Program
Medical weight management for adults: a full evaluation, a plan across four pillars, medication when appropriate, and a maintenance plan from the start.
Written by Dr. Richard Kowalsky, MD, board-certified in obesity medicine Last updated Sources cited Editorial policy
The starting point: a full picture of your health, history and goals.
Practical eating plans that you can live with, not a diet you have to escape from.
Movement prescribed like medicine: specific, gradual and safe for your body.
The habits and pressures around food, addressed with practical tools and no judgment.
When appropriate, FDA-approved medication added to the plan and monitored closely.
Protecting progress for the long run, because the body adapts to weight loss.
Lifestyle care is the foundation of every plan; the USPSTF recommends intensive, multicomponent behavioral programs for adults with a BMI of 30 or higher.[1] Medication is considered for adults who meet guideline criteria.[2]
Five steps, at a pace that suits you. Every step is a conversation.
Your history, your goals and your questions: weight over the years, what you’ve tried, medications, sleep, stress and what matters most to you.
Review of weight-related conditions, current medications that can affect weight, and recent labs. Additional tests are suggested only when they would change your care.
A plan across the four pillars, with realistic first steps. If medication is appropriate, you’ll talk through benefits, side effects and alternatives.
Regular check-ins to see what’s working, manage side effects and adjust. Guidelines suggest checking medication response and safety closely in the first months.[2]
A plan to protect your progress, because the body adapts to weight loss. Maintenance is part of the program, not an afterthought.[6]
Generic names and drug classes only. This table is general education: the right choice depends on your health history, other medications and preferences, and dosing is set individually by your physician.
| Class | Generic examples | How it works | Common side effects | Important cautions |
|---|---|---|---|---|
| GLP-1 receptor agonist | Semaglutide, liraglutide | Increases fullness, reduces appetite, slows stomach emptying | Nausea, vomiting, diarrhea, constipation | Not used with a personal or family history of medullary thyroid cancer or MEN 2; watch for pancreatitis and gallbladder symptoms[3] |
| Dual GIP/GLP-1 receptor agonist | Tirzepatide | Acts on two gut-hormone receptors that regulate appetite and blood sugar | Nausea, diarrhea, constipation, vomiting | Similar cautions to GLP-1 medications[4] |
| Combination, oral | Phentermine-topiramate extended release | Reduces appetite | Tingling, dry mouth, constipation, trouble sleeping | Avoid in pregnancy (contraception counseling needed); avoid with heart disease or uncontrolled blood pressure[3] |
| Combination, oral | Naltrexone-bupropion extended release | Acts on appetite and reward pathways in the brain | Nausea, headache, constipation | Not used with seizure disorders or with opioid medications[3] |
| Lipase inhibitor, oral | Orlistat | Reduces fat absorption from food | Oily stools, urgency, gas | A daily multivitamin is usually advised[3] |
Medications are an add-on to nutrition, activity and behavior care, not a replacement. If weight loss is less than about 5% after 3 months on an adequate dose, guidelines suggest reconsidering the medication.[2]
A little preparation makes the first conversation more useful.
Adults whose weight is affecting their health, energy or daily life, whatever they’ve tried before.
Medication criteria come from clinical guidelines: generally a BMI of 30 or higher, or 27 or higher with a weight-related condition.[2] In trials such as STEP 1 and SURMOUNT-1, medications were studied together with lifestyle support.[5][4]
This is a non-surgical program. When surgery may be the better option, a referral to a metabolic and bariatric surgery program is discussed.[7]
Ask about a first visit, a medication you’ve heard about, or a plan that finally fits your life. Se habla español.