What Is It Like to Take Contrave for Weight Loss?
Key takeaways:
Contrave is a weight-loss medication that’s been approved for a decade.
It can help people curb cravings and lose weight.
Contrave should be paired with a reduced-calorie diet and increased physical activity.
Much of the recent buzz around weight-loss medications has been focused on GLP-1 and GIP agonists like Wegovy (semaglutide) and Zepbound (tirzepatide). But other options exist.
In 2014, the FDA approved the weight-loss medication Contrave (naltrexone / bupropion), which is designed to help people control cravings and, as a result, lose weight. Some insurance companies require people to try this medication, as part of step therapy, before they’ll cover a GLP-1 agonist.
Contrave is intended to be taken with a reduced-calorie diet and increased physical activity. Side effects include nausea, constipation, headaches, dizziness, insomnia, and dry mouth.
Below, three people describe what it feels like to take Contrave to lose weight.
Overcoming emotional eating
Janet Allen started taking Contrave in November 2020. She had tried all sorts of over-the-counter weight-loss remedies, but none improved her relationship with food.
“I was always a binge eater,” says Janet, who is 60 and lives in Washington, D.C. “In my teens and 20s into my 30s, I kept it in check by being incredibly strict with myself. And then, life happened.”
In her 40s, Janet had a challenging career in sales that required frequent travel, and she was also raising a family. All of that stress snowballed: “I became last on my list,” she recalls.
Save over 40% on Qsymia with GoodRx
Discover the once daily Qsymia for weight management. Qsymia is for adults and children 12-17 in combination with a healthy diet and regular exercise.
By the time Janet reached her 50s, she was nearing 300 lbs. Her quality of life had plummeted and she felt hopeless.
“Nothing I could try seemed to stick with me,” she says. “It felt insurmountable. How was I going to lose that amount of weight? It was just so, so sad.”
When the pandemic began, Janet started walking more and tried using a Peloton bike, but neither helped her lose weight. During her annual physical, she discussed her weight with her nurse practitioner. Whereas doctors had previously made her feel embarrassed or ashamed about her weight, this woman spent time trying to figure out why Janet was eating so much. Then, she suggested Janet try Contrave to curb her food cravings.
Within weeks of starting the medication, Janet began to feel full after eating meals. That was “never a sensation I felt before,” she says. “That was revolutionary.”
She started to think of food as fuel and focused on adopting a balanced diet with lots of protein.
For breakfast, for example, she might have protein pancakes, egg whites, and a banana. Later in the morning, she’ll have an apple or orange for a snack. At lunch, she’ll prepare egg salad with cottage cheese on a piece of toast. And later, she’ll have a light dinner, such as a piece of fish with fresh vegetables. She and her husband have always enjoyed having a treat at night, so they have mini ice-cream cones.
Janet takes Contrave twice a day and hasn’t experienced any side effects. Within the first 9 months, she lost 90 lbs, and she’s since dropped another 30 lbs. She no longer has sleep apnea or knee pain. And she can now run 3 miles, while, in the past, she could barely walk around the block without gasping for breath.
“I still pinch myself,” she says.
People remark about how different she looks, Janet adds, but she’s proudest of the internal changes. She’s no longer a reactionary, emotional eater.
“With Contrave, there’s almost a minute where I’m, like, ‘What can I do instead of reaching for that bag of chips?’” she says. “It was transformative because I got to heal on the inside as well as on the outside.”
Janet and her husband are easing into retirement, which she used to dread. She knows her husband enjoys being active, and she thought she wouldn’t be able to keep up with him.
“That’s totally changed,” she says. “I’m just so excited about my future.”
Reclaiming a full life with her kids
Tori Sosa knew the right things to eat. She had trouble with how much she was consuming.
Ever go to a restaurant and be served a bowl of pasta so big you thought you couldn’t possibly eat it all? “I could, 100%,” says Tori, a 31-year-old stay-at-home mom who lives in Texas. “I could eat the bread at the table, the salad, the pasta, the dessert, and be like, ‘Great meal.’”
Tori had dieted on and off since sixth grade. She tried fad diets and prepared meal plans, read books about weight loss, and signed up for weight-loss challenges. Yet she’d still end up having big meals — often of fried chicken, mashed potatoes, and gravy — and would snack all day.
Shortly after having her first child in 2019, she talked to her doctor about her struggles with overeating. She recalls telling him, “I can’t stop myself sometimes. I want this stuff, and I just go for it.’” He suggested she try Contrave to curb her cravings.
The first week she took Contrave, Tori felt a little nauseous while her body adjusted to the medication, but it quickly abated. Within 6 weeks, she started losing weight. After a year, she had dropped 100 lbs.
