More than you will ever need to know about weight loss medication

Courtney Contreras

12d • Precision Health Discussions

🧬 Wednesday Medication Mic Drop: Why some weight-loss meds work better than others (and it’s not willpower)

Not all weight-loss medications are created equal—and it’s not because people “try harder” on one versus another.

Here’s the simplified landscape 👇

📉 Lowest average weight loss (≈3–7%)

Orlistat

🧪 Works in the gut by blocking fat absorption

⚠️ Doesn’t affect hunger hormones or metabolism

🧠 Calorie loss without brain signaling = limited results and no patterned behavior change

💩 The unwanted side effect! no words needed here

📉📉 Moderate weight loss (≈5–10%)

Phentermine

🧪 Sympathomimetic appetite suppression

⚠️ Raises heart rate, BP, stress signaling

🧠 Appetite suppression without metabolic repair isn’t sustainable

📉📉📉 Moderate–High (≈8–12%)

Naltrexone/Bupropion (Contrave)

🧪 Dopamine + reward pathway modulation

⚠️ Works best for emotional/reward-driven eating

🧠 Behavior pathways matter—but biology still runs the show

📉📉📉📉 High (≈10–15%)

Liraglutide (daily GLP-1)

🧪 GLP-1 receptor activation → insulin sensitivity + satiety

⚠️ Shorter half-life = more GI side effects for some

🧠 Hormone signaling beats appetite suppression

📉📉📉📉📉 Very high (≈15–22%+)

Semaglutide / Tirzepatide (weekly GLP-1 / GIP-GLP-1)

🧪 Multi-pathway metabolic signaling:

Insulin sensitivity
Inflammation reduction
Kidney sodium handling
Vagal tone improvement

🧠 Ah-ha: These meds change gut brain communication, changes the way food signals the reward system and the metabolic environment, not just food intake

🔬 Why higher-ranked meds work better

The more effective medications:

Signal to the brain
Improve insulin dynamics
Reduce inflammatory load
Support nervous system regulation

Weight loss happens because the body finally feels safe enough to release energy. Which is why severe calorie restriction alone eventually stops working.

⚠️ Important truth most people miss

If dosing is rushed or nutrition is ignored, even the most effective meds cause: