Weight Loss Prescriptions: What Are Doctors Actually Recommending?

If you’ve noticed Ozempic and similar weight loss drugs all over your social feeds, you’re not imagining things. Doctors at weight loss clinics are fielding more questions than ever about what they can prescribe—not just to celebrities but to regular folks too.

This isn’t about quick fixes or miracle pills. Prescription meds for weight loss are usually for people who’ve tried changing their diet and exercise, but the scale just won’t budge. Most clinics stick to the rules: you usually need a BMI over 30, or 27 with some health issues like type 2 diabetes or high blood pressure. Don’t expect a doctor to hand over a prescription just for a vacation or a wedding.

So, what are doctors actually writing on those prescription pads? It’s not just about old-school appetite suppressants anymore. There’s a new crowd of meds that work with your body in ways you might not expect. Let’s break down the main prescriptions, what they do, and some things you probably won’t hear in TV ads.

• Which Medications Are Prescribed Most Often?
• GLP-1 Drugs: The Game Changers
• Other Prescription Options
• Who Can Get These Prescriptions?
• Tips For Starting Prescribed Weight Loss Drugs

Which Medications Are Prescribed Most Often?

If you walk into a weight loss clinic today, you’ll probably hear one name more than any other: Ozempic. But Ozempic, known generically as semaglutide, isn’t alone anymore. Weight loss prescriptions have really changed in the last couple of years.

Let’s break it down. Here are the top meds doctors reach for when it comes to helping people lose weight:

• GLP-1 agonists: This is the big one. Ozempic (semaglutide), Wegovy (also semaglutide, just dosed for weight loss), and Mounjaro (tirzepatide) all fall under this group. These meds work by mimicking a hormone that helps control your appetite and blood sugar. People who qualify often see steady, real weight loss—not just a few pounds here and there.
• Phentermine: This isn’t new. It’s an appetite suppressant and has been used for decades. It’s best for short-term jumps on the scale, usually a few weeks or months, not years. It comes with some potential side effects (jitteriness, increased heart rate), so it’s not for everyone, especially if you have heart problems.
• Contrave: This pill mixes two drugs—bupropion (an antidepressant) and naltrexone (used for addiction treatment). It works on the reward system in your brain to help reduce cravings and keep you from overeating.
• Qsymia: Another combo pill, this one pairs phentermine with topiramate (usually used for migraines or epilepsy). Like others, it helps with appetite, but it requires you to stay on top of blood pressure and mental health side effects.
• Orlistat (Xenical/Alli): This one blocks your body from absorbing some of the fat from food. Unlike the others, it’s available over the counter in a lower dose (Alli), but it can cause stomach issues, especially if you eat fatty meals.

Here’s a quick look at how these prescriptions stack up in weight loss clinics:

Bottom line: most folks are hearing about GLP-1 meds like Ozempic because they get real, consistent results, but clinics still hand out other prescriptions depending on your history and health. It’s never one-size-fits-all—even famous TikTok doctors mix and match based on what actually works for your body and your lifestyle.

GLP-1 Drugs: The Game Changers

Ask anyone at a weight loss clinic what’s grabbing all the attention, and you’ll hear the same three letters: GLP-1. These medications, including Ozempic (semaglutide), Wegovy (also semaglutide), and Saxenda (liraglutide), weren’t originally made for weight loss. They started out as treatments for type 2 diabetes. But people noticed something else—folks lost a significant amount of weight while taking them.

Here’s how they work: GLP-1 drugs mimic a hormone in your gut that helps control blood sugar and, just as important for weight loss, make you feel full sooner. That means you'll likely eat less without feeling as hungry—or at least, that’s the idea. Studies show people on semaglutide can lose around 15% of their body weight, which is a much bigger drop than what you see with older weight loss prescriptions.

But there are downsides you have to think about. They’re mostly injections, not pills, and you take them once a week (or daily for some). Side effects aren’t rare—issues like nausea, stomach pain, and sometimes more serious problems like gallbladder issues or blood sugar swings.

Insurance is another hurdle. Not everybody gets these drugs covered, and without insurance, they’re expensive. A month’s supply can cost over $1,000. That makes the whole game tricky if you’re thinking long-term.

If you’re considering a weight loss prescription like Ozempic or Wegovy, talk honestly with your doctor. Ask about side effects, coverage, realistic results, and what happens if you stop taking it. These meds can be game changers, but only if they’re used the right way for the right reasons.

