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Almost All Weight Loss Drugs (Good, Bad and Awful) Ever Used in the United States
Welcome to an extensive compilation of nearly every weight loss agent ever utilized in the United States. The term 'drug' is employed here to encompass any substance administered through various routes, including oral ingestion, insufflation, suppository, injection, or intravenous infusion. The American journey through the landscape of weight loss drugs is marked by a myriad of experiences, where moments of triumph are entwined with phases of turmoil. For each effective weight loss agent listed here, one might encounter three or four others that proved to be either harmful, impractical, or simply unattractive. Nevertheless, this chronicle is a testament to our nation's continuous quest for effective weight management solutions. This comprehensive collection is presented not only for its rarity but also for its educational value, offering a unique perspective on a significant aspect of American medical history that remains largely unexplored.

Tapeworm Eggs
Tapeworm Egg: While not actually a drug, a tapeworm egg in a sugar cube was sold and ingested as if it was a drug and so I will list it here. Tapeworm eggs were used in the early 20th century as a weight loss aid. The eggs were ingested, and the tapeworms would grow inside the host's intestines, consuming nutrients and calories. This method is not only dangerous but also illegal in the US. Side effects include abdominal pain, malnutrition, and in severe cases, organ damage and death.
Era in History
Early 20th century
Mechanism of Action
Ingested eggs hatch and grow inside host, consuming nutrients and calories
Used as weight loss aid in early 20th century
Side Effects and Problems
Benefits
Weight loss due to tapeworms consuming nutrients and calories
Side Effects and Problems
Abdominal pain, malnutrition, organ damage, and death in severe cases
Current Status in US
Illegal. Occasional claims that clinics in certain Latin American countries are infecting people.

Dinitrophenol (DNP)
Dinitrophenol (DNP): DNP is an industrial chemical that was discovered in the 1930s to cause rapid weight loss by uncoupling oxidative phosphorylation in cells, increasing metabolic rate. It was banned in the US in 1938 due to its severe side effects, including cataracts, skin lesions, and fatalities due to hyperthermia. DNP remains illegal and is not used in medical practice.
Era in History
1930s
Mechanism of Action
Uncouples oxidative phosphorylation, increasing metabolic rate
Used briefly in the 1930s, banned in 1938
Side Effects and Problems
Benefits
Rapid weight loss
Side Effects and Problems
Cataracts, skin lesions, hyperthermia, and fatalities
Current Status in US
Illegal for human consumption. Industrial chemical.

Amphetamines
Amphetamines: Amphetamines were widely prescribed as appetite suppressants in the 1950s and 1960s. They work by increasing the release of certain neurotransmitters, such as dopamine, which suppress appetite. However, their use declined due to the risk of addiction and side effects like insomnia, increased heart rate, and high blood pressure. Currently, amphetamines are not approved for weight loss in the US.
Era in History
1950s and 1960s
Mechanism of Action
Increase release of neurotransmitters (e.g., dopamine) that suppress appetite
Widely prescribed as appetite suppressants in the 1950s and 1960s
Side Effects and Problems
Benefits
Weight loss due to appetite suppression
Side Effects and Problems
Insomnia, increased heart rate, high blood pressure, addiction
Current Status in US
Not approved for weight loss

Phentermine
Phentermine is the most widely prescribed weight loss drug on Earth. Since it was first approved by the US FDA in 1959, phentermine is estimated to have been prescribed to over half a billion people on Earth. Phentermine is a mainstay of what we call "classic" weight loss drugs. It works very well for most people and extremely well for some. Phentermine is a stimulant and therefore may cause related side effects but these are usually mild and easily managed through dose modulation.
Era in History
1959
Mechanism of Action
Stimulates central nervous system, increasing heart rate and blood pressure while decreasing appetite
Approved by FDA in 1959 and still in use
Side Effects and Problems
Benefits
Weight loss due to appetite suppression
Side Effects and Problems
Dry mouth, insomnia, constipation
Current Status in US
Available by prescription

Phendimetrazine
Phendimetrazine: Phendimetrazine is another sympathomimetic amine approved for short-term use as an appetite suppressant. It works similarly to phentermine and was approved by the FDA in 1961. Side effects include dizziness, dry mouth, and increased heart rate.
Era in History
1961
Mechanism of Action
Sympathomimetic amine that suppresses appetite
Approved by FDA in 1961 and still in use
Side Effects and Problems
Benefits
Weight loss due to appetite suppression
Side Effects and Problems
Dizziness, dry mouth, increased heart rate
Current Status in US
Available by prescription

