Mysimba for weight loss

What is Mysimba?

Mysimba is a medication used in the treatment of overweight and obesity. It contains two active substances, naltrexone and bupropion, which together act on the brain to reduce appetite and dampen food cravings. Mysimba is used as part of a broader treatment plan and must always be prescribed by a doctor. It is important to follow medical instructions carefully and to read the patient information leaflet before starting treatment.

Mysimba can be a valuable support for people who need help reducing their energy intake and changing their eating habits. Regular follow-up of weight and treatment by healthcare professionals is essential in order to assess health risks and treatment effectiveness.

How Mysimba works

Mysimba consists of the two substances bupropion and naltrexone. Together, they modulate neural systems that regulate appetite, cravings, and impulsive eating behaviour. In many individuals, the medication can lead to reduced hunger between meals, a lower tendency to experience sugar cravings, and an improved ability to regulate portion sizes and impulsive food choices. This, in turn, affects overall energy intake.

Eating regularly and making conscious food choices are important for achieving a calorie deficit and supporting sustainable weight loss. By dampening both the physiological and psychological drivers of overeating, the treatment can contribute to reduced energy intake when combined with lifestyle changes.

Recommended indications for use

Mysimba may be a relevant treatment option for patients with a BMI of 30 or higher. It may also be considered for individuals with a BMI of 27 or above if weight-related health conditions are present, such as hypertension, prediabetes, or type 2 diabetes.

The treatment may be particularly helpful for people who experience pronounced difficulties with hunger, cravings, emotional eating, or impulsive overeating. It should always be provided as part of a comprehensive treatment programme that includes dietary counselling, behavioural support, and continuous follow-up.

Please note that certain medical conditions or medications may affect whether Mysimba is suitable. If there is any uncertainty, a doctor should always be consulted for advice.

Treatment for weight loss

In many patients, Mysimba has been shown to reduce appetite and cravings, which can create better conditions for more regular and nutritious eating habits while maintaining a calorie deficit. Improved control over reward-driven eating behaviours may lead to more stable energy intake and a more consistent meal pattern.

Risks and side effects

As with other medical treatments, Mysimba may cause side effects. Common side effects include nausea, vomiting, headache, dry mouth, sleep disturbances, dizziness, and constipation. These usually occur at the beginning of treatment and tend to decrease as the body adapts. The risk of side effects varies between individuals.

Because the medication affects the central nervous system, patients should be attentive to changes in mood, anxiety, or low mood. New or worsening psychological symptoms should be reported to healthcare professionals.

Some medications may interact with Mysimba, particularly those that affect the nervous system or lower the seizure threshold. It is therefore important for the prescribing doctor to review current and previous medications before treatment is initiated.

In the case of severe or persistent side effects, the dose may need to be adjusted or the treatment reconsidered in consultation with healthcare professionals.

Contraindications

Mysimba should not be used by individuals with, among other conditions, epilepsy, uncontrolled hypertension, current or recent substance use disorders, bipolar disorder, current or previous eating disorders, pregnancy, tumours of the central nervous system, end-stage renal disease, or severe liver impairment. A thorough medical assessment is therefore required before starting treatment.

Recommended dose escalation for Mysimba

Treatment with Mysimba begins with one tablet (naltrexone 7.2 mg + bupropion 78 mg per tablet) each morning. The dose is gradually increased over four weeks to the recommended dose of two tablets twice daily, preferably taken with meals.

This dosing regimen is designed to minimise side effects and optimise tolerability.
The recommended maximum daily dose is four tablets, taken as two tablets twice daily.

Treatment with Mysimba should be discontinued after 16 weeks if the patient has not lost at least 5% of their initial body weight.

Suitability and alternatives

Mysimba may be an important treatment option for patients who struggle with pronounced hunger, cravings, or emotionally driven eating. Pharmacological treatment should be combined with lifestyle interventions such as improved meal routines, behavioural change support, increased physical activity, optimised sleep, or other medical treatments.

The choice of treatment strategy should be based on an overall medical assessment and the individual’s specific needs. There are also other medications available for the treatment of obesity that can support weight loss in different ways. The most appropriate medication(s) for each individual patient are determined on a case-by-case basis following medical evaluation.

Positive effects on obesity-related conditions such as type 2 diabetes and high blood pressure

Weight loss in general, regardless of method (lifestyle changes, medication, or surgery), has a well-documented positive effect on several obesity-related conditions, particularly type 2 diabetes and hypertension. Even relatively modest weight loss can improve insulin sensitivity, leading to lower blood glucose levels and reduced strain on the pancreas. In many individuals, this can slow the progression of prediabetes and reduce the risk of developing type 2 diabetes.

Weight loss also has a beneficial effect on blood pressure by reducing vascular strain, improving arterial elasticity, and lowering central blood pressure. Together, these effects reduce the risk of cardiovascular disease. Overall, even moderate weight loss often leads to significant improvements in both metabolic and cardiovascular health markers, thereby reducing the risk of future disease.

Lifestyle changes for weight loss

Lifestyle interventions are a central component in the management of overweight and obesity. By implementing lifestyle changes such as modifying dietary habits and increasing physical activity, individuals can establish new, healthier routines that support sustainable weight loss.

Lifestyle treatment may also include behavioural therapy, in which habits and thought patterns related to food and physical activity are addressed step by step. Patient motivation and engagement are crucial, as long-term results depend on active participation throughout the process. Combining medical treatment with lifestyle changes has been shown to produce better outcomes for weight loss and overall health than medical treatment alone.

Medical treatment in combination with physical activity

To achieve the best possible results in weight loss, it is important to combine medical treatment, such as Mysimba, with regular physical activity. Exercise helps maintain or increase muscle mass, improves metabolism, and strengthens both body and mind. In addition, physical activity can reduce the risk of cardiovascular disease and other health problems commonly associated with overweight and obesity.

Together with medication, an active lifestyle can make it easier to maintain a healthy weight in the long term and improve overall quality of life.

Summary

Mysimba is a medication that can support weight loss by reducing hunger, cravings, and impulsive eating. Its dual effect on appetite and reward systems may help create favourable conditions for establishing healthier eating habits. However, contraindications and potential side effects mean that medical assessment and follow-up are essential. When used in combination with structured lifestyle changes, the treatment can support clinically meaningful and long-term weight loss.

References

European Medicines Agency (EMA). EMA concludes review of weight-management medicine Mysimba. 2025.

Koskinas KC et al. Obesity and cardiovascular disease: an ESC clinical consensus statement. European Heart Journal. 2024;45(38):4063–4098.

Liu Y et al. The effects of bupropion alone and combined with naltrexone on weight loss: a systematic review and meta-regression analysis of randomised controlled trials. Diabetology & Metabolic Syndrome. 2024.

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