The Seven FDA Approved Medications after Bariatric Surgery

Bariatric surgery is a safe and effective treatment to the disease of obesity, but it’s not the only tool in the box! Medications can be utilized for obesity treatment instead of surgery OR in conjunction with surgery. There are seven FDA approved medications for Obesity, and more in FDA trials.

In this blog and video series, I will share more about each medication. First, let’s start with a roundup conversation about all seven drugs!

Here’s the kicker. In the video, I kept saying SIX medications are FDA-approved. My brain isn’t keeping up because the seventh one was approved in November 2023. With two more in stage 3 trials, I might really start getting the number wrong soon!

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It’s not a surprise anymore to hear the statistic about Obesity rates in the United States. We’re around the 40% mark. In June 2013, the American Medical Association voted to recognize Obesity as a chronic disease that requires medical attention and prevention efforts.

Bariatric surgery has been the most effective treatment to the disease of obesity, but in comparison to those who qualify for surgery, a low percentage of the population utilizes it. Whether because of stigma, fear, cost, medical contraindications or the permanent nature, there are several reasons why someone might not choose a surgical treatment.

Thankfully, medication options are growing! This is great news not only for those who want an alternative to a surgery but also for those who need additional treatment in the years following surgery to maintain their weight loss. Weight reoccurrence happens after bariatric surgery and for some, medication is a helpful option to make surgery effective once again in the longer-term.

Seven FDA approved medications after bariatric surgery

Here are the seven medications currently approved for Obesity treatment:

Going newest to oldest:

Tirzepatide (Zepbound®): Stimulates both the GIP and GLP-1 receptors providing more average weight loss than Semaglutide. Once a week injection. The newest FDA approved medication for Obesity treatment. Click here for my video on Zepbound!

Semaglutide (Wegovy®) Ozempic is semaglutide for Diabetes management…same drug ingredient but different dosage for Obesity vs Diabetes: A GLP-1 receptor agonist similar to liraglutide but a once a week injection with more average weight loss.

Liraglutide (Saxenda): Originally used for diabetes treatment, this medication also helps with weight loss by affecting appetite and food intake regulation. The first of the GLP1 class of drugs. Once a week injection.

Phentermine + Topiramate (Qysemia): A combination of phentermine (appetite suppressant) and topiramate (an anticonvulsant) that also helps with weight loss.

Naltrexone + Burproprion (Contrave): A combination of an opioid antagonist (naltrexone) and an antidepressant (bupropion) that work together to reduce appetite and cravings.

Orlistat (Xenical): reduces the absorption of dietary fat in the intestines.

Phentermine (Adipex-P, Lomaira): oldest, least expensive and still utilized a lot today! Appetite suppressant that stimulates the releases of norepinephrine in the brain which reduces hunger.

Each upcoming week I will add a video and a blog featuring each of these medications, the mechanism of how they work, how effective they are, potential side effects and contraindications. I will update this page with link when the episode for each medications releases!

When/why/who would a medication be used after bariatric surgery?

In years past medications didn’t seem like the most helpful option and therefore underutilized as a treatment option. I know in my past positions on bariatric care teams we did not utilize medication help for weight reoccurance.

One of the best things to happen with the newer GLP-1 receptor agonists is the opening of the eyes for all the options for medical treatment. There is no one size fits all and one patient may have success with a medication when someone else may experience side effects.

With seven options (and more to come) we have options to consider. An Obesity Medicine doctor can review things like medical history, past weight history, eating patterns and medication options to try. Their office may be able to help find the most affordable option as well.

These medications are indicated for those with a BMI over 30 or a BMI over 27 with a weight related co-morbidity. They can also be indicated for patients who have gone through a long stall in their weight loss after surgery or weight reoccurance.

Weight reoccurance after bariatric surgery (and who to go see for help)

Nearly every patient will experience some amount of weight reoccurance after bariatric surgery and that is not anyone’s fault. It is the metabolic disease of Obesity that wants to do what it always does. Surgery is a safe and effective treatment option and so are FDA approved medications. They can be used together!

Most programs will wait to introduce medication options until a year after surgery. Not always because some cases are individualized. Since they are treating a disease, it takes clinical judgement at all stages of care.

Many bariatric surgery programs now have a medical arm to their program. They may have a Bariatrician on staff which is a Bariatric physician that specializes in treating Obesity and related disease. Or they may have a Physician Assistant that manages their medical weight management program.

If you don’t have access to a Bariatric team or an Obesity specialized provider to offer that level of care, you can use the Obesity Medicine Find a Provider page to find someone near your Zip Code.

Have you utilized any of these medications? Let us know in the comments!