Article edited for scientific accuracy by Illuminate Labs Blog Editor Taylor Graber MD
Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regards to prescription medication.
Contrave is a prescription weight loss pill, similar to Plenity which we reviewed previously. It’s approved for use in the U.S. for overweight and obese adults above a Body Mass Index (BMI) level of 27.
In this article we’ll review the formulation of Contrave and explain why we believe it’s a dangerous option, and far inferior to more natural methods of weight loss which can be just as effective without serious side effects.
What’s it Made Of?
Contrave has two active ingredients: bupropion and naltrexone.
Bupropion is an antidepressant, and the active ingredient in medications like Wellbutrin and Zyban.
Naltrexone is typically prescribed to treat alcohol and opioid disorders, because it binds to opioid receptors and reduces cravings. This is likely the same mechanism of action for use in weight loss, since it can likely reduce cravings for food.
Like many prescription medications, Contrave also contains a host of inactive filler ingredients, some of which are arguably harmful. Two artificial food colorants (Opadry II Blue and FD&C Blue #2 aluminum lake) are included in this product.
We know from previous medical research that all food dyes approved in the U.S. raise significant health risks, and in our opinion should be avoided.
The dosage of Contrave is titrated up, starting with a lower dose to monitor side effects and eventually reaching a dose of two tablets in the morning and evening after 4 weeks.
Does it Work?
Contrave has published four medical trials on their product which were summarized in this meta-review. Researchers found that in all four trials, the prescription pill had superior weight loss outcomes to placebo alone.
We don’t believe these medical trials were particularly well-designed, because the only weight-loss measures in the placebo groups were calorie restriction and lifestyle changes. We know from previous medical research that long-term dietary adherence to restricted calorie diets is poor. If people just try to eat a smaller amount of an unhealthy, processed diet, they’re likely to be overcome by cravings and fail.
We’d be more impressed with the results if Contrave was compared to a safe dietary intervention like increased fiber intake, which is shown in medical research to be effective for weight loss and is very safe compared to prescription medication.
Regardless, Contrave is proven to be effective for weight loss.
Contrave Side Effects
Just because a treatment modality is effective doesn’t mean it’s always the best option, because efficacy always has to be balanced with safety and risk.
Because Contrave impacts weight loss neurochemically, it seems to carry much higher risk than a weight loss pill that works by physically taking up room in the stomach like Plenity.
The meta-review linked above found that nearly 1 in 3 Contrave patients experienced nausea in the medical trials. Other adverse events like diarrhea, constipation, headache, vomiting, dizziness, insomnia and dry mouth were all reported at higher levels in the Contrave group compared with the placebo group.
Blood pressure was also found to be increased in the Contrave group.
The most concerning side effect though is suicidal ideation, which Contrave lists on their own website (due to required pharmaceutical disclosures) as a potential side effect of their medication.
Any prescription drug affecting brain function carries serious risks, and we believe consumers should take these risks very seriously and speak with their doctor before considering using this medication.
We don’t believe that this medication is worth the side effects, given that there are so many safer and proven alternatives for weight loss that carry no risks at all. Even Plenity would be better in our opinion.
Natural Weight Loss Options
Increasing dietary fiber intake is the safest and most effective way to lose weight over the long term in our opinion. Fiber intake has been well-studied in hundreds of research papers, and is associated with weight loss in a dose-dependent manner in adults consuming restricted diets.
Put simply, increasing fiber intake fills up the stomach with (mostly) indigestible calories. This causes the sensation of fullness and satiation to occur quicker than when eating processed food.
This is the reason why it’s quite easy to eat 1,500 calories in one sitting of pizza, but would be challenging to eat 1,500 calories in one sitting of beans, rice and a large salad. You’ll feel full sooner with the latter option because it contains high amounts of fiber.
Fiber can be obtained through food sources like beans and produce, and also can be obtained via dietary supplements.
We do not recommend Contrave and believe the significant risks associated with this weight loss medication outweigh any benefits.
There seem to be safer options both in regards to pharma drugs and natural alternatives, and we believe that patients subjecting themselves to potential suicidal thoughts just for weight loss treatment is illogical when so many alternatives exist.
Simply increasing fiber intake in the diet may have superior effects to taking Contrave, with none of the risks and at a much lower cost.