What Are Appetite Suppressants?
Appetite suppressants are medications that reduce hunger signals, helping you eat less and lose weight more effectively. They work on the central nervous system or on hormones in the gastrointestinal tract to enhance feelings of fullness. Modern appetite suppressants based on GLP-1 receptor agonists, such as semaglutide and tirzepatide, are among the most effective options, leading to an average weight loss of 15 to 22.5% of body weight according to clinical studies.
In the Netherlands, appetite suppressants are increasingly prescribed to people with obesity (BMI above 30) or overweight (BMI above 27) with associated health conditions. It is important to understand that appetite suppressants are not a magic solution but a tool that works best in combination with lifestyle modifications. At Go Leaner, appetite suppressants are exclusively prescribed by registered physicians after a comprehensive medical intake.
How Do Appetite Suppressants Work in Your Body?
Appetite suppressants can intervene in hunger and satiety regulation through different mechanisms. Understanding these mechanisms helps you make an informed choice.
Effects on the Hypothalamus
The hypothalamus is the part of the brain that processes hunger and satiety signals. Older appetite suppressants like phentermine and sibutramine worked directly on neurotransmitters (norepinephrine, serotonin) in this brain region. These medications have largely been withdrawn from the market due to cardiovascular side effects.
GLP-1 Receptor Agonists: The New Generation
Modern appetite suppressants based on GLP-1 (glucagon-like peptide-1) mimic a natural gut hormone. This hormone:
Medications such as semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro) fall into this category. They are injected weekly and have consistently shown superior results compared to older appetite suppressants in large clinical trials.
Dual Action: GLP-1 and GIP
Tirzepatide, the active ingredient in Mounjaro, works not only on the GLP-1 receptor but also on the GIP receptor (glucose-dependent insulinotropic polypeptide). This dual action leads to an even stronger satiety effect and an average weight loss of 22.5% in the SURMOUNT-1 trial (Jastreboff et al., 2022).
What Types of Appetite Suppressants Exist?
Not all appetite suppressants are equal. Below is an overview of the main categories available or previously available in the Netherlands.
| Type | Active Substance | Administration | Average Weight Loss | Status in Netherlands | |------|-----------------|----------------|--------------------|-----------------------| | GLP-1 agonist | Semaglutide (Wegovy) | Weekly injection | 15-17% | Registered | | GLP-1 agonist | Semaglutide (Ozempic) | Weekly injection | 12-15% | Registered (off-label for obesity) | | GLP-1/GIP agonist | Tirzepatide (Mounjaro) | Weekly injection | 20-22.5% | Registered | | Lipase inhibitor | Orlistat (Alli/Xenical) | Oral capsule | 3-5% | Registered | | Combination | Naltrexone/bupropion (Mysimba) | Oral tablet | 5-8% | Registered | | Amphetamine derivative | Phentermine | Oral | 5-7% | Not available in NL |
GLP-1 based appetite suppressants are currently the gold standard for pharmacological treatment of obesity. They combine effectiveness with a relatively favorable side effect profile.
What Results Can You Expect with Appetite Suppressants?
The effectiveness of appetite suppressants depends on the type of medication, dosage, and the extent to which you implement lifestyle changes.
Clinical Study Results
The STEP-1 trial (Wilding et al., 2021) demonstrated that participants using semaglutide 2.4 mg weekly lost an average of 14.9% of their body weight over 68 weeks. In the control group (placebo), this was only 2.4%. Of semaglutide users, 86.4% achieved at least 5% weight loss.
The SURMOUNT-1 trial (Jastreboff et al., 2022) with tirzepatide showed even more impressive results:
This means someone weighing 100 kg could lose an average of 22.5 kg on the highest tirzepatide dose.
Realistic Expectations
While study results are impressive, it is important to have realistic expectations:
You can calculate your BMI to determine whether you qualify for treatment with appetite suppressants.
What Are the Side Effects of Appetite Suppressants?
Like any medication, appetite suppressants have side effects. With modern GLP-1 based agents, these are usually mild to moderate and decrease as the body adjusts to the medication.
Common Side Effects
The most reported side effects of GLP-1 appetite suppressants are gastrointestinal:
These side effects occur most frequently when starting or increasing the dose and resolve in most people within 4 to 8 weeks. Gradual dose escalation (titration) significantly reduces the likelihood of side effects.
Rare but Serious Side Effects
When to Contact a Doctor?
Contact your treating physician immediately if you experience:
How Are Appetite Suppressants Dosed?
With GLP-1 appetite suppressants, treatment always starts with a low dose that is gradually increased. This minimizes side effects and gives the body time to adjust.
Semaglutide (Wegovy) Titration Schedule
| Week | Dose | Frequency | |------|------|-----------| | Week 1-4 | 0.25 mg | Once weekly | | Week 5-8 | 0.5 mg | Once weekly | | Week 9-12 | 1.0 mg | Once weekly | | Week 13-16 | 1.7 mg | Once weekly | | Week 17+ | 2.4 mg | Once weekly |
The maintenance dose of 2.4 mg per week is reached after approximately 16 weeks. Some patients remain on an intermediate dose longer if side effects are too pronounced.
Tirzepatide (Mounjaro) Titration Schedule
Tirzepatide starts at 2.5 mg weekly and is increased by 2.5 mg every 4 weeks until the optimal dose (5, 10, or 15 mg) is reached. The physician determines which maintenance dose is most appropriate based on effectiveness and tolerability.
What Do Appetite Suppressants Cost in the Netherlands?
The costs of appetite suppressants vary significantly depending on the type of medication and insurance coverage.
