This educational activity is credited for 3 contact hours at completion of the activity.
This course aims to offer an overview of pharmacological interventions for weight loss, exploring their mechanisms of action and approved clinical uses. It examines both FDA-approved and off-label medications, outlines their safety profiles, and highlights key nursing considerations essential for safe and effective patient care.
Obesity has become an escalating global health concern, presenting significant challenges in modern healthcare. For individuals who struggle to achieve weight loss through diet and exercise alone, pharmacological interventions offer a critical alternative. This course provides an overview of weight loss medications, examining their mechanisms of action and clinical indications. It also explores both FDA-approved and off-label treatments, along with their safety profiles and essential nursing considerations.
Upon completion of this course, the learner will be able to:
This activity has been planned and implemented in accordance with the policies of CheapCEForNurses.com.
Cheap CE For Nurses, Inc and its authors have no disclosures. There is no commercial support.
To access Obesity and Weight Loss Medications, purchase this course or a Full Access Pass.
If you already have an account, please sign in here.
To access Obesity and Weight Loss Medications, purchase this course or a Full Access Pass.
If you already have an account, please sign in here.
| Adipose Tissue | Commonly known as fat tissue, is a type of connective tissue that stores energy as fat. |
| Arrhythmias | A condition characterized by abnormal heart rhythm. |
| Bariatric Surgery | A surgery that helps reduce food consumption and help weight loss by removing a part of stomach thereby reducing its size. |
| Body Mass Index (BMI) | A measure of body fat based on weight and height. |
| Brainstem | The distal part of the brain that connects the cerebrum, cerebellum, and spinal cord. |
| Central Nervous System (CNS) | The part of the nervous system consisting of the brain and spinal cord. |
| Central Obesity | Also known as abdominal obesity and truncal obesity. Is the condition of an excessive concentration of visceral fat around the stomach and abdomen to such an extent that it is likely to cause health problems. |
| Coronary Artery Disease | A type of heart disease where the arteries of the heart cannot deliver enough oxygen-rich blood to the heart. |
| Cytokines | Signaling proteins that help control inflammation in the body. |
| Depression | A mood disorder that causes a persistent feeling of sadness and loss of interest. |
| Dopamine | A chemical messenger that helps regulate many functions in the body and brain. |
| Energy Homeostasis | A biological process that involves the coordinated homeostatic regulation of food intake (energy inflow) and energy expenditure (energy outflow). |
| Enteroendocrine Cells | Specialized cells of the gastrointestinal tract and pancreas with endocrine function. |
| Estrogen | A hormone that plays a role in both male and female reproductive systems. |
| Gamma-Aminobutyric Acid (GABA) | A natural amino acid that acts as a calming neurotransmitter in the brain. |
| Ghrelin | A hormone that signals the brain to feel hungry and increases appetite. |
| Glucagon-Like Peptide-1 (GLP-1) | A hormone that is produced and secreted by the brain and intestine upon food consumption. |
| Glucagon | A peptide hormone, produced by alpha cells of the pancreas. |
| Glycemic Control | Maintaining euglycemic blood glucose levels. |
| Heart Failure | A progressive heart disease that affects pumping action of the heart muscles. |
| Hypertension | High pressure in the arteries (vessels that carry blood from the heart to the rest of the body). |
| Hypothalamus | A brain structure that controls your body’s balance and hormones. |
| Insulin Resistance | A complex condition in which the body does not respond as it should to insulin, a hormone the pancreas makes that is essential for regulating blood sugar levels. |
| Lipase Inhibitor | Substances used to reduce the activity of lipases found in the intestine. |
| Liraglutide | An anti-diabetic medication used to treat type 2 diabetes, and chronic obesity. |
| Low Self-Esteem | Lack of confidence, feeling incompetent or inadequate. |
| Menopause | The time when menstrual periods permanently stop, marking the end of reproduction. |
| Monoamine Oxidase Inhibitors (MAOI) | A type of antidepressant that blocks the breakdown of neurotransmitters in the brain. |
| Neurotransmitters | The chemical messengers that carry signals between nerve cells, muscles and glands. |
| Norepinephrine | Also called noradrenaline (NA) or noradrenalin, is an organic chemical in the catecholamine family that functions in the brain and body as a hormone, neurotransmitter and neuromodulator and is responsible for the “fight or flight” response. |
| Obesity | A condition characterized by abnormal or excessive fat accumulation. |
| Orlistat | A medicine that blocks some of the fat that is consumed, causing weight loss and preventing weight gain. |
| Osteoarthritis | The most common form of arthritis that affects any joint and causes pain, stiffness and loss of mobility. |
| Overweight | Having more body fat than normal for height and weight. |
| Pancreatic Beta Cells | Located in the pancreas and found in groups called islets, beta cells create insulin, a hormone that regulates blood glucose levels. |
