these regulations continue to evolve.

Recent regulatory changes include the FDA’s approval of Wegovy in 2021 and Zepbound in 2023 for chronic weight management. The Biden administration had proposed allowing Medicare and requiring Medicaid to cover anti-obesity drugs. But the Trump administration rejected this plan citing the exponential increase in Federal expenses (around $35 billion over 10 years).

The FDA has also clarified its policies regarding compounding pharmacies and GLP-1 drugs as supply issues begin to stabilize. Some states have implemented specific prescribing standards for obesity medications, reflecting a growing focus on the appropriate use of these drugs. The EMA is also revising its guidelines for evaluating weight control products.

These regulatory developments show an increasing recognition of obesity as a disease and a move towards expanding access to medical treatments while ensuring patient safety and product quality.

Chapter 7: Weight Loss Medication Online

If you’re living in the United States and trying to lose weight, prescription medications that need a doctor’s approval are a pretty good way to get real results. These medications, when your doctor watches over how you use them, can help you lose a lot more weight than just changing what you eat and how much you exercise.

The US Food and Drug Administration (FDA) has given the green light to several prescription drugs you can use long-term for weight management. You might hear about newer medications like semaglutide, which doctors call Wegovy and Ozempic, and tirzepatide, known as Mounjaro.

These have gotten a lot of attention because they really work, both in studies and in real life. These medications usually help you lose weight by making you less hungry or making you feel full, so you end up eating less. But to get these weight loss medications in the United States, you need a valid prescription from a doctor.

Why Should You Buy Mediactions from Canada?

If you’re in the USA and looking for these helpful prescription weight loss medications, getting them from Canada can be a smart money move because drugs cost a lot less there than they do here.

This big price difference happens because the Canadian government controls and negotiates drug prices, which means you pay less than you would in the United States. For example, medications like Ozempic can be way more affordable if you get them from Canada.

A lot of people in the US have already started using Canadian pharmacies to get cheaper prescription medications, which shows more and more people think this is okay to do. And the quality and safety rules for medicines in Canada are strict, with Health Canada checking and regulating all medications.

Trustworthy Canadian pharmacies, especially ones with certificates from known organizations like the Canadian International Pharmacy Association (CIPA), follow high standards. The FDA recently said some states can import prescription drugs from Canada, which shows they’re starting to see the good points of this approach.

The process usually works like this: after you order a prescription weight loss medication, you submit your US prescription. The pharmacist looks it over, and if everything checks out, they ship your order right to your door.

Many good Canadian online pharmacies will have Canadian doctors review your US prescription, and they can write you a valid Canadian prescription if needed. This practice, sometimes called “co-signing,” makes sure everything follows Canadian rules while giving US residents access to affordable medications.

If you don’t want to go through that whole long process, you can order from a prescription referral service like Pandameds.Com.

Pandameds.com gives you an easy-to-use website to look at and possibly get these options, connecting you to reputable Canadian online pharmacies and helping with the online consultation.

When you’re thinking about online pharmacies for prescription medications, it’s really important to keep yourself safe by choosing legal and licensed sources to make sure the medications you get are real and good quality.

Chapter 8: Other Treatments for Obesity Management

The research shows that bariatric surgery can help you lose a lot of weight at first and improve health problems related to obesity. But keeping the weight off and staying healthy long-term really depends on eating well, being active, and making good lifestyle choices. Non-medical weight loss programs can give you a structure to help you lose weight, but they don’t all work the same in the long run.

In the end, picking the best non-medical treatment for your obesity is a personal choice that should take into account your health, what you prefer and how committed you are to making lifestyle changes that last.

Surgical Treatments for Obesity

Metabolic and bariatric surgery is a group of procedures that really work for treating severe obesity and the diseases that come with it. These modern surgical techniques have gotten much better over the decades and are now some of the most studied treatments in medicine.

A big improvement has been the use of minimally invasive techniques, like laparoscopic and robotic surgery. These use small cuts, which means less pain, fewer problems, shorter hospital stays and quicker recovery for you.

