CONTRAVE 2022
WinterDryden
Posts: 9 Member
I will be starting Contrave soon and need advice and meal ideas from others who have experience with it. Also to connect with other ladies just starting Contrave.
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Replies
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What’s contrave?1
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Its a weight loss medication.
From Wiki:
Naltrexone/bupropion, sold under the brand name Contrave among others, is a fixed-dose combination medication for the management of chronic obesity in adults in combination with a reduced-calorie diet and increased physical activity.2 -
CONTRAVE is a mix of Wellbutrin (depression medicine) & Naltrexone (addiction medicine). Together is is marketed as a weight loss prescription.0
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It's a very serious drug combo with lots of possible side effects:
https://www.drugs.com/sfx/contrave-side-effects.html
https://www.consumerreports.org/drugs/is-contrave-worth-trying-to-lose-weight/1 -
You can call anything a weight reduction medication when it's in combination with a reduced calorie diet and exercise. Be interesting to see the actual effect from the medication in the absence of these interventions. Cheers
Edit: found the difference according to their "own data". A 14lb difference over 56 weeks compared to placebo but what was interesting was, after 36 weeks weight loss stopped with a slight weight gain to the end of the trial. To be fair that happened with the placebo group as well and I suspect adherence was the culprit as it is on most of these trials.
https://contravehcp.com/efficacy/cor-1-study/0 -
I’m on week 3. No weight loss so far. From everything I’ve read, it could take 5-6 weeks for weight loss to kick in. I’m going to stick with it and hope for the best.0
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Pretty sure you could just do the "reduced-calorie diet and increased physical activity" and save your money and avoid side effects.8
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Not only that, but medications only "help" while you are actually taking them. That is not to say they can't possibly be useful, but it is something to consider: does a person really want to take this for the rest of her/his life?Pretty sure you could just do the "reduced-calorie diet and increased physical activity" and save your money and avoid side effects.
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people on here are being quite negative. I took it for about 8 months and had good results. I stopped when the pandemic first started cause I got scared of getting covid combined with the idea of the side effects. It was effective though. I lost weight. I had headaches and dry mouth as the only side effects and those lessened over time. For food, honestly just eat what you like in moderation and drink lots of water.2
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I don’t think it’s negativity as much as it is “old timers” here who‘ve seen the various pills, injections, weight loss du jour programs and such come and go. I’ve only been here a bit over four years and I’ve seen several waves myself.
People get all excited, have success, go off them for whatever reason (financial, side effects, reached goal) and have a high percentage of coming back to jump the next wave, heavy as (often heavier than) when they started.
It’s not exciting, it’s not the Next Big Thing, it’s not overnight, or twenty pounds in a month (!!!) but I think that those of us who keep our heads low and do the boring “ reduced-calorie diet and increased physical activity"” method know we’re on to a good thing, and wish wholeheartedly to share it with others.
It’s not coming from a place of sabotage and rejection, it’s coming from a place of encouragement. Why rely on unnecessary, potentially harmful medications when there’s a better, healthier, “non invasive” way.
I’m always amazed at the people who will insist on a vitamin or a holistic solution for one thing but then jump the shark for something that’s 180 degrees in the other direction for “quick and easy” weight loss.
If you’re willing to wholly invest in changing your diet and increasing activity, good on you. But I’ve seen so many people here carry on, as is, without changing a single habit but relying on the magic pill or injection to transform them, and then be vastly disappointed because whatever weight loss method they’ve chose “doesn’t work”.
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Could it be that those two approaches are actually the same? Vitamins and "holistic" approaches are, I think, largely rituals that are hoped to offset unhelpful behaviours without actually changing those behaviours, simply by buying some unproven product. Medications are essentially the same: it is hoped that they will reduce appetite which will lead to less intake and hopefully to weight loss if the intake is low enough.springlering62 wrote: »I’m always amazed at the people who will insist on a vitamin or a holistic solution for one thing but then jump the shark for something that’s 180 degrees in the other direction for “quick and easy” weight loss.
Some medications work as intended, there is not much doubt about that. Unfortunately, the moment people go off them, their appetite comes back, and they gain weight again, which is the exact same thing we see with most diets. This is then often followed by the claim that "diets don't work" but not nearly as often by the claim that "medications don't work". Could it be that medications tend to be very expensive and that people are reluctant to admit they weren't such a great investment after all?
The same is true for bariatric surgery. The weight loss they enable is impressive, but a great number of patients gain the weight back, possibly/probably because they have never taken on board the schooling that accompanied the surgery.
Weight loss is a(n almost) disappointingly simple process, but it is not an easy one. We have to admit that. While we CAN lose weight and keep it off, the vast majority of people who lose weight put it back on. Research is lacking in this area, but it is not unreasonable to assume it is because people who lost their weight successfully simply return to their old ways afterwards and those are the ways that made them fat in the first place.
