Phentermine vs Semaglutide for Weight Loss: Which is Better?

Two medications being used for weight loss—phentermine and semaglutide—have become popular options for individuals seeking to manage their weight. It is important to understand how these medications work, their benefits, and potential risks. This article compares phentermine and semaglutide, providing insights to help guide discussions with your healthcare provider. Always consult with a healthcare provider before starting any new medication or treatment plan for weight management.

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Knowing how these drugs differ helps you make an informed decision. This article looks at how phentermine and semaglutide work, their good points, and their downsides. By looking at their effects, how people use them, and what results they achieve, you'll learn valuable information to guide your weight loss journey.

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Key Takeaways

• Semaglutide, a newer weight loss medication, mimics the action of GLP-1 hormones to help regulate blood sugar, boost metabolism, and reduce appetite. It is typically prescribed for long-term use and is administered weekly ^[1].
• Phentermine and semaglutide should only be used under the supervision of a healthcare provider, who can determine the most appropriate treatment based on individual health needs.

• Phentermine is an oral stimulant drug that has been used for over 50 years. It works by stimulating the central nervous system to curb appetite and is typically prescribed for short-term use up to 12 weeks ^[1].

• Studies show that semaglutide leads to an average weight loss of 15-20 pounds over 26-30 weeks, while phentermine results in an average loss of 5-10% of starting weight over 12-14 weeks ^[1].

• Semaglutide is considered more potent than phentermine. The dosage for semaglutide starts at 0.25mg monthly and can increase to 2.4mg, while phentermine is taken daily in doses of 15 to 37.5mg ^[1].

• While phentermine is a controlled substance with the potential for addiction, a recent study suggests that abuse and addiction do not occur in patients treated with the drug for obesity ^[1].

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What Is Semaglutide?

Semaglutide is a drug that belongs to a group called glucagon-like peptide-1 (GLP-1) receptor agonists [3]. This treatment has an impact on both diabetes control and weight loss. Semaglutide copies the GLP-1 hormone, which the gut releases after eating [3]. Healthcare providers use semaglutide to help control blood sugar levels. It was initially created to treat type 2 diabetes [3], but new research shows it can also help people lose weight.

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Semaglutide works in several ways to help people lose weight. It affects brain areas that control hunger after eating, which can cut down on how much food a person eats [4]. It also makes the stomach empty slowly, helping people feel full for longer [4]. These effects together lead to significant drops in weight in people who are obese or overweight.

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One of the main benefits of semaglutide is how well it works over time. This makes it a good choice for anyone who wants to see lasting results as they try to manage their weight loss.

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You need a medical consultation and a prescription from a doctor to get compounded semaglutide for both the injectable and oral forms. Your doctor will decide if semaglutide is right for you and which type: either the injectable form of semaglutide (Wegovy^®, Ozempic^®) or one of the oral forms of semaglutide (Rybelsus^®, SubMagna™).

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How Does Semaglutide Work?

Semaglutide, a GLP-1 receptor agonist, has an influence on the body's natural systems to boost glycemic control and help with weight loss [5]. It lasts for a long period of time, which means patients need fewer doses. This allows them to stick to their treatment plan more easily and makes the treatment more effective [5]. The drug works in several ways:

1. Improving Insulin Response: Semaglutide has an impact on the body's insulin response to high blood sugar levels. This helps manage weight by keeping blood sugar steady, which affects hunger and energy levels [5].
2. Appetite Suppression: Semaglutide typically begins to suppress appetite within a few days to a week of starting the medication, with more noticeable effects developing over the first few weeks.
3. Lowering Glucagon Production: Semaglutide cuts down on glucagon, a hormone that raises blood glucose levels. This has an impact on the body's sugar output. It not only helps control blood sugar but also aids in weight management. It does this by reducing the need to store extra glucose as fat [5].
4. Slowing Gastric Emptying: Semaglutide makes food take longer to leave the stomach, which makes people feel full and less hungry. This causes them to eat fewer calories without trying since they don't feel like eating as often [5].
5. Impact on Brain's Appetite Centers: In addition to its effect on insulin and glucagon, semaglutide has an influence on the brain's appetite-control areas. It makes people feel full and less hungry. This tackles the behavioral side of managing obesity, helping people eat in healthier ways [5].
6. Resisting Enzyme Degradation: Unlike other GLP-1 agonists, semaglutide counteracts breakdown by the dipeptidyl peptidase-IV enzyme. This resistance to breakdown plays a part in its long-lasting effect [6].

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These combined effects lead to less appetite, lower energy intake, better control over eating, and less desire for fatty, high-calorie foods [6]. This multifaceted approach makes semaglutide a strong option for managing weight and controlling diabetes.