| Peripheral Artery Disease (PAD) | Caused by a buildup of fatty, cholesterol-containing deposits (plaques) on artery walls. |
| Phentermine | Used to speed weight loss in overweight people. |
| Pro-Opiomelanocortin Deficiency | A rare genetic disorder that causes severe obesity that begins at an early age |
| Serotonin | A chemical that carries messages between nerve cells and influences mood, sleep, digestion, nausea and more. |
| Serotonin Reuptake Inhibitors (SSRIs) | A class of drugs that are typically used as antidepressants in the treatment of major depressive disorder, anxiety disorder, and other psychological conditions. |
| Sibutramine | An appetite suppressant which has been discontinued in many countries. |
| Sleep Apnea | A potentially serious sleep disorder in which breathing repeatedly stops and starts. |
| Steatorrhea | Oily stool is not always related to an underlying condition. |
| Teratogenicity | The study of abnormalities of physiological development in organisms during their life span. |
| Total Cholesterol | The overall amount of cholesterol in the blood. |
| Triglyceride | Fats in the body that can raise the risk of heart and vascular disease. |
| Type-2 Diabetes | A condition that occurs as a result of the inefficient way that the body regulates and uses sugar as a fuel. |
| Visceral Fat | Also known as intra-abdominal fat, is a type of fat that accumulates deep within the abdominal cavity and surrounds vital organs. |
Obesity remains a significant global health challenge, with its prevalence steadily increasing in recent years. In the United States, the economic and societal impact is profound, with current estimates placing the associated costs at over $1.4 trillion—an alarming rise from the $976 billion recorded a decade ago. These figures encompass a wide range of expenses, including direct medical costs, disability-related expenditures, early mortality, reduced workplace productivity, and increased absenteeism.⁵ Among the available treatment strategies, pharmacological interventions have gained recognition as essential tools, particularly for individuals who struggle to achieve meaningful weight loss through lifestyle changes alone. This course provides an overview of weight loss medications, exploring their mechanisms of action, appropriate clinical applications, FDA-approved and off-label options, safety profiles, and key nursing considerations.
Obesity is a complex medical condition characterized by excessive body fat that negatively affects health. Clinically, obesity is often assessed using Body Mass Index (BMI), a calculation based on height and weight. The World Health Organization (WHO) defines BMI categories as follows: a BMI under 18.5 is underweight, 18.5–24.9 is considered healthy, 25–29.9 is overweight, and 30–39.9 qualifies as obese. A BMI of 40 or higher is classified as morbidly obese.²⁶ While BMI is a convenient screening tool, it has limitations—it does not differentiate between fat and muscle mass. For example, muscular individuals may be incorrectly categorized as overweight or obese.¹⁶
BMI also fails to account for fat distribution, especially central obesity, which is linked to higher health risks. Individuals may fall within a healthy BMI range yet still face obesity-related complications due to high body fat or abdominal fat. For older adults or diverse ethnic populations, BMI may not accurately reflect health status.¹⁶ Despite these shortcomings, BMI remains useful in clinical settings due to its simplicity. To enhance assessment accuracy, providers should evaluate waist circumference, body fat percentage, and personal medical history. A more comprehensive approach helps identify risks in individuals who might otherwise go undiagnosed—for instance, someone with a normal BMI but high visceral fat and diabetes.⁹
Health Risks Associated with Obesity
Being overweight or obese significantly increases the risk of various health problems, including heart disease, type 2 diabetes, respiratory conditions, joint disorders, mental health issues, and certain cancers.⁴ Central obesity, in particular, places strain on cardiovascular function and triggers inflammation, contributing to hypertension, coronary artery disease, and heart failure. Excess visceral fat also disrupts insulin sensitivity and glucose metabolism, increasing the risk of type 2 diabetes. If unmanaged, diabetes can lead to complications like kidney damage and neuropathy.
Obesity also affects respiratory function. Fat deposits around the neck and chest wall restrict lung capacity and contribute to asthma, decreased respiratory muscle strength, and obstructive sleep apnea. In terms of musculoskeletal health, carrying extra weight accelerates wear and tear on major joints, such as knees and hips, contributing to osteoarthritis.⁴
Obesity is also associated with an elevated risk for several cancers, including breast, colon, and pancreatic cancers. Adipose tissue releases hormones and inflammatory markers that promote tumor development and growth. Insulin resistance and systemic inflammation further increase cancer risk. In addition to physical complications, obesity has profound psychological effects. Stigmatization and negative body image contribute to depression, low self-esteem, and social withdrawal.¹² Biological changes related to obesity may also disrupt mood regulation and cognitive performance.