Diethylpropion
Diethylpropion: Diethylpropion, approved in 1959, is a sympathomimetic amine used for short-term treatment of obesity. It reduces appetite and boosts metabolism. Side effects include dizziness, headache, and insomnia.
Era in History
1959
Mechanism of Action
Suppresses appetite and boosts metabolism
Approved by FDA in 1959 and still in use
Side Effects and Problems
Benefits
Weight loss due to appetite suppression and increased metabolism
Side Effects and Problems
Dizziness, headache, insomnia
Current Status in US
Available by prescription

Preludin (phenmetrazine)
Preludin (phenmetrazine): Preludin was an amphetamine-like drug used as an appetite suppressant in the 1960s. However, it was discontinued due to its potential for abuse and addiction.
Era in History
1960s
Mechanism of Action
Amphetamine-like drug that suppresses appetite
Used as appetite suppressant in 1960s
Side Effects and Problems
Benefits
Weight loss due to appetite suppression
Side Effects and Problems
Addiction and potential for abuse
Current Status in US
Discontinued

Didrex (benzphetamine)
Didrex (benzphetamine): Didrex, an anorectic drug, was approved in 1960. It stimulates the central nervous system, suppressing appetite. Side effects include elevated blood pressure, dry mouth, and constipation. Didrex is available by prescription in the US.
Era in History
1960
Mechanism of Action
Stimulates central nervous system, suppressing appetite
Approved in 1960 and still in use
Side Effects and Problems
Benefits
Weight loss due to appetite suppression
Side Effects and Problems
Elevated blood pressure, dry mouth, constipation
Current Status in US
Available by prescription

Fenfluramine (Pondimin) and Dexfenfluramine (Redux)
Fenfluramine (Pondimin) and Dexfenfluramine (Redux): Fenfluramine and its enantiomer dexfenfluramine were approved in the 1970s and 1990s, respectively. They worked by increasing serotonin levels, reducing appetite. However, both were withdrawn from the US market in 1997 due to their association with serious heart and lung issues, including primary pulmonary hypertension and valvular heart disease.
Era in History
1970s and 1990s
Mechanism of Action
Increase serotonin levels, reducing appetite
Used in the 1970s and 1990s, withdrawn in 1997
Side Effects and Problems
Benefits
Weight loss due to appetite suppression
Side Effects and Problems
Primary pulmonary hypertension, valvular heart disease
Current Status in US
Withdrawn from the market

Phenylpropanolamine (Dexatrim)
Phenylpropanolamine (Dexatrim): Phenylpropanolamine was an over-the-counter weight loss ingredient found in products like Dexatrim. It was removed from the US market in 2000 due to its association with an increased risk of hemorrhagic stroke.
Era in History
1980s-1990s
Mechanism of Action
Over-the-counter weight loss ingredient
Used as an OTC weight loss ingredient until 2000
Side Effects and Problems
Benefits
Weight loss
Side Effects and Problems
Increased risk of hemorrhagic stroke
Current Status in US
Removed from the market

Sanorex (mazindol)
Sanorex (mazindol): Sanorex, approved in the 1970s, is a sympathomimetic amine that suppresses appetite. It is rarely prescribed due to concerns about its potential for abuse and side effects, including high blood pressure, dry mouth, and constipation.
Era in History
1970s
Mechanism of Action
Suppresses appetite
Approved in the 1970s
Side Effects and Problems
Benefits
Weight loss due to appetite suppression
Side Effects and Problems
High blood pressure, dry mouth, constipation
Current Status in US
Rarely prescribed

Rimonabant
Rimonabant: Rimonabant is a selective cannabinoid-1 receptor antagonist that was never approved in the US. It was used in Europe for a short time but was withdrawn due to its association with psychiatric side effects, including depression and suicidal thoughts.
Era in History
2000s
Mechanism of Action
Selective cannabinoid-1 receptor antagonist
Never approved in the US, used briefly in Europe
Side Effects and Problems
Benefits
Weight loss due to appetite suppression
Side Effects and Problems
Psychiatric side effects, including depression and suicidal thoughts
Current Status in US
Not approved in the US

Xenical (orlistat) and Alli
Xenical (orlistat) and Alli: Xenical (prescription) and Alli (over-the-counter) are FDA-approved weight loss medications that work by inhibiting the absorption of dietary fat. Side effects include oily stools, gas, and abdominal pain. Alli and Xenical are available in the US.
Era in History
1999 and 2007
Mechanism of Action
Inhibit absorption of dietary fat
Approved in 1999 (Xenical) and 2007 (Alli)
Side Effects and Problems
Benefits
Weight loss due to reduced fat absorption
Side Effects and Problems
Oily stools, gas, abdominal pain
Current Status in US
Available in the US (Xenical by prescription, Alli OTC)