There are several different kinds of bariatric surgery that doctors commonly perform, each with its own procedure, good points, and drawbacks.

1. Roux-en-Y Gastric Bypass (RYGB)

RYGB or just gastric bypass, is a common and effective surgery that’s been used for over 50 years to treat obesity and related conditions. Doctors have been refining the laparoscopic approach since 1993.

The surgery divides your stomach into a small upper pouch, about the size of an egg, and a larger bottom part that gets bypassed and isn’t used for storing or digesting food anymore.

The small intestine is also divided, and your new, smaller stomach pouch connects directly to it, letting food pass through. The section of small bowel that drains the bypassed larger stomach connects further down the small intestine, creating a Y-shaped connection in your bowel. This allows digestive juices to eventually mix with the food you eat.

RYGB works in several ways, including:

• Limiting how much food and calories you can take in because of the smaller stomach.
• Decreasing how many calories and nutrients get absorbed by bypassing part of the small intestine.
• Changing hormones and metabolism, which makes you less hungry and more satisfied after eating.

But RYGB is technically more complicated compared to procedures like sleeve gastrectomy or gastric banding and has a higher risk of vitamin and mineral deficiencies and can cause “dumping syndrome,” a feeling of sickness after eating or drinking, especially sugary foods.

2. Laparoscopic Sleeve Gastrectomy

Often called the “sleeve,” it involves removing about 80% of your stomach, leaving the rest as a narrow, banana-shaped pouch.

This is done by freeing the stomach from surrounding organs and using surgical staplers to remove most of it. This new, smaller stomach holds less food and liquid, which directly reduces the amount of calories you consume.

By removing the part of the stomach that makes most of the hunger hormone (ghrelin), this surgery affects your metabolism by decreasing hunger, making you feel fuller, and helping your body reach and maintain a healthy weight, as well as improving blood sugar control.

Because this operation is relatively simple, it’s safer, avoiding potential complications that can happen with surgery on the small intestine. Good things about sleeve gastrectomy include its technical simplicity and shorter surgery time, making it suitable for certain patients with high-risk medical conditions and potentially as a first step for people with severe obesity.

The fact that sleeve gastrectomy became more popular between 2011 and 2019 suggests that more people prefer this procedure because it’s both effective and relatively simple.

3. Adjustable Gastric Banding (AGB)

It involves placing a silicone device around the upper part of your stomach to limit how much food you can eat. This procedure has been available in the United States since 2001.

The device, made of silicone, is positioned and secured around the upper section of your stomach, creating a small pouch above the band. How full you feel after eating depends on the size of the opening between this small pouch and the rest of your stomach.

This size can be adjusted by injecting or removing fluid through a port placed under your skin. Food passes through your stomach normally, but the amount is limited by the smaller opening the band creates.

This procedure generally doesn’t work as well for type 2 diabetes and has a more modest impact on metabolism compared to other bariatric surgeries.

The big decrease in the use of gastric banding from 2011 to 2019 shows it’s becoming less popular, probably because it doesn’t work as well and has more complications compared to other options.

4. Biliopancreatic Diversion with Duodenal Switch (BPD/DS)

The process starts with creating a tube-shaped stomach pouch, similar to the sleeve gastrectomy. It’s also like the gastric bypass because a significant portion of the small intestine is bypassed.

After creating the sleeve-like stomach, the first part of the small intestine is separated from the stomach. A section of the small intestine is then brought up and connected to the outlet of your newly created stomach.

The smaller, banana-shaped stomach limits how much food you can eat. The food stream bypasses about 75% of the small intestine, the most extensive bypass among commonly performed procedures.

Because of this, if you have this procedure, you must take vitamin and mineral supplements afterward.

Good things about BPD/DS include excellent results for improving obesity, affecting bowel hormones to reduce hunger and increase fullness, and being the most effective procedure for treating type 2 diabetes.

But it has slightly higher complication rates than other bariatric procedures and carries the highest risk of malabsorption and vitamin/micronutrient deficiencies.

5. Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S)

It is a newer bariatric surgery procedure endorsed by the American Society for Metabolic and Bariatric Surgery. It’s similar to the BPD/DS but simpler and quicker to perform because it only involves one surgical bowel connection.