Epidemiology of Obesity
Obesity has reached epidemic proportions worldwide, affecting people across all demographics. Globally, around 3 billion adults are overweight, and 16% are classified as obese.²⁷ In the United States, one-third of adults are overweight, while approximately 40% live with obesity.¹⁴ Severe obesity disproportionately affects women, with 11% impacted compared to 6% of men. This disparity is partly due to differences in fat metabolism and hormonal shifts, especially during menopause, which often leads to increased visceral fat.¹⁰
The issue extends to younger populations as well. Among individuals aged 2 to 19 in the U.S., one in six is overweight and one in five is obese.¹⁴ These rates have more than doubled since the 1980s, driven by poor dietary habits, sedentary behavior, urban environments, and socioeconomic challenges.¹⁴ Racial, ethnic, and economic disparities also influence obesity prevalence. Non-Hispanic Black adults exhibit the highest rates (38%), followed by Hispanic (32%) and non-Hispanic white adults (28%).¹⁵ Factors such as genetics, cultural attitudes toward food and exercise, access to nutritious foods, and quality of healthcare all contribute to these disparities.
Weight management medications utilize various pharmacological mechanisms to target the biological systems that regulate appetite, metabolism, and energy balance.³ These medications act on specific molecular pathways in the central nervous system (CNS), gastrointestinal system, and peripheral tissues to promote weight loss. Many weight loss medications influence neurotransmitters such as serotonin, dopamine, and norepinephrine. For example, drugs that inhibit serotonin reuptake, like sibutramine, increase serotonin levels in the brain, which can elevate mood and decrease appetite—both of which support weight reduction.²
Medications that act on dopamine receptors, such as phentermine, influence the brain’s reward system. By reducing dopamine reuptake, they diminish the desire for reward-based eating and food cravings, making it easier to follow a calorie-controlled diet. Additionally, phentermine enhances norepinephrine activity, which suppresses hunger, increases satiety, and boosts energy expenditure.³ This combination helps individuals maintain a calorie deficit needed for weight loss.
Other medications target hormonal pathways involved in hunger and digestion. Ghrelin, a hormone produced in the stomach, stimulates appetite.ⁱ³ Drugs that block ghrelin activity can reduce food cravings. In contrast, medications like liraglutide and semaglutide mimic glucagon-like peptide-1 (GLP-1), a hormone that plays several roles in appetite and glucose regulation.²⁵ GLP-1 agonists bind to receptors in the gut, pancreas, and brain, increasing insulin secretion, decreasing glucagon release, slowing gastric emptying, and enhancing satiety. These effects result in better glycemic control and reduced food intake.
GLP-1 receptor activation in the brain also influences regions involved in appetite and energy regulation, such as the hypothalamus and brainstem, further promoting weight loss through decreased hunger and increased energy output.²⁵
Some medications, such as orlistat, target digestive enzymes rather than neurotransmitters or hormones. Orlistat inhibits pancreatic lipase, an enzyme responsible for breaking down dietary fat. By reducing fat absorption in the intestine, orlistat decreases total caloric intake, leading to weight loss.
Indications for Weight Loss Medications
When prescribing weight loss medications, healthcare professionals evaluate BMI, associated comorbidities, prior weight loss efforts, and the patient’s psychological condition.³ These medications are typically indicated for adults with a BMI of 30 or higher (obese). They may also be appropriate for individuals with a BMI of 27 or higher (overweight) who have at least one obesity-related condition such as type 2 diabetes, hypertension, dyslipidemia, or sleep apnea.
In some situations, individuals with a healthy BMI but significant risk factors—such as a strong family history of obesity, a history of gestational diabetes, or marked abdominal obesity—may be considered for treatment. Before initiating pharmacotherapy, patients should have attempted non-pharmacologic weight loss strategies such as diet modification, physical activity, and behavioral interventions.³ If these measures fail to yield sufficient results, medications may be introduced as a less invasive alternative to bariatric surgery.
Since many weight loss medications affect neurotransmitters and receptors in the CNS, they can influence mood, alertness, and cognitive function. Therefore, evaluating the patient’s psychological readiness for treatment is essential. Providers should continue to monitor mental health status throughout the course of treatment to identify any emerging concerns and ensure adherence to the therapy plan.
