Best Weight Loss Medications and Supplements: Your Expert-Ranked Guide for 2026
Everything you need to know about Triple G, cheap Zepbound alternatives, Wegovy pills, all-natural options and more
Lately, those of us who want help losing weight have more options than ever before. So what exactly is the best weight loss medication? There isn’t just one answer, says functional medicine expert Bronwyn Holmes, MD, a medical advisor for the telehealth company Eden. Beyond how effective a drug or supplement is, we also need to consider what we can afford, personal preferences (like pills over injections) and if we can live with potential side effects. Here, Dr. Holmes and other experts help break down the pros and cons to help you find the best drug or supplement for your body and your life.
The 4 best prescription weight-loss medications, according to doctors
We’ll start with the most powerful:
1. Zepbound
“Zepbound is the most effective FDA-approved medication for weight loss to date, based on head-to-head trial data,” says Dr. Holmes. Study participants given the generic version of the drug, tirzepatide, lost an average of 21 percent of their body weight over 72 weeks with no special diet or exercise and up to 26 percent with diet and exercise.
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How it works: “Zepbound mimics two hormones called GLP-1 and GIP. These hormones work in the gut to reduce appetite and increase the feeling of being full,” says Brynna Connor, MD, an Austin-based longevity expert and ambassador for NorthWestPharmacy.com. “They also slow digestion and improve how the body responds to and regulates blood sugar.”
Pros of Zepbound: All our experts agree it’s the most effective option available (though a more powerful ‘Triple G’ drug is on the horizon that may work as well as weight loss surgery). On top of that, Zepbound offers many additional health benefits, including significant improvements in heart health, diabetes and glucose control, liver health, sleep apnea, joint pain, kidney health and overall quality of life.
Cons of Zepbound: Many insurance plans and Medicare/Medicaid won’t cover any medication strictly for weight loss, and the out-of-pocket price is steep—currently $449 per month for higher doses from the manufacturer’s Lilly Direct pharmacy. This med also requires a weekly injection.
As for side effects, about half of patients experience nausea; on top of that, vomiting, diarrhea and constipation are also fairly common. More serious issues are less likely but possible, including gallbladder disease, pancreatitis and worsening diabetic retinopathy.
2. Wegovy injections and pills
Wegovy is a brand name for semaglutide, which is also found in the diabetes medication Ozempic. Studies show an average person using higher doses of a weekly semaglutide injection loses about 15 percent of their body weight—and that number goes as high as 22 percent when diet and exercise are added.
As for newly-approved daily Wegovy pills, results published in the New England Journal of Medicine link higher doses to an average body-weight reduction of about 14 percent. Experts say head-to-head studies are needed, but it appears the pills may be less bioavailable and thus somewhat less effective than injections.
How Wegovy works: While Zepbound mimics two hormones, Wegovy artificially increases levels of just GLP-1. It still has a big impact on appetite and metabolism, says Rekha Kumar, an obesity medicine specialist and medical advisor at Found. And many of the same health benefits experienced by Zepbound users happen for Wegovy users too.
Pros of Wegovy: The highest/most effective doses without insurance coverage cost about $349 a month for both pills and injections from the manufacturer’s Novocare pharmacy. It saves you $100 per month over Zepbound. And for those who don’t do needles, there is finally an effective pill. Plus, “some patients feel more ‘engaged’ when taking a daily dose of oral Wegovy, helping them stay aligned with lifestyle goals,” Dr. Holmes.
Cons of Wegovy injections: In general, Wegovy carries the same or very similar side effect risks and downsides as Zepbound. As for Wegovy pills: For best absorption, they must be taken daily “on an empty stomach with avoidance of food, drink and other medications for at least 30 minutes afterward,” notes Dr. Holmes. So it can be a hassle.
3. Qsymia
A blend of phentermine and topiramate extended release, two medications used for decades, “Qsymia is the most effective non-GLP-1 option,” says Fernando Ovalle Jr, MD, an expert contributor to Drugwatch.com with advanced training in obesity medicine from Columbia University. Findings in the journal Obesity show that the highest dose helps people lose about 11 percent of their body weight.
How Qsymia works: “Phentermine is a stimulant that acts as an appetite suppressant, while topiramate affects neurotransmitters in the brain to decrease appetite and enhance satiety,” explains Dr. Holmes.
Pros of Qsymia: This is an oral medication, so no needles. It’s less expensive than GLP-1 meds and the appetite suppression is strong. “Qsymia can be quite effective for the right individual,” says Dr. Holmes. “Some see double-digit losses when lifestyle support is added.” With a prescription from a doctor, you can get a 30-day supply from the manufacturer for $98 at QsymiaEngage.com.
Cons of Qsymia: ”It can cause cognitive effects, such as brain fog, as a result of the topiramate, as well as stimulant effects like increased heart rate and/or anxiety,” says Dr. Connor. People who are pregnant or might get pregnant shouldn’t take Qsymia, as topiramate increases the risk of birth defects. And Qsymia may not be the best option for those with anxiety or heart issues.