The operation starts with a sleeve gastrectomy, removing about 80% of your stomach. Then, the first part of the small intestine (the duodenum) is divided, and a loop of the intestine is measured several feet from its end and connected to your newly created stomach pouch.

After SADI-S, food travels through your smaller stomach and directly into the latter portion of the small intestine, bypassing a significant segment and causing food to mix with digestive juices further down the tract.

This allows for enough vitamin and mineral absorption while still promoting good weight loss.

As a relatively new procedure, ongoing research is essential to fully understand its long-term outcomes and safety.

Healthy Dietary Approaches for Weight Loss and Obesity Management

The basic principle of a successful weight loss diet is to create a calorie deficit, which means you consume fewer calories than your body uses. This calorie deficit should be achieved through balanced nutrition, making sure you get enough essential nutrients from fruits, vegetables, whole grains, lean protein sources, and healthy fats.

At the same time, it’s important to limit foods and beverages high in added sugars, sodium, saturated and trans fats, and cholesterol, as these can add excess calories and lead to health problems.

Various dietary patterns have been recommended for weight loss and obesity management, each with its own focus and potential benefits.

1. Low-Fat Diets

Focuses on reducing your overall intake of fat, typically to below 30% of your total daily calories. These diets emphasize lean protein sources, fruits, vegetables, and whole grains. But research hasn’t consistently shown that low-fat diets work better than other dietary approaches for achieving long-term weight loss. The emphasis may be better placed on the quality of fats you consume rather than just the total amount.

2. Low-Carbohydrate Diets

Involves limiting carbohydrate intake to varying degrees, often below 40% of total daily energy, with ketogenic diets restricting it to less than 10% or 20-50 grams per day. These diets typically increase your intake of protein and fat. The Atkins diet, a well-known low-carbohydrate, high-protein approach, has shown effectiveness for weight loss in the short to medium term. However, the long-term sustainability and potential for nutrient deficiencies with such restrictive diets remain a concern.

3. Mediterranean Diet

Inspired by the traditional eating patterns of countries bordering the Mediterranean Sea. These are rich in fruits, vegetables, whole grains, legumes, nuts, seeds, and olive oil, with moderate amounts of fish, poultry, and dairy. The intake of red meat and processed foods is limited. This dietary pattern has been consistently linked to both weight loss and improvements in heart and metabolic health.

4. DASH (Dietary Approaches to Stop Hypertension) Diet

Originally designed to lower blood pressure, has also proven effective for weight loss. It emphasizes fruits, vegetables, whole grains, and low-fat dairy, while limiting saturated and total fat, cholesterol, and sodium. This makes it a particularly good option if you have obesity and high blood pressure or other heart risk factors.

5. Plant-Based Diets

Focuses on foods derived from plants, including fruits, vegetables, whole grains, legumes, nuts, and seeds. These diets, often high in fiber and nutrient-dense, have shown promise in promoting weight loss and improving blood sugar, cholesterol, and inflammation levels. However, careful planning is essential to ensure you get all the necessary nutrients.

Beyond the specific types of diets, the principles of portion control and mindful eating play a critical role in successful weight management. Being aware of how much you’re eating and not overdoing it is really important. Your body actually tells you when you’re hungry or full – paying attention to these signals can help control how much you eat. Mindful eating, which means eating slowly and really enjoying each bite without distractions like TV, can also help you manage your weight better.

Recommendations from trusted sources like the Dietary Guidelines for Americans and the American Heart Association give you a roadmap for healthy eating. These guidelines suggest making healthy eating a way of life instead of just following short-term diets.

The American Heart Association specifically says you should eat more fruits, veggies, and whole grains, choose healthier oils, pick lean proteins, check food labels, and make smarter food choices.

Role of Exercise in Weight Loss and Overall Health

Exercise breaks down into two main types: cardiovascular (aerobic) exercise and strength (resistance) training. Both have different but complementary jobs in helping with obesity.