Over the past two decades, the Food and Drug Administration (FDA) has approved six medications for long-term weight management. These include⁸:
An additional medication, lorcaserin, was approved in 2012 but later withdrawn from the market in 2020 due to potential cancer risks.⁶
Bupropion-Naltrexone (Contrave)
This combination therapy, approved in 2014, merges bupropion—an antidepressant and smoking cessation aid—with naltrexone, commonly used in managing opioid and alcohol dependency.⁸ Research indicates that the combined formulation enhances weight loss outcomes, with clinical trials showing an average of 11 pounds lost over one year compared to placebo. However, treatment adherence can be limited due to a higher incidence of adverse effects relative to other anti-obesity medications. Common side effects include constipation, dry mouth, dizziness, nausea, and vomiting. Bupropion-naltrexone can also elevate blood pressure, necessitating regular monitoring, particularly during treatment initiation. It is contraindicated in individuals with uncontrolled hypertension, those on opioids, and patients taking monoamine oxidase inhibitors or medications that lower the seizure threshold.
Liraglutide (Saxenda)
A GLP-1 receptor agonist, liraglutide is administered via subcutaneous injection and used to treat type 2 diabetes and obesity.⁸ Following its FDA approval in 2014, studies showed significant improvements in weight and blood sugar control in overweight or obese patients with diabetes.⁶ While effective, liraglutide frequently causes gastrointestinal symptoms—most notably nausea and vomiting—which often lead to early discontinuation. Despite this, it remains a viable treatment option for patients who can tolerate its effects and prefer injectable therapies.
Orlistat (Xenical, Alli)
Approved in 1999, orlistat is a lipase inhibitor that reduces fat absorption in the gastrointestinal tract by approximately 30%.⁸ When combined with dietary and exercise modifications, it can effectively reduce BMI, total body weight, and cholesterol levels. On average, it leads to a 5% reduction in baseline body weight. Orlistat’s benefits extend to cardiovascular health due to improvements in lipid profiles and endothelial function. However, its mechanism of action frequently results in gastrointestinal disturbances, such as oily stools and increased flatulence. These effects can interfere with the absorption of fat-soluble vitamins. Orlistat is not recommended during pregnancy or breastfeeding and is unsuitable for children under 12. Special caution is required in patients with thyroid issues, epilepsy, coagulation disorders, or HIV due to potential drug interactions.
Phentermine-Topiramate (Qsymia)
This combination therapy includes phentermine, a sympathomimetic that suppresses appetite, and topiramate, an anticonvulsant that enhances satiety.⁸ Approved by the FDA in 2012, clinical trials showed a weight reduction of 5% or more from baseline.⁶⁷ The medication’s efficacy is often higher than that of other anti-obesity treatments, although side effects such as insomnia, blurry vision, headaches, and neuropsychiatric symptoms like anxiety and mood disturbances can occur. Its use is contraindicated in pregnancy due to the risk of birth defects and should be avoided in individuals with glaucoma. Additionally, phentermine’s similarity to amphetamines raises concerns about potential misuse. Nonetheless, it is generally well-tolerated and effective in promoting weight loss.
Semaglutide (Wegovy)
A once-weekly GLP-1 receptor agonist, semaglutide was approved in 2021 for chronic weight management.⁶ Data from the STEP clinical trial program demonstrated that participants achieved an average weight loss of up to 16%, significantly outperforming the placebo group.⁸ Additional benefits included reductions in waist circumference and systolic blood pressure. Gastrointestinal complaints—such as nausea, abdominal discomfort, vomiting, and diarrhea—are common but manageable. Compared to liraglutide, semaglutide shows superior weight loss outcomes, with a more favorable administration schedule (weekly vs. daily). This makes it an appealing option for patients willing to undergo injectable treatment.
Setmelanotide (Imcivree)
Setmelanotide, approved in 2020, is a melanocortin-4 receptor (MC4R) agonist that works by enhancing signaling in the hypothalamus to suppress appetite and increase energy expenditure.²³ Unlike earlier agents in this class, setmelanotide has not been associated with increased heart rate or blood pressure. It is specifically indicated for patients aged six years and older who have obesity due to rare genetic disorders, including pro-opiomelanocortin (POMC) deficiency, proprotein convertase subtilisin/kexin type 1 (PCSK1) deficiency, or leptin receptor mutations. Genetic confirmation of these conditions is required prior to treatment. Setmelanotide does not cure these disorders but significantly aids in weight reduction and appetite control. It is administered daily via subcutaneous injection. Side effects may include injection site reactions, hyperpigmentation, gastrointestinal issues, and changes in sexual function. Depression and suicidal ideation have also been reported, necessitating close psychological monitoring during treatment.
Some prescription drugs, while not approved by the FDA for weight loss, are commonly used off-label due to observed secondary effects that promote weight reduction.⁷ These medications are originally intended for other health conditions but have shown potential for supporting weight management based on clinical experience, emerging research, or the prescribing provider’s judgment. Despite these uses, they remain outside official FDA indications for obesity treatment due to limited clinical trial data supporting their long-term safety and efficacy.