Semaglutide comes in pill form, as a sublingual suspension, and as an injection. Each type of semaglutide has its pros and cons, and there are several factors to consider when deciding between semaglutide tablets vs injections. By mimicking a natural hormone that controls hunger and blood sugar, semaglutide tablets work by helping people manage their weight by reducing food cravings.

Following semaglutide safety guidelines will help cut back on possible side effects and help you get the best results as you work towards managing your weight loss.

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What Is Phentermine?

Phentermine, a drug the FDA gave the green light to in 1959, helps people lose weight in the short term [7]. It's meant for people 16 and up who have a tough time with obesity or some extra pounds [7]. This medicine falls under the anorectics group, also known as appetite suppressants. These drugs cut down hunger and limit how many calories you eat [7].

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Doctors might prescribe phentermine to patients whose body mass index (BMI) is 30 or above, which falls into the obesity category [7]. Also, people with a BMI of 27 or more who have at least one health issue related to their weight, like high blood pressure, high cholesterol, or type 2 diabetes, could be good candidates to use this medicine [7].

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You can get phentermine under different brand names, like Adipex-P^®, Lomaira^®, and Suprenza^® [7]. Doctors prescribe it on its own or with other weight loss drugs. For example, Qsymia^® mixes phentermine with topiramate [7].

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Phentermine is a controlled substance because it's chemically similar to amphetamine and can lead to dependence [7]. This means you need a prescription to get it and should take it under a doctor's guidance. Scientists don't understand exactly how phentermine cuts appetite, but they think it has an effect on brain chemicals [7].

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Phentermine can help you lose weight, with doctors prescribing it for up to 12 weeks [7]. To get the best results, you should use this medicine as part of a bigger plan to manage your weight. This plan should include eating a healthy diet and exercising.

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If you're considering semaglutide alternatives, options like phentermine or other GLP-1 receptor agonists, like Saxenda^® (liragutide), might be effective for weight management and blood sugar control. It's important to discuss these alternatives with your healthcare provider to determine the best fit for your needs and health goals.

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How Does Phentermine Work?

Phentermine is an indirect-acting sympathomimetic drug that affects the central nervous system to curb hunger and speed up metabolism [8]. It acts by causing noradrenaline to be released from presynaptic vesicles in the lateral hypothalamus. This higher noradrenaline level in the synaptic cleft then stimulates beta2-adrenergic receptors [8].

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The medicine does more than just affect noradrenaline. It influences dopamine levels and indirectly impacts serotonin [8]. This mix of effects causes a nonstop fight-or-flight reaction in the body, which cuts down on hunger cues as the body focuses on immediate energy needs [8].

Research indicates that phentermine might block neuropeptide Y, a key pathway that triggers hunger [8]. This extra way of working adds to its ability to suppress appetite.

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While scientists don't understand how phentermine helps people lose weight, they think it works as a sympathomimetic agent. This means it might curb hunger and boost metabolism [9]. Because it has an impact on both appetite and metabolism, phentermine can be useful to manage weight in the short term when people also eat right and exercise.

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Semaglutide And Phentermine Compared

Phentermine: Weight Loss Effectiveness

Phentermine, an older stimulant drug, has been in use for over fifty years to reduce appetite. Research indicates that people who take phentermine shed 5-10% of their initial weight in 12-14 weeks [1]. Yet, its impact tends to lessen as time goes on, and people often gain back weight after they stop taking it [10].

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Semaglutide: Weight Loss Effectiveness

Semaglutide, a developed GLP-1 receptor agonist, has shown impressive outcomes in clinical studies. The STEP program revealed that semaglutide caused an average weight reduction of 15% when compared to the placebo group [10]. Research indicates that semaglutide leads to an average weight drop of 15-20 pounds over a 26-30 week period [1].

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Phentermine: Safety

Phentermine often leads to side effects like dry mouth, headaches, dizziness, and trouble sleeping [1]. It can also speed up your heart rate, raise your blood pressure, and might make you dependent on it because it's similar to amphetamines [10]. People with glaucoma, high blood pressure that's not under control, or serious heart problems should stay away from phentermine [11].

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Semaglutide: Safety

Users often experience nausea, vomiting, diarrhea, and constipation as side effects, but these lessen with time [10] [1]. People with a history of thyroid cancer or MEN Type 2, or those with a family history of these conditions, should not take semaglutide [11]. 

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Knowing how long semaglutide stays in your system is important. It sticks around for several weeks because it has a long half-life of about one week. This means that even after you stop taking the medication, it continues to have an effect as your body gets rid of it. Sticking to semaglutide safety guidelines will help you cut down on possible side effects and get the best results as you work to manage your weight.

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Phentermine: Cost

Phentermine has a lower price tag, with monthly costs starting at $14 [11].