Cardiovascular Exercises & HIIT

This includes activities that get your heart pumping and make you breathe harder, like walking briskly, running, swimming, or biking. It’s really good at burning calories and helping create that calorie gap you need for losing weight.

Beyond just helping with weight, cardiovascular exercise really improves your heart health, how well your lungs work, and your blood flow. When you do aerobic activity regularly, you’ll have more energy, better fitness, and feel stronger overall.

It also lowers your risk of developing chronic problems like heart disease, stroke, type 2 diabetes, and some cancers. Plus, cardio exercise can boost your mood, cut down on stress, and help you sleep better. It’s super important for keeping weight off long-term too.

If you’re short on time, high-intensity interval training (HIIT) might work for you. This is where you do short bursts of really hard exercise followed by rest periods. It can give you similar benefits to regular aerobic workouts but takes less time.

Strength Training for Muscle Building

You might hear this called resistance training or weight training. It involves exercises that work your muscles using weights, resistance bands, or just your body weight. While cardio is great at burning calories during your workout, strength training helps with weight management by building and maintaining muscle.

Your muscles burn more calories than fat does, even when you’re just sitting around. This means having more muscle helps your body burn more calories all day long, boosting your metabolism. Strength training also helps reduce your overall body fat percentage and makes you stronger.

It’s also great for building strong bones and lowering your risk of osteoporosis. It can make everyday activities easier and might reduce your risk of metabolic syndrome, type 2 diabetes, and heart disease.

Strength training works your fast-twitch muscle fibers, which improves your muscle strength and size. This increases how many calories your body can burn even when you’re not exercising.

Expert Advice on Exercise for Weight Loss

Organizations like the American College of Sports Medicine (ACSM) and the World Health Organization (WHO) provide guidelines for physical activity for weight loss and maintenance.

For good health, you should aim for at least 150 minutes every week of moderate-intensity aerobic activity. If you want to lose more weight and keep it off, you might need more, like 200-300 minutes or more each week.

You should also do muscle-strengthening activities that work all your major muscle groups at least twice a week. During moderate-intensity exercise, you should be able to talk but not sing.

If you’ve lost weight already, keeping it off might require even more activity, with some studies suggesting 60-90 minutes of moderate activity daily. The ACSM’s updated guidelines in 2024 stress that all types of physical activity are good for you, and exercise plans should be tailored to your individual needs and goals, looking at more than just your weight.

To successfully make physical activity part of your weight management plan, it’s best to start slow and gradually do more.

• Picking activities you actually enjoy is key to sticking with it long-term.
• Finding ways to move more in your daily life, like taking the stairs or walking during breaks, can also add to your overall activity.
• You can break up exercise into shorter sessions throughout the day if one long workout isn’t possible.
• If your joints hurt, try low-impact options like swimming, water aerobics, or using an elliptical machine for effective workouts with less strain on your body.
• Walking is particularly accessible and beneficial for many people, especially if you’re new to physical activity.

Chapter 9: Weight Loss Planning to Achieve in 3 Months

Weight loss is a long journey that requires sheer determination, but it also requires a realistic plan that you can stick to. To help you out, we have created this in-depth weight loss plan for a period of three months. This plan is divided into two parts: nutrition and exercise. So read till the last to get a 360 overview of the strategy.

Setting Realistic Goals and Expectations

Setting realistic goals is the first step in any successful weight loss journey. It’s pretty important to understand what you can actually achieve in a healthy way, as this can really impact how motivated you stay and whether you stick with your plan long-term.

Importance of Setting Achievable Weight Loss Goals

The National Heart, Lung, and Blood Institute (NHLBI) says that “setting the right goals” is a key first step to reaching a healthy weight. These goals help point you in the right direction and give you a way to check how you’re doing.

Why you want to lose weight makes a big difference in your journey, too. Research shows that if your reasons are about getting healthier and fitter, rather than just looking better, you’re more likely to keep going with your weight loss efforts over time.

Weight loss journeys are pretty long, which is why having goals you can actually reach helps you avoid feeling discouraged. Vague goals like “lose weight” don’t work as well as specific ones like “walk for 30 minutes, five days a week” or “cut 500 calories daily by choosing healthier foods.”