Examples of off-label medications used for weight loss include certain antidepressants, antiepileptics, and diabetes treatments. Some antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and bupropion, may contribute to weight loss in specific patients. Although they are not typically used as primary weight loss therapies, they are sometimes better tolerated than approved anti-obesity drugs. Similarly, antiepileptic drugs like topiramate and zonisamide have appetite-suppressing properties and may help reduce binge eating behavior. However, evidence supporting their long-term effectiveness and safety for weight management remains inconclusive.
Diabetes medications such as metformin and certain formulations of semaglutide, including Ozempic, have also been linked to weight reduction. This effect, however, is primarily based on clinical observation rather than formal studies focused on weight loss outcomes in non-diabetic populations.
Prescribing off-label is legally permissible and not inherently unethical, but some jurisdictions impose restrictions to ensure safe practice.⁷ For instance, Ohio law prohibits prescribing controlled substances for weight loss outside of their FDA-approved labeling. These regulations aim to protect patients and maintain adherence to clinical standards.
Before prescribing medications off-label for weight management, healthcare providers must assess each patient’s unique medical history, risk factors, and treatment goals. They must also carefully weigh potential benefits against possible adverse effects and ensure there are no safer, evidence-based alternatives.
Benefits
Weight loss medications can lead to meaningful and lasting reductions in body weight when incorporated into a broader weight management program.¹ Depending on the medication and dosage, individuals typically achieve a 5%–7% reduction in baseline body weight within three months. For someone weighing 250 pounds, this equates to approximately 12.5 pounds of fat loss. Such weight reduction may improve respiratory function, reduce symptoms of obstructive sleep apnea, regulate blood sugar, lower blood pressure, and enhance lipid profiles.
These medications offer additional benefits tied to their mechanisms of action.¹ GLP-1 receptor agonists like liraglutide and semaglutide improve insulin sensitivity, while orlistat may reduce LDL cholesterol levels.²⁵ Some GLP-1-based therapies have demonstrated cardiovascular benefits beyond weight loss by reducing inflammation, improving vascular function, and lowering the risk of heart disease and stroke among individuals with obesity and metabolic disorders. Weight loss medications also aid in sustaining weight loss by supporting behavior changes that foster long-term weight management.
Weight reduction improves joint health by easing mechanical stress, thus relieving discomfort and improving mobility. Psychologically, visible physical improvements can enhance self-image and confidence. This often encourages increased physical activity and social participation, contributing to a better overall quality of life. Achieving weight goals may foster a sense of empowerment and motivation, further reinforcing healthy lifestyle choices. The mental and emotional gains from successful weight loss contribute to greater well-being and life satisfaction.
Contraindications
Despite their benefits, weight loss medications carry certain risks and contraindications that must be evaluated carefully.³ Individuals with cardiovascular conditions—such as hypertension, heart disease, or a history of stroke—may be at greater risk when using specific weight loss drugs. Some medications can impact mood, potentially worsening conditions like anxiety or depression. Medication interactions are also a concern, especially where efficacy may be diminished or adverse effects intensified. For instance, orlistat may impair the absorption of fat-soluble vitamins, and combining it with vitamin supplements may require additional monitoring. Similarly, using bupropion-naltrexone alongside psychiatric drugs may raise the risk of psychiatric disturbances.
Common side effects such as nausea, abdominal discomfort, and diarrhea warrant caution for individuals with existing gastrointestinal issues.³ Weight loss medications may also be unsuitable for people with impaired liver or kidney function, or those with hypersensitivities to certain drug ingredients. Pregnant and breastfeeding women should not use weight loss medications, as their effects on fetal development or infants remain insufficiently understood. Some drugs may cross the placenta or appear in breast milk, posing potential developmental or hormonal risks.
Stimulant-based medications like phentermine and diethylpropion present a risk of dependence due to their action on reward pathways and neurotransmitter release. These are not recommended for individuals with a history of substance use disorders. Because of these potential risks, providers must conduct thorough evaluations to determine candidacy and ensure ongoing follow-up to optimize safety and effectiveness during treatment.
When evaluating the use of weight loss medications in children, age is a vital consideration. Current pediatric obesity management guidelines advocate for a cautious and selective approach, typically recommending pharmacologic treatment only for adolescents with severe obesity, significant co-morbidities, and failure to respond to lifestyle modifications.²¹ The American Academy of Pediatrics (AAP) and the FDA provide age-specific guidance to ensure safe and appropriate treatment.
For children under 12, the use of weight loss medications is extremely limited due to insufficient safety data and concerns about growth and development.²¹ In rare cases involving specific genetic disorders, such as those addressed by setmelanotide, medication may be prescribed. However, the primary approach for this age group involves structured lifestyle interventions—such as dietary modifications, physical activity, and behavioral support—delivered under the care of a multidisciplinary team that may include pediatricians, dietitians, and mental health professionals.
