Weight Loss Medication Decision Guide
Let's find your best weight loss option
Answer these questions to get personalized recommendations about which medications might work best for you.
Your Results
Based on your answers, here are the weight loss medications that best match your needs:
Orlistat (Xenical/Alli)
Orlistat blocks fat absorption in the gut. It's available as prescription (Xenical) or OTC (Alli).
Best for: Mild weight loss goals, prescription-free option
Liraglutide (Saxenda)
A GLP-1 hormone analogue that slows stomach emptying and reduces appetite.
Best for: Significant weight loss goals (10%+), improved blood sugar control
Phentermine
Appetite suppressant that can help jump-start weight loss with short-term use.
Best for: Short-term use, quick start with moderate risk
Contrave
Combines bupropion and naltrexone to reduce cravings and reward center activation.
Best for: Managing cravings with behavioral therapy
Green Tea Extract
Natural supplement with mild fat-burning properties.
Best for: Gentle weight loss support with minimal side effects
Trying to lose stubborn pounds can feel like chasing a moving target. Orlistat is a prescription fat‑blocker that stops about 30% of dietary fat from being absorbed. It’s sold as Xenical (prescription) or Alli (over‑the‑counter) and has been on the market for more than two decades. But is it really the best option for you, or do other medications or natural supplements offer a smoother ride?
Quick Takeaways
- Orlistat works in the gut, so it has no impact on appetite or metabolism.
- Phentermine is an appetite suppressant that can cause insomnia and raises heart rate.
- Liraglutide (Saxenda) mimics a gut hormone, leading to steady weight loss and improved blood sugar.
- Combination drugs like Contrave (bupropion/naltrexone) hit both cravings and reward pathways.
- Herbal options (green tea extract, Garcinia cambogia) have modest effects and minimal side‑effects, but lack robust clinical data.
How Orlistat Works - The Core Mechanism
Orlistat inhibits pancreatic lipase, an enzyme that breaks down triglycerides into absorbable fatty acids. By blocking this enzyme, roughly one‑third of the fat you eat passes through your intestines unchanged and is eliminated in the stool. Because the action is purely mechanical, you won’t feel jittery or experience a “high” that stimulant‑based drugs can give.
Key attributes:
- Administration: 120 mg capsule taken with each main meal containing fat.
- Effectiveness: Clinical trials show an average 3-5% additional weight loss over diet‑only groups after one year.
- Side‑effects: Oily stools, flatulence, and occasional vitamin A/D/E/K deficiency if supplements aren’t taken.
Common Alternatives - What’s on the Market?
When you hear “weight‑loss drug,” most people think of appetite suppressants or hormone analogues. Below are the most frequently prescribed or popular over‑the‑counter options.
Phentermine is a short‑acting stimulant that tricks the brain into feeling full. It’s often the first line for people who need a quick jump‑start.
Liraglutide (brand name Saxenda) is a synthetic version of the GLP‑1 hormone, which slows stomach emptying and improves insulin sensitivity.
Contrave combines bupropion (an antidepressant) with naltrexone (an opioid antagonist) to curb cravings and reduce reward‑center activation.
Herbal and nutraceutical choices such as Green tea extract (rich in EGCG) or Garcinia cambogia are marketed for mild fat oxidation, but their evidence base is thinner.
Side‑Effect Profile - What to Expect
Every weight‑loss aid comes with trade‑offs. Below is a side‑by‑side look at the most common adverse events.
| Drug | Primary Side‑Effects | Serious Risks |
|---|---|---|
| Orlistat | Oily stools, flatulence, possible vitamin deficiency | Rare liver injury, pancreatitis (very low incidence) |
| Phentermine | Insomnia, dry mouth, increased heart rate | Elevated blood pressure, potential for dependence |
| Liraglutide | Nausea, vomiting, constipation | Pancreatitis, gallbladder disease, rare thyroid tumors (in rodents) |
| Contrave | Dizziness, headache, nausea | Suicidal thoughts (monitor mood), increased blood pressure |
| Green tea extract | Stomach upset, mild headache | Potential liver toxicity at high doses |
Effectiveness - How Much Weight Can You Lose?
Effectiveness varies widely based on dose, adherence, diet, and genetics. Here’s a snapshot from major studies and meta‑analyses.