Healthy Rates of Weight Loss

Health authorities like the Centers for Disease Control and Prevention (CDC) always recommend losing weight gradually and steadily because you’re more likely to keep it off. The healthy rate they suggest is about 1 to 2 pounds per week.

This slower rate targets fat loss while helping save your muscle. It’s also easier on your body and lets you slowly develop eating and exercise habits that you can actually keep up with for the long haul.

Over three months, this means you lose between 12 and 24 pounds in a healthy way. Cutting about 500 calories a day usually leads to about one pound of weight loss each week.

Rather than focusing on a specific number of pounds, you should aim to lose a percentage of your current weight. The NHLBI suggests starting with 5-10%, which can be more realistic and personal than just picking a number.

Importance Of Tracking Progress

Tracking isn’t just about stepping on a scale. You can also measure different parts of your body (like waist, hips, and limbs), notice how your clothes fit, pay attention to changes in your energy and mood, and keep track of how well you’re sticking to your diet and exercise plan.

This helps with mindful eating, keeps you motivated, and helps you spot patterns or triggers. The act of tracking itself can change your behavior – knowing you’ll have to write down what you eat will make you think twice before making certain choices, making you more aware of your eating and activity.

Your 3-Month Nutrition Plan

A good nutrition plan is the cornerstone of successful weight loss. This section covers the food part of your 3-month plan, with a practical approach to food choices, portion control, and meal timing to create a calorie deficit while making sure you get all the nutrients you need.

Understanding Calorie Deficit

A calorie deficit happens when you burn more calories than you eat. Over time, this makes your body use stored fat for fuel, which leads to weight loss.

The total number of calories you burn each day is called your Total Daily Energy Expenditure (TDEE).

You can create a calorie deficit in three main ways:

• Eating fewer calories from food and drinks.
• Burning more calories through physical activity.
• Doing both of these together, which usually works best and is more sustainable.

Building a Balanced 3-Month Weight Loss Diet Plan

A balanced diet gives you all the essential nutrients—proteins, carbohydrates, fats, vitamins, and minerals—that your body needs to work properly, especially when you’re losing weight.

Macronutrient Breakdown (Protein, carbohydrates, and healthy fats)

Dietary guidelines generally suggest these ranges:

• Carbohydrates: 45-65% of your total daily calories
• Fats: 20-35% of your total daily calories
• Protein: 10-35% of your total daily calories

1. Protein

Protein makes you feel fuller than carbs or fats, which can help you eat fewer calories overall. Your body also burns more calories digesting protein than other nutrients.

2. Carbohydrates

Carbs are your body’s main energy source. For weight loss, you’ll want to focus on complex carbohydrates, which have more fiber and don’t spike your blood sugar as much.

3. Fats

Healthy fats are essential for many body functions, including making hormones, absorbing certain vitamins, and providing energy.

Table: Recommended Macronutrient Ratios for Weight Loss

Meal Planning Strategies (Portion Control, Meal Prepping tips)

These strategies help you consistently manage how many calories you eat and make you less likely to make impulsive, unhealthy food choices.

Portion Control

Controlling portion sizes is really important for managing your calorie intake, even when you’re eating healthy foods.

1. Use Smaller Dinnerware: Research shows that the size of your plates and bowls can affect how much you think you’re eating. Using smaller plates can make normal portions look bigger, so you eat less but still feel satisfied.
2. The Plate Method: Think of your plate as a guide. A good approach is to fill half with non-starchy veggies, one quarter with lean protein, and one quarter with complex carbs or whole grains. This helps you get a good mix of nutrients while naturally controlling calories.
3. Read Food Labels: It’s important to understand and pay attention to serving sizes on nutrition labels, since a package often contains more than one serving.
4. 20-Minute Rule: It takes about 20 minutes for your stomach to tell your brain it’s full. Waiting this long before getting seconds can help your body register that it’s satisfied, which prevents overeating.
5. Hand-Guide for Portions: Your hands can be a handy tool for estimating portion sizes without needing measuring cups or scales. This method helps you make smart choices in different situations, including when eating out.