For adolescents aged 12 and older, FDA-approved weight loss medications may be considered under strict clinical supervision and only after a comprehensive evaluation of potential risks and benefits. Pharmacotherapy in this population should be integrated into a holistic treatment plan that includes continued education, psychological support, and behavioral strategies to reinforce healthy habits. Ongoing monitoring is essential to assess for side effects, evaluate adherence, and ensure safe medication use.
It’s important to note that most weight loss drugs approved for adults are not approved for pediatric use. Off-label prescribing should be done with extreme caution and individualized to the patient’s specific needs, considering age, severity of obesity, co-existing health issues, and the overall risk profile. Long-term data on the safety and efficacy of these medications in children and adolescents remain limited, and research is ongoing to better define appropriate usage in younger populations.
Weight loss medications are not designed to serve as standalone solutions. Instead, they function as supportive tools within a broader weight management strategy that integrates nutrition, exercise, and behavioral modification.¹ Patients should work closely with registered dietitians or nutritionists to receive individualized dietary guidance aimed at establishing healthier eating habits. This includes meal planning, portion control, and selecting nutrient-dense foods. Emphasis should be placed on increasing intake of whole foods—such as fruits, vegetables, whole grains, and lean proteins—while reducing consumption of processed foods, added sugars, and unhealthy fats.
Alongside dietary changes, incorporating regular physical activity is crucial. Patients should engage in a mix of aerobic exercises—such as walking, cycling, swimming, or jogging—and resistance training to build muscle and enhance metabolic rate. Exercise regimens should be tailored to the patient’s physical capabilities and health conditions, with adjustments to duration, frequency, and intensity as appropriate.
Because obesity is often linked with psychological and emotional factors, behavioral interventions play an essential role.¹⁷ Mental health issues such as stress, emotional eating, poor body image, and disordered eating behaviors can undermine weight loss efforts, even when medication is used. Patients experiencing emotional distress may struggle to maintain the behavioral changes necessary for long-term success. Therefore, psychological support should be integrated into treatment, and patients’ mental and emotional readiness for change should be considered. Regular follow-up appointments allow providers to monitor patient progress, manage medication side effects, and make timely adjustments to treatment.
Discontinuation of Weight Loss Medications
Weight loss medications may need to be discontinued for several reasons and must be phased out carefully to support ongoing health goals.¹ If a patient has successfully reached their target weight and is able to maintain it through lifestyle changes, tapering off medication may be appropriate. However, to prevent weight regain, the transition should include reinforcement of lifestyle habits and possibly alternative non-pharmacological interventions.
In cases where a medication does not produce meaningful weight loss or the patient sees minimal benefits despite adherence, discontinuation may be necessary. Treatment should then be reevaluated to explore other pharmacological or non-drug options. Additionally, the emergence of significant side effects—particularly those that compromise comfort or safety—can also prompt cessation. In some instances, new contraindications or updated safety data may require a change in therapy. Providers must stay current on research and weigh the risks and benefits of continued medication use for each individual, ensuring decisions reflect the patient’s specific health profile and treatment goals.
The use of weight loss medications requires a thoughtful and individualized approach that blends clinical judgment with patient-centered care.²² Nurses are essential throughout this process, from initial evaluation to long-term follow-up and patient education. As frontline caregivers, they are responsible for assessing the patient’s overall health, identifying co-existing medical conditions, and determining medication eligibility. This assessment supports informed decision-making and ensures treatment plans are based on a thorough understanding of each patient’s unique health profile. Nurses should work closely with physicians, dietitians, and other healthcare professionals to develop comprehensive care strategies tailored to the patient’s medical needs, lifestyle, and personal goals.
In practice, nurses are responsible for consistently monitoring patients who are prescribed weight loss medications.²⁴ This includes regular tracking of weight, blood pressure, heart rate, and possible side effects. Early recognition of adverse reactions allows for timely intervention, reducing the risk of serious complications. Beyond monitoring, nurses play a crucial educational role. They should clearly explain how the medication works, outline realistic expectations for weight loss, and prepare the patient for possible side effects. In cases where medications are used off-label, patients must be fully informed about the reasons for the prescription, potential risks, and available alternatives. Educating patients in this way empowers them to participate actively in their treatment and supports long-term adherence.
Nurses also help guide patients in making meaningful lifestyle changes that enhance the effectiveness of medication. This includes offering practical advice on dietary improvements, physical activity, and stress management strategies. Their role extends beyond the physical aspects of care into the psychosocial realm, which is vital for sustainable weight loss.