Meridia (sibutramine)
Meridia (sibutramine): Meridia was approved in 1997 and worked by increasing serotonin, norepinephrine, and dopamine levels, reducing appetite. It was withdrawn from the US market in 2010 due to an increased risk of cardiovascular events.
Era in History
1997
Mechanism of Action
Increases serotonin, norepinephrine, and dopamine levels, reducing appetite
Approved in 1997, withdrawn in 2010
Side Effects and Problems
Benefits
Weight loss due to appetite suppression
Side Effects and Problems
Increased risk of cardiovascular events
Current Status in US
Withdrawn from the market

Topiramate
Topiramate: Topiramate is an anticonvulsant medication that is sometimes prescribed off-label for weight loss. It works by suppressing appetite and increasing feelings of fullness. Side effects include dizziness, fatigue, and memory problems.
Era in History
1990s
Mechanism of Action
Anticonvulsant medication with appetite-suppressing effects
Used off-label for weight loss
Side Effects and Problems
Benefits
Weight loss due to appetite suppression and increased fullness
Side Effects and Problems
Dizziness, fatigue, memory problems
Current Status in US
Available by prescription (off-label for weight loss)

Qsymia (phentermine/topiramate)
Qsymia (phentermine/topiramate): Qsymia, a combination of phentermine and topiramate, was approved by the FDA in 2012. It helps patients lose weight by suppressing appetite and increasing feelings of fullness. Side effects include dizziness, dry mouth, and constipation.
Era in History
2012
Mechanism of Action
Combination of appetite-suppressing drugs
Approved by FDA in 2012
Side Effects and Problems
Benefits
Weight loss due to appetite suppression and increased fullness
Side Effects and Problems
Dizziness, dry mouth, constipation
Current Status in US
Available by prescription

Belviq (lorcaserin)
Belviq (lorcaserin): Belviq was approved in 2012 and worked by activating serotonin 2C receptors in the brain, reducing appetite. It was withdrawn from the US market in 2020 due to an increased risk of cancer.
Era in History
2012
Mechanism of Action
Activates serotonin 2C receptors in the brain, reducing appetite
Approved in 2012, withdrawn in 2020
Side Effects and Problems
Benefits
Weight loss due to appetite suppression
Side Effects and Problems
Increased risk of cancer
Current Status in US
Withdrawn from the market

Contrave (naltrexone/bupropion)
Contrave (naltrexone/bupropion): Contrave, approved in 2014, is a combination of naltrexone, an opioid antagonist, and bupropion, an antidepressant. It helps patients lose weight by suppressing appetite and reducing cravings. Side effects include nausea, headache, and constipation.
Era in History
2014
Mechanism of Action
Combination of opioid antagonist and antidepressant
Approved by FDA in 2014
Side Effects and Problems
Benefits
Weight loss due to appetite suppression and reduced cravings
Side Effects and Problems
Nausea, headache, constipation
Current Status in US
Available by prescription

Metformin
Metformin: Metformin is a diabetes medication that can cause modest weight loss in some patients. It works by decreasing the absorption of glucose and reducing insulin resistance. Side effects include gastrointestinal symptoms such as diarrhea, abdominal pain, and bloating.
Era in History
1950s
Mechanism of Action
Decreases absorption of glucose and reduces insulin resistance
Used as a diabetes medication, sometimes causes weight loss
Side Effects and Problems
Benefits
Modest weight loss in some patients
Side Effects and Problems
Gastrointestinal symptoms, such as diarrhea, abdominal pain, and bloating
Current Status in US
Available by prescription

Ephedra and Ephedrine
Ephedra and Ephedrine: Ephedra, a plant containing ephedrine alkaloids, was a popular weight loss ingredient in the 1990s and early 2000s. It was banned in the US in 2004 due to its association with serious side effects, including heart attacks, seizures, and strokes.
Era in History
1990s-early 2000s
Mechanism of Action
Plant containing ephedrine alkaloids
Popular weight loss ingredient until banned in 2004
Side Effects and Problems
Benefits
Weight loss
Side Effects and Problems
Heart attacks, seizures, strokes
Current Status in US
Banned in the US

GLP-1 Agonists
GLP-1 Agonists: GLP-1 agonists, such as liraglutide (Saxenda), are medications originally developed for diabetes but also approved for weight loss. They work by mimicking the effects of the hormone glucagon-like peptide-1, increasing satiety and delaying gastric emptying. Side effects include nausea, vomiting, and diarrhea. Saxenda is available by prescription in the US.
Era in History
2010s
Mechanism of Action
Mimic the effects of glucagon-like peptide-1, increasing satiety and delaying gastric emptying
Approved for weight loss (e.g., liraglutide/Saxenda)
Side Effects and Problems
Benefits
Weight loss due to increased satiety and delayed gastric emptying
Side Effects and Problems
Nausea, vomiting, diarrhea
Current Status in US
Available by prescription (e.g., Saxenda)