Insurance coverage: In the Netherlands, GLP-1 appetite suppressants for weight loss are currently not routinely covered by basic health insurance. Ozempic is covered for type 2 diabetes but not for obesity without diabetes. Wegovy has coverage status for specific patient groups through prior authorization.
At Go Leaner, current prices are transparently displayed. Costs include the medication, medical supervision, and monitoring by registered physicians.
Who Qualifies for Appetite Suppressants?
Not everyone can simply use appetite suppressants. Strict medical criteria apply:
Indications:
Contraindications:
How Do Appetite Suppressants Compare to Other Weight Loss Methods?
Appetite suppressants are not the only option for weight loss. It is useful to put them in perspective.
| Method | Average Weight Loss | Sustainability | Invasiveness | |--------|--------------------|--------------|--------------| | Diet + exercise | 3-5% | Moderate (high relapse) | None | | GLP-1 appetite suppressants | 15-22.5% | Good (with continuation) | Minimal (injection) | | Orlistat | 3-5% | Moderate | None | | Gastric sleeve | 25-30% | High | High (surgery) | | Gastric band | 15-20% | Moderate | High (surgery) |
GLP-1 based appetite suppressants fill the gap between conservative treatment (diet/exercise) and bariatric surgery. They offer substantial weight loss without the risks of an operation.
Are Appetite Suppressants Safe Long-Term?
The long-term safety of GLP-1 appetite suppressants is supported by growing evidence. The SELECT trial (Lincoff et al., 2023) followed more than 17,000 participants for an average of 40 months and demonstrated that semaglutide was not only safe but also reduced the risk of cardiovascular disease by 20%.
Key findings on long-term use:
However, weight regain occurs in most people after stopping the medication. Research by Wilding et al. (2022) showed that participants regained two-thirds of lost weight within one year of stopping semaglutide. This underscores the importance of a long-term strategy.
Frequently Asked Questions About Appetite Suppressants
Are appetite suppressants addictive?
Modern GLP-1 appetite suppressants are not addictive. Unlike older amphetamine-like appetite suppressants, they do not work on the reward system in a way that leads to dependence. Interestingly, research is being conducted on whether they may actually help with addiction issues.
Can you combine appetite suppressants with other medications?
GLP-1 appetite suppressants can be combined with most medications, but there are exceptions. Insulin and sulfonylureas may need dose adjustments due to hypoglycemia risk. Always discuss interactions with your doctor.
How quickly do you notice the effect of appetite suppressants?
Most users notice reduced appetite within the first 1-2 weeks. Significant weight loss on the scale typically becomes visible after 4-8 weeks. Maximum effect is reached after 6-12 months on the maintenance dose.
Can you drink alcohol while using appetite suppressants?
Alcohol is not strictly prohibited but is discouraged. Alcohol contains many calories, can worsen nausea, and reduces the appetite-suppressing effect. Many users report spontaneously having less desire for alcohol.
What happens when you stop appetite suppressants?
After stopping, appetite gradually returns to its original level. Without lifestyle adjustments, weight returns partially or completely in most people within 12 months. Therefore, guidance during potential tapering is essential.
Conclusion
Appetite suppressants based on GLP-1 receptor agonists represent a breakthrough in obesity treatment. With average weight loss of 15 to 22.5%, they offer an effective and relatively safe alternative for people in whom diet and exercise produce insufficient results. Side effects are usually mild and temporary, and long-term safety is supported by large clinical studies.
It is essential that appetite suppressants are prescribed and supervised by a qualified physician who monitors your health and optimizes dosing. Want to know if appetite suppressants are suitable for your situation? Check how it works at Go Leaner for more information about the treatment process.
This article is informational and does not replace medical advice. Always consult a physician before starting appetite suppressants.
Frequently Asked Questions
Are appetite suppressants addictive?
Modern GLP-1 appetite suppressants are not addictive. Unlike older amphetamine-like agents, they do not work on the reward system in a way that leads to dependence. They are safe for long-term use under medical supervision.
How quickly do appetite suppressants work?
Most users notice reduced appetite within 1-2 weeks. Significant weight loss becomes visible after 4-8 weeks. Maximum effect is reached after 6-12 months on the maintenance dose.
What are the side effects of appetite suppressants?
The most common side effects are nausea (20-44%), diarrhea (15-30%), and constipation (10-24%). These are usually mild, occur when starting or increasing the dose, and resolve within 4-8 weeks.
Are appetite suppressants covered by health insurance?
GLP-1 appetite suppressants for weight loss are currently not routinely covered by Dutch basic health insurance. Wegovy may be covered in specific cases through prior authorization. Ozempic is only covered for type 2 diabetes.
What happens when you stop appetite suppressants?
After stopping, appetite returns to its original level. Research shows most people regain two-thirds of lost weight within 12 months of stopping. Lifestyle adjustments and guidance during tapering are therefore essential.
Who qualifies for appetite suppressants?
Appetite suppressants are suitable for people with a BMI of 30 or higher, or a BMI of 27 or higher with a weight-related condition such as type 2 diabetes or hypertension. Previous weight loss attempts must have produced insufficient results.
Sources
- 1.Once-Weekly Semaglutide in Adults with Overweight or Obesity, Wilding JPH et al., New England Journal of Medicine, 2021. DOI: 10.1056/NEJMoa2032183
- 2.Tirzepatide Once Weekly for the Treatment of Obesity, Jastreboff AM et al., New England Journal of Medicine, 2022. DOI: 10.1056/NEJMoa2206038
- 3.Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (SELECT), Lincoff AM et al., New England Journal of Medicine, 2023. DOI: 10.1056/NEJMoa2307563
- 4.Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance, Wilding JPH et al., JAMA, 2022. DOI: 10.1001/jama.2022.0836