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Semaglutide: Cost

Semaglutide comes with a much higher price, ranging from $900 to $1,300 per month [11]. The semaglutide costs can add up quickly if your insurance doesn't cover it. Prices can change based on your insurance plan, where you buy the semaglutide, and other factors. Research shows patients might pay up to 68% of the cost themselves for weight loss drugs.

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Semaglutide vs Phentermine: Pros And Cons

Semaglutide Pros

1. Weight Reduction: Research trials show that semaglutide helps people lose about 15% of their body weight [12].

2. Hunger Control: Semaglutide acts like the GLP-1 hormone, which helps manage appetite and reduce feelings of hunger [12].

3. Long-Term Use: Semaglutide differs from phentermine in its design for extended use, which might provide ongoing weight control advantages [13].

4. Additional Health Benefits: Semaglutide, as a GLP-1 receptor agonist, can help to control blood sugar levels. This makes it useful for people who have type 2 diabetes [12].

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Semaglutide Cons

1. Side Effects: Users often experience nausea, diarrhea, constipation, and stomach pain [12].

2. Administration Method: If patients don’t use the oral form, semaglutide requires patients to self-administer a shot every week, which some people might find to be a hassle [12].

3. Cost: Semaglutide can be costly. Monthly expenses range from $900 to $1,300 [13].

4. Limited Long-Term Data: We don't yet know the long-term impacts of using semaglutide to lose weight [12].

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Phentermine Pros

1. Long-Standing Reputation: Doctors have prescribed phentermine for more than 50 years, building up extensive real-world knowledge [14].

2. Budget: Phentermine tends to be cheaper, with some patients paying as little as $14 a month [11].

3. Short-Term Effectiveness: Research indicates people lose 5-10% of their initial weight in 12-14 weeks on average [1].

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Phentermine Cons

1. Short-Term Use: Doctors prescribe phentermine to use for up to 12 weeks [7].

2. Potential for Dependence: Phentermine, being a controlled substance, might lead to addiction and dependence [7].

3. Side Effects: Dry mouth, headaches, dizziness, and trouble sleeping often happen [1].

4. Heart Risks: Phentermine can speed up your heartbeat and raise your blood pressure [10].

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Phentermine vs Semaglutide Overall

Studies show that semaglutide works well. People in the STEP program lost about 15% of their weight on average compared to those who took a placebo [1]. This beats what we see with phentermine, which helps people lose about 5-10% of their starting weight over 12-14 weeks [1].

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Semaglutide stands apart from phentermine because it works well for a long period of time. Phentermine tends to become less effective over time, but semaglutide helps people keep weight off even after they stop taking it [10]. This makes semaglutide a preferred choice for people who need to lose weight and keep it off.

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Semaglutide has an impact on more than just weight loss. Research shows it helps control blood sugar in people with type 2 diabetes. It also lowers the risk of heart problems and death in patients who already have heart disease [10]. These extra perks make semaglutide a good option for people dealing with health issues linked to obesity.

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Many people have lost a lot of weight using this drug. These semaglutide success stories show how semaglutide can help people lose weight and boost their overall health when paired with a healthy diet and exericise. Always talk to your doctor to figure out the best way to treat your condition.

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It's also essential to understand semaglutide dosages and guidelines. Follow your healthcare provider's instructions carefully and report any side effects or concerns you may experience while using semaglutide.

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Final Thoughts On Phentermine And Semaglutide

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As we've seen, semaglutide and phentermine both play a role in weight loss treatment, but semaglutide emerges as a stronger and more flexible option. It can cause major weight loss, along with other health perks, making it an attractive choice for people struggling with obesity. Yet, you should always talk to a doctor before choosing between these drugs, keeping in mind your own health needs and situation.

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Losing weight for good takes more than just medications. While drugs like semaglutide and phentermine can help, they work better when you also make changes to your lifestyle, like eating well and working out. 

If you are considering other options, check some of our other comparisons:

• Lipotropic Injections vs Semaglutide
• Semaglutide vs. Tirzepatide
• Semaglutide Tablets vs Injection
• Dulaglutide vs Semaglutide
• Metformin vs Semaglutide
• Saxenda vs Semaglutide:

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FAQ

Does semaglutide help you lose more weight than phentermine?

Semaglutide has been shown to be more effective than phentermine to lose weight. Studies show that semaglutide helps people shed about 15% of their body weight [15]. Phentermine, on the other hand, cuts 5-10% of starting weight in 12-14 weeks [10]. Semaglutide stands out for its long-term results. It can help keep the weight off even after people stop taking it [2].

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Can you take semaglutide and phentermine together?

Some doctors might prescribe both drugs at once, but we don't know much about how safe or effective it is to combine semaglutide and phentermine [15]. Doctors might consider this combo for people who are overweight or have diabetes to help them lose more weight. But remember, taking both drugs together could make side effects more likely [15].