Addressing psychosocial factors is a key part of nursing care in weight management.¹¹ Nurses should use empathetic communication and motivational interviewing to uncover underlying attitudes, behaviors, and barriers related to weight. Creating a judgment-free space helps patients feel safe sharing their experiences and challenges. Key psychosocial elements that nurses should evaluate include:
By acknowledging and addressing these factors, nurses provide holistic care that promotes both physical health and emotional resilience. Their comprehensive involvement enhances the likelihood of sustained weight loss and improves overall quality of life.
Weight management medications serve as a vital tool in the broader strategy to address the growing global epidemic of overweight and obesity. These medications support individuals in achieving significant weight loss, improving metabolic health, enhancing mobility, and fostering psychological resilience. However, their use demands thorough evaluation of possible risks, including cardiovascular concerns, psychiatric side effects, and potential drug interactions. Special attention is required when considering these medications for pediatric populations, emphasizing cautious, individualized care guided by current clinical evidence.
Nurses are instrumental in the effective use of weight loss medications, overseeing their administration, monitoring patient responses, and providing essential education. Their role also includes addressing the emotional and social factors that influence weight, ensuring that care is comprehensive and patient-centered. Long-term success in weight management relies on a coordinated, interdisciplinary approach that integrates medication, lifestyle changes, and behavioral support. By prioritizing collaboration and evidence-based care, healthcare providers can more effectively reduce the impact of obesity and improve the quality of life for patients across all populations.
Atlas, Steven J, et al. Medications for Obesity Management: Effectiveness and Value. Vol. 29, no. 5, 1 May 2023, pp. 569–575, https://doi.org/10.18553/jmcp.2023.29.5.569.
Bello, Nicholas, and NC Liang. “The Use of Serotonergic Drugs to Treat Obesity – Is There Any Hope?” Drug Design, Development and Therapy, Feb. 2011, p. 95, dx.doi.org/10.2147%2FDDDT.S11859, https://doi.org/10.2147/dddt.s11859.
Chakhtoura, Marlene, et al. “Pharmacotherapy of Obesity: An Update on the Available Medications and Drugs under Investigation.” Pharmacotherapy of Obesity: An Update on the Available Medications and Drugs under Investigation, vol. 58, 1 Apr. 2023, pp. 101882–101882, https://doi.org/10.1016/j.eclinm.2023.101882.
Chatterjee, Ayan, et al. “Identification of Risk Factors Associated with Obesity and Overweight—a Machine Learning Overview.” Sensors, vol. 20, no. 9, 11 May 2020, p. 2734, https://doi.org/10.3390/s20092734.
“Economic Impact of Obesity Increased to $1.4 Trillion.” Milkeninstitute.org, 2020, milkeninstitute.org/article/economic-impact-obesity-increased-14-trillion-says-milken-institute.
FDA. “FDA Approves New Drug Treatment for Chronic Weight Management, First since 2014.” FDA, 4 June 2021, www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014.
Hendricks, Ed. “Off-Label Drugs for Weight Management.” Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, vol. Volume 10, June 2017, pp. 223–234, https://doi.org/10.2147/dmso.s95299.
Idrees, Zarwa, et al. “FDA-Approved Pharmacotherapy for Weight Loss over the Last Decade.” Cureus, vol. 14, no. 9, 17 Sept. 2022, https://doi.org/10.7759/cureus.29262.
Ji-Hee Haam, et al. “Diagnosis of Obesity: 2022 Update of Clinical Practice Guidelines for Obesity by the Korean Society for the Study of Obesity.” Journal of Obesity & Metabolic Syndrome, vol. 32, no. 2, 30 June 2023, pp. 121–129, https://doi.org/10.7570/jomes23031.
Kanter, Rebecca, and Benjamin Caballero. “Global Gender Disparities in Obesity: A Review.” Advances in Nutrition, vol. 3, no. 4, 1 July 2012, pp. 491–498, https://doi.org/10.3945/an.112.002063.
Mitchell, Ellen S., et al. “Psychosocial Characteristics by Weight Loss and Engagement in a Digital Intervention Supporting Self-Management of Weight.” International Journal of Environmental Research and Public Health, vol. 18, no. 4, 10 Feb. 2021, p. 1712, https://doi.org/10.3390/ijerph18041712.
Nadolsky, Karl, et al. American Association of Clinical Endocrinology Consensus Statement: Addressing Stigma and Bias in the Diagnosis and Management of Patients with Obesity/Adiposity-Based Chronic Disease and Assessing Bias and Stigmatization as Determinants of Disease Severity. Vol. 29, no. 6, 1 June 2023, pp. 417–427, https://doi.org/10.1016/j.eprac.2023.03.272.