Tori says Contrave works for her because it tells her brain she’s not actually hungry and doesn’t need to be eating all day.
“It makes me feel full quicker,” she says. “I started eating probably half the amount of food I was eating before. And it cut back my cravings an outstanding amount.”
Pre-Contrave, Tori couldn’t walk by a platter of cookies without thinking, “I need that,” she says. But after taking the medication, she suddenly had no problem resisting.
Now, Tori craves vegetables and other healthy food options. For breakfast, she has a small bowl of cereal with oat milk. Lunch might be a turkey wrap with tons of veggies. And for dinner, she usually has grilled chicken or fish.
Tori says the best part of losing weight is that she can now live a full life with her kids, who are 12 weeks and 5 years old.
“There's usually something that you couldn't do while you were overweight, and then it changes into something you can do,” she says. “One of those things for me was that I could not ride a roller coaster with my son. I couldn’t fit and the bar couldn’t close.”
Now, Tori can have fun with her son at amusement parks, in the little toy car he drives around the yard, and even on the trampoline, since she no longer exceeds the weight limit.
Free from constant thoughts about food
About a year and a half ago, Katie Kabala started hearing about Ozempic (semaglutide) and asked her doctor if it might be a good fit for her. He recommended gastric bypass surgery instead.
“I was super offended by that, because I didn’t see myself as that overweight,” says Katie, who’s 40 and works in community development for the local government in Hilton Head, South Carolina. Her doctor then recommended an alternative: Contrave.
“I went home and did some research on how to make sure it works for me, because I was adamant that I was not going to have gastric bypass,” Katie says of Contrave. “One of the big things I found is that it only really works if you put in the work.”
Looking back on that initial doctor’s appointment, Katie realizes she was technically morbidly obese. She weighed 215 lbs at the time, and she’s now lost more than 90 lbs. Though she felt a little dizziness when she started taking Contrave, it’s otherwise been smooth sailing.
“It was almost immediately that I felt the changes in my brain chemistry,” she says. “I used to wake up in the morning and my first thought was food: What was I going to eat that day for breakfast, lunch, and dinner? It was constantly in the back of my mind.”
Just two days into Contrave, Katie realized she was forgetting to eat, which had never before happened to her before.
“It feels so free now,” she says. “I feel like I’m so much happier, just because I don’t have the stress of food anymore.”
Katie aims to eat about 1,200 calories a day, and she goes to Orangetheory Fitness four times a week. She doesn’t allow herself any cheat days.
“I feel like this medicine made it OK for me to do that,” she says. “It never felt like I was denying myself anything.”
Katie eats three meals a day, including soup for lunch, which is always under 300 calories per serving. Some of her favorites include white chicken chili, roasted cauliflower soup, and white cheddar soup.
“I’m never starving,” she says. “Prior to this, whenever I tried to lower my calories, it never worked because it felt like I was hungry all the time. But now, I’m wondering if I was hungry or if I was just obsessing about the thought of the food.”
Overall, Katie says, she’s grateful that Contrave unlocked the ability for her to make an array of healthy changes.
“People are always like, ‘It’s so easy to lose weight,’” she says. “It’s really not. And I feel like this leveled the playing field and allowed me to do that.”
What does the pharmacist say?
Stacia Woodcock, PharmD
Pharmacy Editor
Contrave (bupropion / naltrexone) is an effective oral weight-loss medication. It’s approved for adults with a body mass index (BMI) of 30 or higher and those with a BMI of 27 along with a weight-related medical condition.
Contrave helps reduce cravings to curb your appetite, so it’s especially helpful for emotional eating. But it works best if you also exercise regularly and choose healthy, low-calorie foods.
You’ll start with just 1 tablet of Contrave per day, and then work your way up to the target dosage of 2 tablets twice a day over the next 3 weeks. This helps your body adjust to the medication. Don’t increase your dosage faster than recommended, as this can raise the risk of side effects.
Common Contrave side effects include nausea, constipation, and headaches. You may also feel dizzy and have trouble sleeping. In many cases, Contrave side effects go away over time. Taking Contrave with food can help lessen nausea, but you should avoid high-fat meals. Fatty foods can increase how much Contrave you absorb and raise your risk of serious side effects, such as seizures.
Contrave contains an antidepressant, so be sure to let your prescriber know if you’re taking any other mental health medications before starting treatment. You should also avoid alcohol while taking Contrave as it can raise your risk of seizures, as well as interfere with your weight-loss goals.
In some cases, Contrave can raise blood pressure levels. So it may not be the best choice for those with a history of heart problems. Your prescriber can help ensure Contrave is a safe option for you based on your medical history.
Why trust our experts?
Was this page helpful?
Related Articles
Browse medications
View AllResearch prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.