Saxenda, Xenical & Mysimba Overview

It’s no secret that losing weight is hard, and there are many obstacles in our environment and physiology that can prevent us from successfully losing weight and keeping it off.

If lifestyle changes have not been enough for you to lose weight, you may benefit from prescription weight loss treatment. Prescription treatments, when combined with healthy behaviours, make losing weight easier so that you can reach your goals.

Some of the most popular prescription weight loss treatments include Saxenda, Xenical, and Mysimba. They each use different active ingredients and work in different ways, and may vary in suitability depending on your medical history. We’ve detailed the benefits and considerations of each treatment so you can decide which one would best suit you.

Overview

	Saxenda	Xenical	Mysimba
Format	Injection	Tablet	Tablet
How it works	Suppresses appetite	Prevents fat from being absorbed	Suppresses appetite and increases energy expenditure
Who can take it	BMI of 30+ or 27+ if you have other weight-related conditions	BMI of 30+	BMI of 30+ or 27+ if you have other weight-related conditions
Side effects	Nausea, vomiting, diarrhoea, constipation	Headache, abdominal pain, increased urgency with needing to use the toilet, oily or fatty stools	Nausea, vomiting, constipation, headache
Benefits	Simple, once daily injection Weight loss begins at 2 weeks and usually provides noticeable results in 9 months	Easy to take tablet before meals Results usually noticeable between 2-3 months	Easy to take tablet You should lose 5% of your initial body weight within 16 weeks
Considerations	Must be comfortable with self-injections Must follow strict temperature instructions for storage	Avoid high fat meals (you may experience adverse gastrointestinal side effects if you do not evenly distribute your fat intake over your three main meals) Take a multivitamin a few hours before, as the drug prevents fat-soluble vitamins A, D, E & K from being absorbed	Avoid alcohol
Do not take if you have:	Severe heart failure Delayed stomach emptying Inflammatory bowel disease	Cholestasis (a liver disorder) Chronic malabsorption syndrome	High blood pressure Certain medications
Interactions with other medications	Tell your doctor if you are on anticoagulants or diabetes medications that belong to the class ‘sulfonylurea’	Tell your doctor if you are on: anticoagulants Ciclosporin iodine salts levothyroxine amiodarone	Do not take if you are on: monoamine oxidase inhibitors opiates opiate-containing medicines Tell your doctor about all of the medications you are taking, as some may need to be adjusted.

Saxenda

Saxenda, often referred to in the press as the ‘slimming jab’, comes in the form of a pre-filled injection pen. It contains the active ingredient liraglutide, which works by suppressing your appetite, helping you feel fuller for longer. It is intended for people with a BMI over 30, but may also be prescribed if you have a BMI of 27 or up and at least one other weight-related condition.

Doctors will usually start you out on a smaller dose, which will be increased gradually over a few weeks to avoid side effects like nausea and vomiting.

You should expect to lose at least 5% of your initial body weight after 12 weeks of use.

Saxenda may be more suitable for you if:

• you prefer the ease of only taking the medication once a day
• you have trouble swallowing tablets or would prefer not to take a tablet
• your body is unable to absorb certain fat-soluble nutrients (Xenical may make this worse)

Saxenda may not be right for you if:

• you are uncomfortable with injections (Xenical and Mysimba, which both come in pill format, may be more suitable)
• you have severe heart failure
• you are currently taking anticoagulants or a diabetes medication belonging to the drug class ‘sulfonylurea’

Xenical

Xenical contains the active ingredient orlistat. This is the same active ingredient in the popular over-the-counter treatment Alli, but in a higher dose. Orlistat prevents the enzyme lipase from breaking down fat. This means that, when you eat a meal containing fat, instead of being absorbed, it passes through your system, preventing a third of fat from being absorbed.

It is important that you evenly distribute the fat content of your meals throughout the day when on Xenical, as eating large meals high in fat can cause side effects.

You should notice a 5% reduction in weight after 12 weeks of taking the drug.

Xenical may be more suitable for you if:

• you would prefer to take a tablet
• you would like to be able to drink alcohol, as drinking is not recommended while on Mysimba and Saxenda

Xenical may not be right for you if:

• your BMI is below 30 (Mysimba and Saxenda are available if your BMI is 27+ and have at least one weight-related condition)
• you would find it difficult to adhere to a low-fat diet
• you do not want to take a tablet before meals (look into Mysimba below, which is only taken twice a day)
• you are currently taking anticoagulants, ciclosporin, iodine salts, or levothyroxine

Mysimba

Mysimba contains two active ingredients, bupropion and naltrexone, which help to suppress appetite and increase energy expenditure. This means you feel less hungry on a low-calorie diet, and ensures that food is burned more efficiently during exercise. It is meant for people who have a BMI over 30, but may also be prescribed with a BMI over 27 with at least one other weight-related condition.

You should notice a 5% reduction in weight after 16 weeks of taking Mysimba.

Mysimba may be more suitable for you if:

• you would prefer to take a tablet
• your body is unable to absorb certain fat-soluble nutrients (Xenical may make this worse)

Mysimba may not be right for you if:

• you normally drink a large amount of alcohol (drinking alcohol while on Mysimba can cause severe complications)
• you would rather take a medication once a day (Saxenda may be a better option)
• you have high blood pressure
• you are currently taking monoamine oxidase inhibitors or opiates or opiate-containing medicines
• you will need to drive and operate machinery while taking it, as it may reduce your ability to concentrate

When starting a new medication, you should always inform your doctor of your medical history and any other medications you are taking. Weight loss may also change the amount of medication you need, so it is important to tell your doctor if you are planning on losing weight.

When undergoing medical weight loss treatment, it is important that you also make the correct lifestyle changes to ensure successful, sustainable weight loss. Prescription medications can help get you started, but maintaining a healthy weight long-term is a result of behaviour change and healthy habits.