Other Prescription Options

Everyone is talking about GLP-1 drugs, but they’re not the only players when it comes to weight loss prescriptions. Doctors in weight loss clinics sometimes reach for older medications if the new wave isn’t the right fit or if insurance says no. Here’s a quick breakdown of what else might come up:

• Phentermine: This is one of the earliest prescription appetite suppressants out there. It works by amping up your central nervous system, kind of like caffeine but stronger. It’s cheap and works short term—up to 12 weeks. People lose a few pounds quickly, but it’s not a forever thing and definitely not for anyone with a heart condition.
• Contrave (bupropion/naltrexone): This is a combo med. Bupropion is often used for depression or quitting smoking, and naltrexone blocks certain brain signals tied to cravings. Together, they help take the edge off both hunger and food obsession.
• Qsymia (phentermine/topiramate): This is a mix—one part is old-school phentermine, the other is topiramate, a drug for migraines and seizures. Together, they work better for weight loss than either alone, and you can take it longer-term than just phentermine.
• Orlistat (Xenical, Alli): This one’s all about fat. Orlistat blocks fat from being absorbed in your gut. If you eat a lot of high-fat foods while on it, you’ll know—think bathroom trouble. Still, it helps with steady, moderate weight loss, and it’s available over the counter in a lower dose as Alli.

Want a quick side-by-side? Here’s how some non-GLP-1 options stack up in terms of average extra weight lost, per real clinical studies:

These drugs aren’t usually handed out unless your doctor thinks the benefits outweigh the risks. They don’t work magic and work best alongside changes in diet and exercise. And if you’ve got medical conditions or take daily meds, your doctor will double-check that nothing’s going to clash in a bad way.

Who Can Get These Prescriptions?

Not everyone can walk into a clinic and come out with a prescription for weight loss prescriptions. Doctors use specific guidelines so meds like GLP-1 drugs or appetite suppressants don’t get handed out just because someone wants to shed a few pounds for a big event.

The standard is usually set by body mass index (BMI), the simplest tool for measuring extra weight. Here’s how it typically breaks down:

• BMI of 30 or higher: You’re considered to have obesity and likely qualify for a prescription.
• BMI of 27 or higher and at least one weight-related health problem such as type 2 diabetes, high blood pressure, or sleep apnea: You also qualify by most clinic standards.

If you’re not sure about your BMI, almost every weight loss clinic will calculate it for you. Online BMI calculators work too, but the doctor’s office does it as part of a checkup before any script is written.

It’s not just about the number, though. Before a doctor gives you any weight loss prescriptions, they’ll ask about your medical history, medications you’re already taking, and maybe even check things like blood work or liver function. If you’re pregnant, breastfeeding, or dealing with certain mental health diagnoses, you’ll probably be steered toward non-prescription routes first.

If you’re already on meds for conditions like depression or heart disease, the doctor will double-check to avoid any nasty surprises with drug interactions. And for some folks—especially older adults or those with severe kidney or liver problems—weight loss meds just aren’t in the cards. It’s all about safety first.

If you think you might be a candidate for prescribed weight loss clinics treatments, come to your appointment ready to talk about your health history, goals, and what you’ve tried already. Honest conversations here go a long way.

Tips For Starting Prescribed Weight Loss Drugs

So your doctor is considering writing you a prescription for a weight loss prescription. Getting the script isn’t the end of the story; it’s really the start of a whole new routine. Here’s what you need to know before you start popping those pills or grabbing that injection pen.

First, talk openly with your provider at the weight loss clinic. If you have any history of thyroid or pancreatic issues, bring it up. Most of the newest meds—like the famous GLP-1 drugs—aren’t for folks with a past of certain endocrine problems. The doctor needs to know about every medication and supplement you already take, since some combos can cause problems.

• Set realistic expectations. Weight loss prescriptions can make a real difference, but they’re not magic. In clinical research, people typically lose 10-15% of their body weight over several months, not in a few weeks.
• Know the side effects. Stomach issues are super common, especially with GLP-1 drugs like Ozempic and Wegovy—think nausea, vomiting, and diarrhea. That’s why many clinics start with a low dose and go up slowly.
• Stick to follow-ups. Most weight loss clinics will set up regular check-ins to see how you’re doing. Use these to track progress, bring up any side effects, and adjust your prescription if needed.
• Don’t ditch diet and activity plans. None of these meds will work well if you keep up old eating or movement habits. The best results come when you combine the prescription with healthy changes in what you eat and how you move.
• Insurance might be a pain. Even though these drugs are all over the news, getting insurance to pay for them is a hassle for a lot of people, especially for newer GLP-1 options. Double-check with your plan before you get sticker shock at the pharmacy.

Here’s a quick look at what you might expect based on different options doctors prescribe:

Big thing to remember: skipping doses or stopping suddenly can set you back. Always check with your doctor before changing how you take your medication. And if you notice anything weird—like mood swings, severe pain, or vision changes—call your clinic fast. Starting on a weight loss prescription is a team effort.