Nagi, Karim, and Abdella M. Habib. “Biased Signaling: A Viable Strategy to Drug Ghrelin Receptors for the Treatment of Obesity.” Cellular Signalling, vol. 83, July 2021, p. 109976, https://doi.org/10.1016/j.cellsig.2021.109976. Accessed 6 May 2021.
NIH. “Overweight & Obesity Statistics .” National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Health, 13 Dec. 2018, www.niddk.nih.gov/health-information/health-statistics/overweight-obesity.
Petersen, Ruth, et al. “Racial and Ethnic Disparities in Adult Obesity in the United States: CDC’s Tracking to Inform State and Local Action.” Preventing Chronic Disease, vol. 16, no. 16, 11 Apr. 2019, www.cdc.gov/pcd/issues/2019/18_0579.htm, https://doi.org/10.5888/pcd16.180579.
Pray, Rachel, and Suzanne Riskin. “The History and Faults of the Body Mass Index and Where to Look Next: A Literature Review.” Cureus, vol. 15, no. 11, 3 Nov. 2023, www.ncbi.nlm.nih.gov/pmc/articles/PMC10693914/, https://doi.org/10.7759/cureus.48230.
Rangbulla, AdityaKumar. “Obesity Treatment – Is Pharmacotherapy the Answer?” International Journal of Applied and Basic Medical Research, vol. 10, no. 3, 2020, p. 147, https://doi.org/10.4103/ijabmr.ijabmr_113_20. Accessed 3 July 2022.
Research, Center for Drug Evaluation and. “FDA Approves Treatment for Chronic Weight Management in Pediatric Patients Aged 12 Years and Older.” FDA, 27 June 2022, www.fda.gov/drugs/news-events-human-drugs/fda-approves-treatment-chronic-weight-management-pediatric-patients-aged-12-years-and-older.
—. “FDA Approves Weight Management Drug for Patients Aged 12 and Older.” FDA, 30 Sept. 2021, www.fda.gov/drugs/news-events-human-drugs/fda-approves-weight-management-drug-patients-aged-12-and-older.
—. “FDA Requests the Withdrawal of the Weight-Loss Drug Belviq, Belviq XR (Lorcaserin) from the Market.” FDA, 13 Feb. 2020, www.fda.gov/drugs/drug-safety-and-availability/fda-requests-withdrawal-weight-loss-drug-belviq-belviq-xr-lorcaserin-market.
Singhal, Vibha, et al. “Pharmacotherapy in Pediatric Obesity: Current Evidence and Landscape.” Current Opinion in Endocrinology, Diabetes & Obesity, vol. 28, no. 1, 12 Nov. 2020, pp. 55–63, https://doi.org/10.1097/med.0000000000000587.
Tchang, Beverly G., et al. “Long‐Term Weight Loss Maintenance with Obesity Pharmacotherapy: A Retrospective Cohort Study.” Obesity Science & Practice, 2 Dec. 2021, https://doi.org/10.1002/osp4.575.
Trapp, Christine M, and Marisa Censani. “Setmelanotide: A Promising Advancement for Pediatric Patients with Rare Forms of Genetic Obesity.” Current Opinion in Endocrinology, Diabetes and Obesity, vol. 30, no. 2, 2 Feb. 2023, pp. 136–140, https://doi.org/10.1097/med.0000000000000798.
Turer, Christy Boling. “Tools for Successful Weight Management in Primary Care.” The American Journal of the Medical Sciences, vol. 350, no. 6, 1 Dec. 2015, pp. 485–497, www.ncbi.nlm.nih.gov/pmc/articles/PMC4666822/, https://doi.org/10.1097/MAJ.0000000000000530.
Wang, Jing-Yue, et al. “GLP−1 Receptor Agonists for the Treatment of Obesity: Role as a Promising Approach.” Frontiers in Endocrinology, vol. 14, 1 Feb. 2023, p. 1085799, www.ncbi.nlm.nih.gov/pmc/articles/PMC9945324/#B23, https://doi.org/10.3389/fendo.2023.1085799.
WHO. “Body Mass Index (BMI).” Www.who.int, 2023, www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index.
World Health Organisation. “Obesity and Overweight.” World Health Organization, 1 Mar. 2024, www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
Zhu, Da Q, et al. “Nurses’ Self-Efficacy and Practices Relating to Weight Management of Adult Patients: A Path Analysis.” International Journal of Behavioral Nutrition and Physical Activity, vol. 10, no. 1, 2013, p. 131, https://doi.org/10.1186/1479-5868-10-131.
To access Obesity and Weight Loss Medications, purchase this course or a Full Access Pass.
If you already have an account, please sign in here.
To access Obesity and Weight Loss Medications, purchase this course or a Full Access Pass.
If you already have an account, please sign in here.