A note about phentermine: Used on its own, phentermine can lead to losses of 7 percent to even 10 percent of body weight—and for a fraction of the cost of other prescription options. We found a month’s supply for about $17 at GoodRx.com. Just keep in mind that your doctor may advise against this stimulant option if you have anxiety, sleep trouble or heart issues.
4. Contrave
Contrave affects certain areas of the brain involved in hunger and cravings, helping some people eat less and reduce calorie intake over time. While studies show an average loss of 8 percent of body weight, an Obesity study found that 4 out of 10 people in a weight loss program on the highest dose lost 15 percent of their body weight or more (far exceeding benefits seen with a placebo).
How Contrave works: It contains bupropion, an antidepressant that can also reduce appetite, along with naltrexone, a compound that works on the brain to decrease hunger and cravings.
Pros of Contrave: Since it is in part an antidepressant, it may offer relief from brain-driven urges to eat, including intense comfort-food cravings and binge eating. “Studies have also found that Contrave can improve mood and energy in some patients,” adds Dr. Connor. And it’s another oral medication with a more moderate price point. Through the manufacturers’ CurAccess Patient Support Program, many people with an Rx can get Contrave for about $99 per month.
Cons of Contrave: “It can take several weeks of dose ramp-up to reach the full dose, and results may take 8–12 weeks to meaningfully appear,” says Dr. Holmes. “Common side effects are nausea, headaches, constipation, insomnia and dizziness. These typically subside, but may impact tolerability.”
It’s also important to note that bupropion in Contrave carries an increased risk of suicidal thoughts, particularly in younger adults or those with bipolar disorder. This medication is also not appropriate for anyone with a history of seizure disorders, uncontrolled high blood pressure or eating disorders.
Over-the-counter weight loss pills to consider
While these options aren’t as powerful as a prescription, there’s evidence that they can give you a nice natural boost.
Caffeine
A 2019 systematic review found that for every doubling in caffeine intake, weight decreased by approximately 22%.
How caffeine works: Caffeine can contribute to weight loss by increasing the body’s energy expenditure and enhancing fat oxidation, as well as acting as a short-term appetite suppressant, says Dr. Holmes
Pros of caffeine: It’s readily available in multiple forms, it’s energizing, “and it has been shown to help improve athletic performance if used before workouts,” Dr. Connor notes. Choose a bargain-brand coffee, and you’ll pay as little as 58 cents a day for a four-cup “dose.”
Cons of caffeine: Did someone say jitters? Caffeine can contribute to anxiety and sleep disruption—both of which can undermine weight loss, cautions Dr. Holmes.
The body can also develop a tolerance to caffeine quickly, which requires more of the stimulant to have the same/desired effect. Talk to your doctor about what is right for you, but a general guideline is to consume no more than 400 mg (equivalent to about four cups of coffee) each day.
2. Psyllium Husk
This old-fashioned fiber is trending with good reason. A 2023 study found moderate but significant weight loss with 10 grams of psyllium husk per day for 16 weeks, with an average weight loss of 5 pounds—no diet required.
How psyllium husk works: Made from the outer coating of psyllium seeds, the supplement is loaded with soluble fiber “that absorbs water in the gastrointestinal system and then forms a gel that slows digestion, increases the feeling of fullness, and stabilizes blood sugar,” says Dr. Connor.
Pros of psyllium: Found in Metamucil and store-brand knockoffs, it is low-cost. Costco’s Kirkland brand, for example, runs about 21 cents per 10 grams. And, hey, most of us need more fiber for optimal health anyway.
Cons of psyllium: It may cause GI discomfort and even blockages if you don’t take it with enough water. “It can actually worsen symptoms in individuals who have bowel strictures,” says Dr. Connor. (As always, check with your doctor before taking any new supplement.)
3. Green tea extract
In one Tufts study, adults in a weight loss program given a supplement equivalent to about four cups of green tea daily lost two times more weight—about 5 pounds in 12 weeks—and dramatically more abdominal fat than those who got a placebo.
How green tea works: Green tea extract contains powerful antioxidants that help increase fat oxidation, “and research has shown that it may reduce ghrelin, the hunger hormone,” says Dr. Connor.
Pros of green tea: Weight loss may be moderate, but Dr. Connor notes that green tea antioxidants have many other powerful benefits, including reduced inflammation, better heart health, improved brain function and much more. And if you buy a bargain brand, green tea costs about 7 cents per cup.
Cons of green tea: Green tea extract can contribute to liver toxicity at very high doses. The maximum tolerated dose is 9,900 mg per day, equivalent to about 24 cups. (While it’s unlikely you’d drink a dangerous amount, use caution if choosing supplements.) Green tea can also cause caffeine sensitivity in some people, so consider decaf if you’re sensitive.
The bottom line when choosing a weight loss medication or supplement
There are so many options out there if you want them. Talk to your doctor about your needs, lifestyle and budget. And no matter what you choose, experts urge you to consider it a tool to help you develop better habits. Eating well and staying active are key to weight loss and a long, happy, healthy life!
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