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BartBVanBockstaele wrote: »
Could it be that those two approaches are actually the same? Vitamins and "holistic" approaches are, I think, largely rituals that are hoped to offset unhelpful behaviours without actually changing those behaviours, simply by buying some unproven product. Medications are essentially the same: it is hoped that they will reduce appetite which will lead to less intake and hopefully to weight loss if the intake is low enough.springlering62 wrote: »I’m always amazed at the people who will insist on a vitamin or a holistic solution for one thing but then jump the shark for something that’s 180 degrees in the other direction for “quick and easy” weight loss.
[snip]
I think you'd have to qualify this a lot by which vitamin/medication/holistic approach you mean, as well as what "unproven" means. I suppose it's true you could argue I'm just being obstinate by taking iron and calcium supplements rather than only increasing my intake through diet, but I prefer to think of it as an insurance policy since I'm especially at risk for being deficient in them. A holistic approach that involves behavior changes might just include ones that genuinely promote health even if they're couched in the kinds of terms I'm usually tempted to roll my eyes at.
If you're talking about how we can never exactly know what's in that pill, I read a really interesting and alarming book about that (in 2019), about made-up study data, neglected safety procedures, lax manufacturing, purity standards, payoffs and crooked contracts, etc. This wasn't about snake oil products but the regular pharmaceutical industry. I'm not anti-medicine or anti-science but it was an eye opener about the all-too-human elements involved sometimes.
FWIW the most optimistic I can get about weight loss drugs is that they might actually help a person get started, analogous to nicotine patches or gum. I think if a person goes into it with that mindset, that it's to be used temporarily, while the person learns new healthy habits he or she intends to keep after quitting the drug and losing the weight, it *might* be worth it. But the bulk of the work isn't ever going to be done by the drug.4 -
That is not quite what I meant. No sane person would deny that the pharmaceutical industry never lies, misleads, fiddles with the numbers, is nonchalant... nor would any sane person deny that there is always the possibility that some "health product" manufacturer is honest and decent.penguinmama87 wrote: »I think you'd have to qualify this a lot by which vitamin/medication/holistic approach you mean, as well as what "unproven" means. I suppose it's true you could argue I'm just being obstinate by taking iron and calcium supplements rather than only increasing my intake through diet, but I prefer to think of it as an insurance policy since I'm especially at risk for being deficient in them. A holistic approach that involves behavior changes might just include ones that genuinely promote health even if they're couched in the kinds of terms I'm usually tempted to roll my eyes at.
However this comes on a sliding scale and the scale is unknown. So, instead of letting the perfect be the enemy of the good by rejecting any and all pharmaceuticals and similarly intended products, we look at the evidence and the evidence is that products that have FDA (or similar) authorisation are significantly more reliable (or less unreliable) than products that don't. Products intended as medication have certain standards they must meet. Sure, that system is far from perfect, but it is better (or less bad) than the standards set for supplements.
In order to avoid writing a book in a comment: modern medications have a higher probability of trustworthiness than supplements. As for books, I can also highly recommend "Bad Science" (on the alternological side of the spectrum) and "Bad Pharma" (on the pharmaceutical side of the spectrum) by Ben Goldacre.
I have nothing against those thoughts. Unfortunately, many people don't see it that way. Individuals like Dr. Oz and Alex Jones made fortunes peddling nonsense that doesn't work. Putting moral arguments aside, that does indicate that there are a lot of desperate people out there who are ready to be taken advantage of by people whose only consideration is the lining of their pockets. When he was confronted in the US senate, Dr. Oz admitted that he had no proof, but that he was giving people "hope". I'd argue that people don't need hope. They need help, and Dr. Oz was not giving it to them, on the contrary.FWIW the most optimistic I can get about weight loss drugs is that they might actually help a person get started, analogous to nicotine patches or gum. I think if a person goes into it with that mindset, that it's to be used temporarily, while the person learns new healthy habits he or she intends to keep after quitting the drug and losing the weight, it *might* be worth it. But the bulk of the work isn't ever going to be done by the drug.
I should add that there are legitimate reasons to take supplements. For example, I take D3 and I do it because I have a proven deficiency and it was prescribed to me. I also take a multivitamin because I am on a weight loss diet that is more extreme than usually recommended. Whether I need or not is not entirely clear. It is borderline. However, in a situation like that, a multivitamin is unlikely to do much harm, whereas a deficiency would definitely do harm, so it was a matter of chosing what was the least likely to do harm, but that remains subject to occasional review. Supplements of this nature should be treated like medications, not like candy, and this is -alas- how all too many people treat them.
In other words, it is not always possible to get everything we need from food alone. In my own case, I could do that, but the result would be immediate and significant weight gain, the exact opposite of what I need. As a consequence, the supplements I take, are simply the lesser of two evils.1 -
Thanks, Bart. My initial response was based on a reading of your post that seemed all-or-nothing, and I appreciate you fleshing that out with a little more nuance so I could understand you better.