Meal Prepping Tips

Meal prep means planning and cooking meals or parts of meals ahead of time. This saves you time during busy weekdays, reduces stress about daily cooking, and makes sure you have healthy, portion-controlled options ready to go, so you’re less tempted by convenience foods that are often high in calories and low in nutrients.

1. Start with small batches: When you’re just starting out, only prep for 2-3 days.
2. Chop vegetables in advance: Wash and chop veggies like onions, peppers, carrots, and broccoli. Store them in containers that don’t let air in for quick additions to salads, stir-fries, or snacks.
3. Create portions in containers: After you prepare meals, divide them into individual serving-size containers. This helps with portion control and makes grab-and-go meals easy.

3-Month Cut Plan

A “cutting diet” or “cut plan” comes from bodybuilding and fitness. It’s a diet designed to reduce body fat while keeping as much muscle as possible, to get a leaner, more defined look.

1. Fix Caloric Deficit: As we talked about earlier, calculate your TDEE and aim to eat about 500-750 fewer calories each day to lose 1-1.5 pounds per week.
2. Consume More Protein: Try to eat protein at the higher end of the recommended range, about 1.6-2.2 grams per kilogram of body weight (or 0.7-1 gram per pound).
3. Balance Fats and Carbohydrates: Make sure you get enough healthy fats (20-30% of your total calories) for hormone production and overall health. The rest of your calories should come from carbs, mainly complex, high-fiber ones.
4. Focus on Unprocessed Foods: This includes lots of vegetables, fruits, lean protein sources, and whole grains.

Your 3-Month Exercise Plan for Optimal Results

Diet and exercise working together is key to successful, lasting weight loss. While what you eat controls “calories in,” exercise significantly affects “calories out” and plays a big role in shaping your body composition.

Combining Cardio & Strength Training

A good exercise program for weight loss should include both cardiovascular (aerobic) exercise and strength (resistance) training for the best results.

Cardiovascular (Aerobic) Exercise

Cardio involves activities that raise your heart rate and breathing for a sustained period, challenging your heart and lungs.

For weight loss, aim for 150-300 minutes of moderate-intensity cardio per week, or 75-150 minutes of vigorous-intensity cardio per week. You can break this down into 3-5 sessions per week, each lasting 30-60 minutes.

Examples: Brisk walking, jogging, running, cycling, swimming, dancing, rowing, using elliptical trainers or stair climbers, and attending fitness classes.

Strength (Resistance) Training

Strength training involves working your muscles against resistance, which increases muscle strength, endurance, and mass.

Try to do at least 2-3 strength training sessions per week, targeting all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms). Sessions can last 30-60 minutes.

Examples: Lifting weights (dumbbells, barbells, kettlebells, weight machines), bodyweight exercises (push-ups, squats, lunges, planks), using resistance bands.

Week 1-4: Building a Foundation (Beginner-Friendly Exercises)

The main goals here are to get your body used to regular physical activity, establish a consistent workout routine, and learn proper exercise form.

Full-body workouts often work best for beginners, done 2-3 times per week on non-consecutive days to allow enough recovery time.

Weekly Workout Schedule: Weeks 5-8 (Increasing Intensity)

The second month focuses on progressively overloading the muscles to stimulate further adaptation, strength gains, and endurance improvements. This phase tests and builds resilience, as workouts become more challenging.

Weekly Workout Schedule: Week 9-12: Maximizing Results

The final month is about pushing towards peak fitness within the 3-month timeframe, solidifying strength gains, and maximizing body composition changes. The intensity and complexity of this phase are achievable due to the foundation built in the previous two months.

Frequently Asked Questions

Q1 – Why is BMI used to measure overweight and obesity?

Body Mass Index (BMI) is a widely used tool to screen for overweight and obesity by relating a person’s weight to their height. This calculation provides a single number that healthcare providers can use to estimate the amount of body fat an individual may have.

Furthermore, it is a quick and simple calculation that does not require specialized equipment, making it easy to assess during routine office visits. The measurement is non-invasive and inexpensive to obtain.