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What weight loss pill is stronger than phentermine?

A study in 2021 found that semaglutide shots led to more weight loss than other approved weight-loss drugs, phentermine included [2]. Semaglutide acts like the GLP-1 hormone, which controls hunger and blood sugar. This makes it pack more punch for managing weight over time [1].

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References

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1. Natalya, MD. Emerson Medical. Emerson Medical. Published September 14, 2023. Accessed August 15, 2024. https://www.natalyachalikmd.com/blog/semaglutide-vs-phentermine

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2. Crider C, Ngo P. Semaglutide and Phentermine: What to Know About These Weight Loss Drugs. Healthline. Published June 22, 2023. Accessed August 15, 2024. https://www.healthline.com/health/semaglutide-and-phentermine-together

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3. UCLA Health. Semaglutide, also known as Ozempic, for weight loss - what you need to know. uclahealth.org. Published January 12, 2023. Accessed August 15, 2024. https://www.uclahealth.org/news/article/semaglutide-weight-loss-what-you-need-know

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4. Anderson LA. How does semaglutide work for weight loss? Drugs.com. Published March 9, 2024. Accessed August 15, 2024. https://www.drugs.com/medical-answers/semaglutide-work-weight-loss-3573689/

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5. Skinlogic. Demystifying Semaglutide: Understanding Its Mechanism of Action. skinlogic.org. Published March 8, 2024. Accessed August 15, 2024. https://skinlogic.org/demystifying-semaglutide-understanding-its-mechanism-of-action/

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6. Alorfi NM, Algarni AS. Clinical Impact of Semaglutide, a Glucagon-Like Peptide-1 Receptor Agonist, on Obesity Management: A Review. Clinical Pharmacology: Advances and Applications. 2022;Volume 14:61-67. doi:https://doi.org/10.2147/cpaa.s374741

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7. Van G. Does Phentermine Work for Weight Loss? A Diet Pill Reviewed. Healthline. Published January 24, 2019. Accessed August 15, 2024. https://www.healthline.com/nutrition/phentermine-weight-loss

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8. DrugBank Online. Phentermine. go.drugbank.com. Published June 13, 2005. Accessed August 15, 2024. https://go.drugbank.com/drugs/DB00191

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9. Lonneman DJ, Rey JA, McKee BD. Phentermine/Topiramate Extended-Release Capsules (Qsymia) for Weight Loss. Pharmacy and Therapeutics. 2013;38(8):446-452. Accessed August 15, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3814438/

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10. Genesis Lifestyle Medicine. PHENTERMINE VS. SEMAGLUTIDE FOR WEIGHT LOSS. genesislifestylemedicine.com. Published August 15, 2024. Accessed August 15, 2024. https://www.genesislifestylemedicine.com/blog/phentermine-vs-semaglutide-for-weight-loss/

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11. Carter, MD M. Weight Loss Medications: Semaglutide vs Phentermine - Modern Body Clinic. Modern Body Clinic. Published February 14, 2023. Accessed August 15, 2024. https://modernbodyclinic.com/weight-loss-medications-semaglutide-vs-phentermine/

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12. Taylor, MD. The Pros and Cons of Semaglutide for Weight Loss - Dr. Taylor. Southwest Family Medical. Published September 7, 2023. Accessed August 15, 2024. https://swfamilymedical.com/pros-cons-semaglutide-for-weight-loss/

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13. Garone S, Gilden A. Semaglutide Weight Loss Drugs: Pros, Cons, and Considerations. EverydayHealth.com. Published June 30, 2024. Accessed August 15, 2024. https://www.everydayhealth.com/weight/here-is-when-doctors-say-to-consider-a-weight-loss-drug-like-ozempic/

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14. Pope C. Phentermine: 7 things you should know. Drugs.com. Published May 16, 2024. Accessed August 15, 2024. https://www.drugs.com/tips/phentermine-patient-tips

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15. Javit N. Compare The Differences of Wegovy vs. Phentermine for Weight Loss. GoodRx Health. Published February 8, 2024. Accessed August 15, 2024. https://www.goodrx.com/conditions/weight-loss/wegovy-vs-phentermine

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‌Disclaimer: The FDA does not approve compounded medications for safety, quality or manufacturing. Prescriptions and a medical evaluation are required for certain products. The information provided on this blog is for general informational purposes only. It is not intended as a substitute for professional advice from a qualified healthcare professional and should not be relied upon as personal health advice. The information contained in this blog is not meant to diagnose, treat, cure, or prevent any disease. Readers are advised to consult with a qualified healthcare professional for any medical concerns including side effects. Use of this blog's information is at your own risk. The blog owner is not responsible for any adverse effects, or consequences resulting from the use of any suggestions or information provided in this blog. 

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