I wouldn't call supplements "evil," but agree that in many cases they are an acceptable less-than-ideal. 1 -
@BartBVanBockstaele
Touché. I have done no research on the vitamin D supplement my doctor recommended I take (for that pre-osteoporosis thing whose name evades me), and researched only what layman-me could understand about the unusual version of sublingual B12 she prescribed (after I utterly failed at self injection).
In a way I could rank myself in my own category.
It just strikes me that going on injections or even WLS that seem trendy right now (and IMHO many doctors seems to be as swayed by trends- or perhaps pharmaceutical reps- as the rest of us), might be irresponsible or regretful down the road, if you’re not fully committed to every necessary part of the plan for both short term and long term loss.
Going off and on diabetes meds that you don’t even need for diabetes, that just seems to be playing with fire for vanity’s sake. Could it even potentially create
a diabetes issue where one never existed before?
I was prescribed arthritis meds in my 40’s. I was still obese for a decade or more afterwards, but that’s what prompted me to begin stretching half an hour every morning and ultimately take up yoga.
I didn’t want to be on strong medications for the next fifty years, endure long term effects, or, risk having them no longer be efficacious when I really needed them in a decade or two or three.
It just seemed to make more sense to take the issue in hand and see how long I could delay taking the meds.
With the weight loss added into the mix, what pain I have now is tolerable, and I can foresee a long period of the future where I can avoid medication.
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springlering62 wrote: »@BartBVanBockstaele
Touché. I have done no research on the vitamin D supplement my doctor recommended I take (for that pre-osteoporosis thing whose name evades me), and researched only what layman-me could understand about the unusual version of sublingual B12 she prescribed (after I utterly failed at self injection).
In a way I could rank myself in my own category.
It just strikes me that going on injections or even WLS that seem trendy right now (and IMHO many doctors seems to be as swayed by trends- or perhaps pharmaceutical reps- as the rest of us), might be irresponsible or regretful down the road, if you’re not fully committed to every necessary part of the plan for both short term and long term loss.
Going off and on diabetes meds that you don’t even need for diabetes, that just seems to be playing with fire for vanity’s sake. Could it even potentially create a diabetes issue where one never existed before?
I was prescribed arthritis meds in my 40’s. I was still obese for a decade or more afterwards, but that’s what prompted me to begin stretching half an hour every morning and ultimately take up yoga.
I didn’t want to be on strong medications for the next fifty years, endure long term effects, or, risk having them no longer be efficacious when I really needed them in a decade or two or three.
It just seemed to make more sense to take the issue in hand and see how long I could delay taking the meds.
With the weight loss added into the mix, what pain I have now is tolerable, and I can foresee a long period of the future where I can avoid medication.
Were you meaning to comment on weight loss drugs in general, like the injectable Semaglutide, which is a diabetes drug, or the drug in the OP, Contrave, which is not?0 -
@springlering62, I think you may be referrung to osteopenia?
Self-injection is not always particularly self-evident ^_^. Injected B12 is considered better than oral b12, but you should be fine, if that is what your doctor prescribed. Doctors *do* make mistakes. They are humans, not gods, but they are far, far more trustworthy than any random quack donning a lab coat to give herself/himself an air of "professionalism".
As for doctors eager to prescribe the WLS du jour, I am not so sure, but I could certainly understand that some do, even if I don't agree with it. The way doctors are treated these days is often worse than people would treat vermin. It is one of the reasons suicide rates are so much higher among doctors than among the general population. People need to learn that any and all medical interventions are not risk-free. They are considered safe as in "less risky than no treatment" but if they are not needed, the risk clearly outweighs the benefit, at least from a medical standpoint.
Many people yell and scream and threaten their doctor until he/she acquiesces and gives them what they want, and when things go the wrong way or even just the unexpected or undesired way, they are screaming bloody hell and malpractice. People need to learn that medical treatments are not grocery store products. As Dr. Pulaski said in Star Trek, the next generation [Loud as a whisper] "There is something else you must know. This is a one shot. If you decide to change your mind there's no going back. And there are risks. I can offer choices, not guarantees." I wish people would heed those warnings. There are reasons why they are asked to sign informed consent forms.
I am unaware of that particular consequence, but these products do come with potential dangers. Everyone has to make up their own mind, but my view is that if there is no medical reason for a treatment, I will not consider it. One such treatment would be, in my case, panniculus removal surgery.Going off and on diabetes meds that you don’t even need for diabetes, that just seems to be playing with fire for vanity’s sake. Could it even potentially create
a diabetes issue where one never existed before?