- Orlistat: Average 3-5% of initial body weight after 12 months; up to 10% in highly compliant patients.
- Phentermine: 5-10% weight loss in 3-6 months; effectiveness tapers after 6 months due to tolerance.
- Liraglutide: 8-12% reduction over 56 weeks; also improves HbA1c in pre‑diabetic users.
- Contrave: 5-9% weight loss over 1 year; works best when paired with behavioral therapy.
- Green tea extract: 1-2% additional loss when combined with calorie‑restricted diet.
Bottom line: If you need a modest, diet‑supported drop, Orlistat can be enough. For larger goals, injectable GLP‑1 agents or stimulant combos usually outperform it.
Cost Considerations - What Will It Hit Your Wallet?
Price is a practical blocker for many. Below is an average monthly cost in Australia (2025 prices, pharmacy list).
- Orlistat (Alli 60 mg OTC): AU$30-$45.
- Orlistat (Xenical 120 mg Rx): AU$150-$200.
- Phentermine (generic): AU$40-$60.
- Liraglutide (Saxenda injection): AU$350-$450.
- Contrave (generic combination): AU$120-$170.
- Green tea extract capsules: AU$15-$30.
Insurance in Australia may cover Saxenda for diabetic patients, but not most other agents. OTC options like Alli and green tea are the most budget‑friendly.
Choosing the Right Option - Decision Guide
Use this quick checklist to narrow down the best fit for you:
- Do you have a history of heart disease or hypertension? Skip stimulants like Phentermine.
- Are you comfortable with injections? If yes, Liraglutide offers strong results.
- Is vitamin deficiency a concern? Orlistat requires daily multivitamin supplementation.
- Do you want a prescription‑free route? Green tea extract or Alli may suit you.
- Are you aiming for >10% body‑weight loss? Consider GLP‑1 agents or combination therapy.
Always discuss with a healthcare professional before starting any medication. They’ll check labs, evaluate drug interactions, and tailor dosage.
Real‑World Stories - What Users Say
“I tried Orlistat for six months while following a low‑fat diet. I lost 7 kg, but the oily stools were embarrassing at work. I switched to Saxenda and dropped another 12 kg without the mess.” - 42‑year‑old accountant, Brisbane.
“Phentermine helped me curb late‑night snacking, but after a year my blood pressure spiked. My doctor moved me to Contrave, and the cravings are under control now.” - 35‑year‑old mother of two.
These anecdotes illustrate the trade‑offs that data alone can’t capture.
Final Thoughts - Which Path Fits Your Lifestyle?
There’s no one‑size‑fits‑all answer. If you prefer a gut‑focused, non‑systemic approach and don’t mind taking a daily vitamin, Orlistat remains a solid, affordable choice. If rapid, clinically proven loss is your goal and you can handle injections, Liraglutide is the clear leader. For those wary of prescription meds, green tea extract offers a mild boost with virtually no risk.
Pick the tool that aligns with your health profile, budget, and willingness to manage side‑effects. And remember: medication works best when paired with a balanced diet, regular movement, and behavior change support.
Can I take Orlistat without a prescription?
Yes. The 60 mg dose (Alli) is sold over‑the‑counter in Australia. The 120 mg prescription strength (Xenical) requires a doctor’s note.
How long does it take to see results with Orlistat?
Most users notice a modest drop (1-2 kg) within the first 8‑12 weeks if they stick to a low‑fat diet and take the drug with each meal.
Do I need to take vitamins with Orlistat?
Yes. Because Orlistat blocks fat absorption, fat‑soluble vitamins A, D, E, and K can become deficient. A once‑daily multivitamin taken at a different time than the medication is recommended.
Is Liraglutide safe for people without diabetes?
Yes, Saxenda is FDA‑approved for weight management in non‑diabetic adults with a BMI ≥ 30 kg/m², or ≥ 27 kg/m² with at least one weight‑related condition. Monitoring for pancreatitis is advised.
Can I combine Orlistat with other weight‑loss drugs?
Combining Orlistat with other appetite suppressants is generally discouraged because of overlapping side‑effects and unclear efficacy. Always ask a clinician before stacking medications.
Aaron Kuan
October 24, 2025 AT 19:14