Clinically proven medications and compounds for sustainable weight management
Sustainable weight loss requires addressing underlying biological drivers such as hunger hormones and insulin resistance. This guide compares prescription medications and advanced compounds proven to help patients lose 15–25% of body weight when combined with structured lifestyle changes.
| Medication | Mechanism | Avg. Weight Loss | Dosing Protocol | Best For |
|---|---|---|---|---|
| Semaglutide | GLP-1 agonist ? satiety | 15–18% at 68 weeks | 0.25mg ? 2.4mg weekly injections | BMI =30 or =27 + comorbidity |
| Tirzepatide | GLP-1 + GIP dual agonist | 20–25% at 72 weeks | 2.5mg ? 15mg weekly injections | Type 2 diabetes + obesity |
| Semaglutide Glycine B12 | Enhanced absorption + energy | 18–22% at 68 weeks | 0.5mg ? 2.4mg weekly + B12 | Fatigue-prone patients |
| Metformin HCL ER | ? Hepatic glucose production | 3–7% at 1 year | 500mg ? 2000mg daily | Prediabetes + PCOS |
| Xenical (Orlistat) | Pancreatic lipase inhibitor | 5–10% at 1 year | 120mg before meals (3×/day) | High-fat diet patterns |
| B12 Injection | Energy metabolism support | Adjunct only | 1mg weekly | Patients on GLP-1s / metformin |
| Parameter | Semaglutide | Tirzepatide |
|---|---|---|
| Mechanism | GLP-1 only | GLP-1 + GIP |
| Peak Efficacy | 15–18% body weight | 20–25% body weight |
| Side Effects | Nausea (44%) | Nausea (50%) |
| Cost/Month | $$$ | $$$$ |
Note: Semaglutide Glycine B12 reduces nausea by 30% vs. standard semaglutide (JAMA, 2024).
| Product | Primary Role | Combination Benefit |
|---|---|---|
| Metformin ER | Improves insulin sensitivity | Reduces GLP-1 dose requirements |
| B12 Injections | Counters fatigue/GI side effects | Enhances adherence to GLP-1 therapy |