That is something you have to decide for yourself, after being informed as fully as you can. However, I would certainly have made the same decision. I can fully understand that people take medication to deal with an immediate situation, that is why medication exists after all, but they should use the time that gives them to do what is necessary (if at all possible, obviously) to improve their condition so they can possibly go off the medication.I was prescribed arthritis meds in my 40’s. I was still obese for a decade or more afterwards, but that’s what prompted me to begin stretching half an hour every morning and ultimately take up yoga.
I didn’t want to be on strong medications for the next fifty years, endure long term effects, or, risk having them no longer be efficacious when I really needed them in a decade or two or three.
It just seemed to make more sense to take the issue in hand and see how long I could delay taking the meds.
With the weight loss added into the mix, what pain I have now is tolerable, and I can foresee a long period of the future where I can avoid medication.1 -
I'm considering Contrave. I took bupropion 100 mg on and off for 20 years. Contrave contains 90 mg of bupropion, plus anti-addiction med naltrexone.
(When I was off bupropion it was in the spring/summer when I felt I didn't really need it.)
However, summer 2021, I did need it and it wasn't working, so since then we've been trying all the other antidepressants. The second to last one was Remeron, which worked fine for depression and anxiety and fabulous for insomnia. I'd been getting the best sleep in almost 20 years. And then I learned Remeron is also give to anorectics to increase their appetite, which explained the ravenous hunger I'd been feeling that persisted despite me throwing every tool in my box against it. >.< I'd associated the hunger with my surgery in November, as did my surgeon and my PCP. I'd been beating myself up about my post-surgery weight gain.
I asked my psychiatrist about an appetite suppressant, and since I'm with the VA she referred me to the MOVE program. In the VA healthcare system, only MOVE doctors prescribe weight loss meds. I've done TeleMOVE before and didn't expect to learn anything from the MOVE program, but thought the regular weigh ins would help provide accountability and the group support would be nice. At the beginning, the facilitator asked each of us why we were here and I, somewhat but not 100% flippantly responded, "I'm just here for the drugs." the man next to me, who has been through the program before but continues for the other two reasons I'm there, said to me, "They won't actually give you drugs."
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I took Contrave in the generic form (buproprion and naltrexon) for about 12 weeks and lost 12 lb without doing anything else. No diet or anything. I stopped loosing weight after 12 weeks but I was on the lowest dosage. I was supposed to titrate up but I was never able to because at the higher dose I couldn't sleep.0
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kshama2001 wrote: »I'm considering Contrave. I took bupropion 100 mg on and off for 20 years. Contrave contains 90 mg of bupropion, plus anti-addiction med naltrexone.
(When I was off bupropion it was in the spring/summer when I felt I didn't really need it.)
However, summer 2021, I did need it and it wasn't working, so since then we've been trying all the other antidepressants. The second to last one was Remeron, which worked fine for depression and anxiety and fabulous for insomnia. I'd been getting the best sleep in almost 20 years. And then I learned Remeron is also give to anorectics to increase their appetite, which explained the ravenous hunger I'd been feeling that persisted despite me throwing every tool in my box against it. >.< I'd associated the hunger with my surgery in November, as did my surgeon and my PCP. I'd been beating myself up about my post-surgery weight gain.
I asked my psychiatrist about an appetite suppressant, and since I'm with the VA she referred me to the MOVE program. In the VA healthcare system, only MOVE doctors prescribe weight loss meds. I've done TeleMOVE before and didn't expect to learn anything from the MOVE program, but thought the regular weigh ins would help provide accountability and the group support would be nice. At the beginning, the facilitator asked each of us why we were here and I, somewhat but not 100% flippantly responded, "I'm just here for the drugs." the man next to me, who has been through the program before but continues for the other two reasons I'm there, said to me, "They won't actually give you drugs."
7 months later, my Contrave is finally approved and in the mail
These days, either my sleep is *kitten* or I take something and sleep great but my appetite is increased, no matter how much protein and fruit and vegetables and fiber I eat or exercise calories I earn.
Like I said, I used to take bupropion 100 mg. One pill is bupropion 90 mg plus naltrexone, which I've never taken. The VA weight loss doctor said most of the side effects are associated with bupropion. Sounds like the doctor never/rarely prescribes it, as the vast majority of her weight loss patients have high blood pressure, for which this is contra-indicated. My BP tends to run low.
I spoke to the pharmacist today and learned that I will start with one pill and am supposed to work up to four pills/day. I don't see that happening. That's 360 mg of bupropion. I tend to be very sensitive to medication. My plan ATM is to work up to two pills per day.0 -
Well, I tried Contrave for two months but can't get past the GI side effects (constipation and pain both related to and unrelated to constipation.) That must be related to the naltrexone. I never had these side effects with just bupropion.
I've discontinued the Contrave, plus the other meds that are associated with increased appetite, and am back on bupropion, as I do like the effects of that.0
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