Weight Loss

POPP 1

Obesity

medical condition in which excess body fat adversely effects health

Anorexiant

Category of drugs that suppresses your appetite by

1. blocking fat absorption.

2. target satiety centers which reduces your hunger by making you believe you “feel” full.

phentermine (Adipex P)

C4

once daily

sympathomimetic (satiety center)

SHORT_TERM weight management

Sympathomimetic

Category of drugs

2 actions for MOA

1. stimulate CNS which increases Nor-Epinephrine

2. Stimulate satiety center in brain so you feel full

Antidiabetic/ Gut Hormones (GLP-1 and GIP)/ Blood sugar pathway

1. Category of drugs that

Regulates blood sugar and metabolism

Weight Loss = secondary effect

Targets of these drugs are: 2. and 3.

(Contrave) buproprion/ naltrexone 

(antidepressant)/ (opioid antagonist)

Combo = anorexiant

Used for CHRONIC weight management

twice a day

acts on Mesolimbic dopamine circuit (decrease cravings for food, esp. sweets)

Qsymia: phentermine/ topiramate

C4

sympathomimetic, anticonvulsant

REMS program

CHRONIC weight management

x2/ day

liraglutide (Saxenda)

GLP1-RA (satiety ccenter)

parenteral, SubQ with a MULTIUSE pen

CHRONIC weight mgmt.

x1/ day

GLP1-RA

Category of drugs that 

increase insulin release

suppress appetite

increase feelings of fullness

Wegovy: semaglutide

GLP1-RA (satiety center)

parenteral

SubQ with a SINGLE use pen

CHRONIC weight mgmt. 

Zepbound: tirzepatide

GLP-1 RA & GIP

Anorexiant & satiety center

x1/ WEEK

CHRONIC weight management

Mounjaro: tirzepitide

antidiabetic

x1/ week

orlistat

lipase inhibitor

Inhibits fat absorption

ALLI-OTC

Xenical-RX

Severe side effects: SHARTS

** Decrease side effects: take CILIUM, a seed bulk laxative

lipase inhibitor

Category of drug that

inhibits gastrointestinal lipase enzymes

inhibits fat absorption

orlistat: (Alli): OTC

Lipase inhibitor

60 mg capsule

take 3x a day with food

chronic weight management

orlistat: xenical- RX

lipase inhibitor

take 3x/day with food

120 mg capsule

chronic weight management

psyllium

gastrointestinal lipase enzyme

phentermine C4: Adipex P

short term weight management (1)

1. Contrave: buproprion, naltrexone

2. Qsymia: phentermine/ topiramate

3. Saxenda: liraglutide

4. Wegovy: semaglutide

5. Zepbound: tirzepatide

6. Mounjaro: tirzepatide

7. Mounjaro: antidiabetic

8. Alli-OTC: orlistat

9. Xenical-RX: orlistat

Chronic weight management treatments (9)

phentermine C4: Adipex P

sympathomimetic (1)

buproprion, naltrexone: Contrave

antidepressant/ opioid antagonist

phentermine, topiramate: Qsymia C4

sympathomimetic, anticonvulsant

1. liraglutide: Saxenda

2. semaglutide: Wegovy

GLP1-RA (2)

tirzepatide

1. Zepbound (anorexiant)

2. Mounjaro (antidiabetic)

GLP1-RA and GIP (2) drugs, 1 class

orlistat

1. ALLI-OTC 60 mg capsule

2. Xenical- RX 120 mg capsule

lipase inhibitors 2 drugs, 1 class

x1/ day

Dosing phentermine C4: Adipex P

x2/ day

Dosing buproprion, naltrexone: Contrave

x2/ day

Dosing phentermine/ topiramate: Qsymia C4

x1/ day

Dosing liraglutide: Saxenda

x1/ week

Dosing semaglutide: Wegovy

x1/ week

Dosing tirzepatide: Zepbound and Mounjaro

x3/ day with food

Dosing orlistat: Alli-OTC and Xenical- RX

phentermine: Adipex P C4

liraglutide: Saxenda

Dosing drugs x1/ day (2)

tirzepatide: Zepbound, Mounjaro

semaglutide: Wegovy

Dosing drugs x1/ week (3)

orlistat:

Alli- OTC 60 mg capsule

Xenical- RX 120 mg capsule

Dosing drugs x3/ day with food 1 class, 2 drugs

1. buproprion, naltrexone: Contrave

2. phentermine, topiramate: Qsymia C4

Dosing drugs x2/ day (2)

buproprion, naltrexone: Contrave

These 2 drugs combined together make an anorexiant

phentermine/ topiramate: Qsymia C4

***REMS drug: Risk, Evaluation and Mitigation Strategy

Risk or birth defects, pregnancy considerations

delays gastric emptying

Satiety center effects

Stimulate GLP-1 and GIP receptors on the pancreas, stimulate insuline release, when you stimulate insulin release, you decrease glucafon which lowers blood sugar levels.

BTW: Glucagon raises blood sugar

Antidiabetic effects

1. fat

2. free fatty acids

3. dietary, slick, oily fat

Lipase enzymes metabolize 1. from your diet into free 2. which can be absorbed by your body. If you inhibit lipase enzymes, the 1. is not metabolized into free 2. and it is not absorbed. So then you have a lot of 3. and you get DIARRHEA!