Q2 – How much weight do you lose on medical weight loss?

On average, patients participating in medical weight loss programs can expect to lose approximately 1 to 3 pounds per week. However, this rate can fluctuate, and the total amount of weight loss achieved can be substantial. 

For instance, a study published in the Journal of General Internal Medicine indicated that patients in a medically supervised weight loss program lost an average of 11.1 pounds over a 12-week period. Another study in Obesity found that a program including meal replacement shakes, medication, and lifestyle counseling resulted in an average weight loss of 34 pounds over 16 weeks.

Q3 – What is the most successful medication for weight loss?

Among the most effective weight loss medications currently available are the glucagon-like peptide-1 (GLP-1) receptor agonists. This class of drugs mimics a natural hormone in the body that helps regulate appetite and blood sugar levels. 

Several GLP-1 agonists have been approved for weight loss, including semaglutide (marketed as Wegovy and Ozempic), tirzepatide (marketed as Zepbound and Mounjaro) and liraglutide (Saxenda).

Q4 – What insurance plans cover weight loss medication?

Some Medigap and Medicare Advantage plans designed for retirees may include coverage for obesity treatments, so it’s essential to check the specifics of those plans.   

Medicaid, a joint federal and state program providing healthcare coverage to low-income adults and children, has varying policies on weight loss medication coverage depending on the state. Some state Medicaid programs might cover certain weight loss drugs, often requiring prior authorization to ensure medical necessity.

Q5 – How to get insurance to cover weight loss medication?

To increase the chances of obtaining insurance coverage for weight loss medications in the US, individuals should first thoroughly review their insurance policy to understand the specific details of their coverage. 

If the insurance plan requires prior authorization for the specific medication, the patient and their provider will need to complete the necessary steps to obtain this approval. 

The coverage might be initially denied. Patients have the right to appeal a denial of coverage and should act quickly to initiate the appeals process, often requiring a letter from their prescribing doctor.

Q6 – Does insurance cover weight loss medication?

In the US, coverage for weight loss medications is complex and often not guaranteed. Medicare, the federal health insurance program for individuals aged 65 or older and certain younger people with disabilities, generally does not cover medications prescribed solely for weight loss due to legal restrictions. 

However, if a medication like Ozempic or Mounjaro is also approved by the FDA for treating another medical condition, such as type 2 diabetes, and is prescribed for that purpose, Medicare might offer coverage.mounjaro.

Q7 – How much is Mounjaro without insurance?

Ozempic or Wegovy without insurance coverage in the US can exceed $15,000 per year, translating to over $1,000 per month. Given that Mounjaro (tirzepatide) is in a similar class of medications and has comparable efficacy to Ozempic and Wegovy, it is reasonable to infer that its cost without insurance in the US would likely fall within a similar high range.

Q8 – Is it OK to buy prescription drugs from Canada?

Despite the general prohibition, there is a growing movement to allow the importation of prescription drugs from Canada to help lower drug costs for Americans, as medications are often significantly cheaper in Canada due to government regulations on drug pricing. 

Some states in the US have been actively pursuing the importation of certain prescription drugs from Canada through specific programs and with FDA authorization. Florida became the first state to receive such authorization in January 2024.

Q9 – Can a U.S. citizen get prescriptions in Canada?

US citizens can generally get prescriptions filled by licensed pharmacies in Canada. However, Canadian pharmacies typically cannot accept prescriptions directly from US doctors. Instead, the US prescription usually needs to be reviewed and “cosigned” by a Canadian physician.

To avoid this hassle you can directly order medications from Canadian prescription referral service like Pandameds.Com which accepts US prescriptions and provides genuine medications.

Q10 – Is there anything over the counter like Ozempic?

No, there are no over-the-counter (OTC) medications that work exactly like Ozempic. Ozempic, and similar weight loss drugs like semaglutide, tirzepatide, and metformin, are only available with a prescription.

In the UK, orlistat (brand name Alli) is available over the counter, but it works differently than Ozempic and is not as effective for weight loss.