Naltrexone and Weight Loss: What You Need to Know

New weight loss trends seem to appear constantly. From carnivore and keto diets to medications like Ozempic and naltrexone, it's challenging to separate effective solutions from passing fads. While a pill that helps shed pounds sounds appealing, it's important to understand the full picture—including potential side effects and health implications.

What Is Naltrexone?

Naltrexone is an FDA-approved prescription medication primarily used to treat alcohol use disorder (AUD) and opioid use disorder (OUD). It's a controlled substance that requires medical supervision and is typically administered as part of a comprehensive treatment plan that includes behavioral therapy and counseling. Available in pill or extended-release injection form, naltrexone helps address substance use disorders through multiple approaches.

Common Uses of Naltrexone

Beyond its primary applications, naltrexone has several other uses:

• Low-Dose Naltrexone (LDN): At 1-5 mg daily (about one-tenth the clinical dose), LDN shows anti-inflammatory effects and has been studied for conditions like multiple sclerosis, fibromyalgia, long COVID, and autoimmune disorders.
• Contrave: This FDA-approved weight management medication combines naltrexone with bupropion. The combination affects the brain's reward system to influence eating behaviors and works best alongside lifestyle changes like diet and exercise.

How Naltrexone Works

Naltrexone is an opioid antagonist, meaning it blocks substances from binding to opioid receptors in the brain. This prevents the pleasure response typically associated with substance use, reducing psychological dependence and cravings. Think of it like losing your sense of taste while eating chips—without the reward, you're less likely to continue.

Research shows naltrexone also reduces dopamine release and affects the hypothalamus-pituitary-adrenocortical (HPA) axis, contributing to its effectiveness in treating substance dependence.

The Weight Loss Connection

Naltrexone's impact on the opioid system—which regulates mood, hunger, pain, and reward—can lead to several effects that influence weight:

• Decreased appetite and reduced calorie intake
• Diminished reward feedback from food
• Improved insulin sensitivity and blood sugar regulation
• Increased energy levels and physical activity
• Better mood and reduced stress hormones

Alcohol vs. Naltrexone: Weight Effects

While naltrexone may support weight loss, alcohol typically contributes to weight gain through:

• Empty calories that add up quickly
• Lowered inhibitions leading to poor food choices
• Disrupted fat metabolism as the body prioritizes alcohol processing
• Altered hunger and fullness hormones

Using Naltrexone for Weight Loss

There are two main approaches to using naltrexone for weight management:

• Primary Use: FDA-approved formulations like Contrave specifically target obesity.
• Secondary Use: Capitalizing on appetite-suppressing side effects when taking naltrexone for other conditions.

Important Safety Considerations

Naltrexone should never be taken with opioids or opioid-containing medications, as this can cause serious withdrawal or overdose. Common side effects include:

• Nausea, constipation, or diarrhea
• Fatigue, headaches, or insomnia
• Anxiety or mood changes

Contrave adds bupropion's side effects, which may include dizziness, dry mouth, sleep disruptions, and increased risk of mood changes or suicidal thoughts.

Who Should Consider Naltrexone for Weight Loss?

Naltrexone should be a last resort for weight loss after traditional methods have failed, particularly when excess weight causes significant health concerns. Those prescribed naltrexone for other conditions should not prioritize weight loss but can benefit from implementing healthy habits alongside treatment.

Who Should Avoid Naltrexone?

Naltrexone is not suitable for:

• Anyone under 18 years old
• Individuals currently using opioids or experiencing opioid withdrawal
• Those with certain medical conditions without medical supervision

Building a Healthy Lifestyle

Regardless of medication use, these habits support overall well-being:

• Stay Active: Find enjoyable movement, whether walking, stretching, or structured exercise
• Eat Balanced Meals: Focus on whole foods with protein, carbohydrates, and healthy fats
• Connect Socially: Build relationships to support mental health
• Pursue Interests: Engage in activities that bring joy and fulfillment

Final Thoughts

Naltrexone offers multiple benefits but comes with significant considerations. While it can contribute to weight loss, it should only be used after exploring other options and under medical guidance. Remember that weight is just one aspect of health—focusing on overall well-being through sustainable habits leads to lasting health and happiness.