The full menu of approved options
From injectable GLP-1 and dual agonists to oral combinations and a lipase inhibitor, the FDA-approved arsenal now spans a wide efficacy range — roughly 2.4% to 20.9% placebo-adjusted weight loss. The right choice depends on your biology, your tolerance, and your goals. This table lays out the entire landscape.
| Generic Name | Trade Name(s) | Receptor Targets & Class | FDA Status | Placebo-Adjusted Weight Loss Efficacy | Primary Biological Action | Source |
|---|---|---|---|---|---|---|
| Tirzepatide | Zepbound (weight loss), Mounjaro (diabetes) | Dual GLP-1 and GIP receptor agonist | Chronic weight management (FDA-approved 2023) | 17.8%–20.9% (at 15 mg dose) | Slowing gastric emptying, increasing satiety, and improving glycemic control via dual-action central signaling | 2, Background Knowledge, Inferred, Wikipedia Anti-Obesity Medications |
| Semaglutide | Wegovy (weight loss), Ozempic (diabetes) | Selective GLP-1 receptor agonist | Chronic weight management (FDA-approved 2021) | 12.0%–12.4% | Slowing gastric emptying and central appetite suppression via the hypothalamus to reduce cravings | 3, 2, Background Knowledge, Inferred, Wikipedia Anti-Obesity Medications |
| Phentermine/topiramate | Qsymia | Substituted amphetamine (Sympathomimetic amine) / GABA modulator & carbonic anhydrase inhibitor | Chronic weight management (also indicated for short-term) | 8.8%–10.2% | Appetite suppression via norepinephrine release and increased satiety via neurotransmitter modification | Background Knowledge, Inferred, Wikipedia Anti-Obesity Medications |
| Liraglutide | Saxenda (weight loss), Victoza (diabetes) | Selective GLP-1 receptor agonist | Chronic weight management | 4.0%–5.4% | Regulation of appetite and calorie intake by slowing gastric emptying and increasing feelings of fullness | Background Knowledge, Inferred, Wikipedia Anti-Obesity Medications |
| Naltrexone/bupropion | Contrave | Opioid antagonist / Norepinephrine-dopamine reuptake inhibitor (NDRI) | Chronic weight management | 4.0%–5.0% | Targets the reward system (mesolimbic) and hypothalamus to reduce food cravings and appetite | Background Knowledge, Inferred, Wikipedia Anti-Obesity Medications |
| Phentermine | Adipex-P, Lomaira | Substituted amphetamine (Sympathomimetic amine; TAAR1 agonist) | Short-term use (up to 12 weeks) | 3.0%–4.0% (or ~5 kg / 11 lb) | Stimulation of norepinephrine release to suppress appetite | Background Knowledge, Inferred, Wikipedia Anti-Obesity Medications |
| Orlistat | Xenical (Prescription), Alli (OTC) | Gastric and pancreatic lipase inhibitor (Non-receptor) | Chronic weight management | 2.4%–4.0% (or ~3 kg / 6.6 lb) | Inhibition of gastrointestinal lipases to prevent the absorption of dietary fat in the intestines | 3, Background Knowledge, Inferred, Wikipedia Anti-Obesity Medications |
| Sibutramine | Meridia | Not in source | Withdrawn | Not in source | Appetite suppression |
Reading the table
Efficacy climbs with receptor coverage: selective GLP-1 (Wegovy) hits ~12%, the dual GLP-1/GIP agonist tirzepatide (Zepbound) reaches ~18–21% at the top dose, and oral/combination options (Qsymia, Contrave) occupy the 4–10% band with a different side-effect profile. Lower efficacy is not worse — it is often the right trade for someone who tolerates oral meds or needs short-term support.
The short version
- The FDA-approved arsenal spans roughly 2.4 percent to 20.9 percent placebo-adjusted weight loss, and efficacy climbs with receptor coverage rather than forming a single ladder.
- Tirzepatide, sold as Zepbound for weight loss and Mounjaro for diabetes, is a dual GLP-1 and GIP agonist approved in 2023 that reaches 17.8 to 20.9 percent at the 15 mg dose.
- Semaglutide, sold as Wegovy and Ozempic, is a selective GLP-1 receptor agonist approved in 2021 with 12.0 to 12.4 percent placebo-adjusted weight loss.
- Phentermine with topiramate (Qsymia) lands at 8.8 to 10.2 percent, while liraglutide (Saxenda) reaches 4.0 to 5.4 percent and naltrexone with bupropion (Contrave) reaches 4.0 to 5.0 percent.
- Phentermine alone is approved for short-term use up to 12 weeks at 3.0 to 4.0 percent, and orlistat (Xenical or Alli) blocks intestinal lipases for 2.4 to 4.0 percent.
- The oral and combination options occupy the 4 to 10 percent band with a different side-effect profile, which the article says is often the right trade rather than a worse choice.
Choose with a provider, not a comment section
Every option in this table is a prescription for a reason. Get matched with a local weight-loss provider who can match your profile to the right class — free, no obligation.
