How many pounds can you lose on Contrave?

October 7, 2025 •

4 min read

Clinical trials show that, when combined with diet and exercise, patients taking Contrave typically lose between 5% and 10% of their initial body weight over a period of 56 weeks. This means the number of pounds can vary significantly depending on your starting weight and how your body responds to the medication.

Quick Summary

Clinical trial data indicates that patients using Contrave alongside lifestyle changes lose an average of 5% to 10% of their initial body weight. The actual number of pounds varies greatly by individual, with some losing more and others experiencing less significant results. Factors like diet, exercise, genetics, and consistency all play a role in the outcome. Comparison with other weight-loss medications reveals a more moderate effect, though still clinically significant. Patients who do not lose at least 5% of their body weight by week 12 at the full dose may be advised to discontinue treatment.

Key Points

Average Weight Loss: In clinical trials, patients taking Contrave lost an average of 5% to 10% of their initial body weight over 56 weeks when combined with diet and exercise.
Individual Variability: The number of pounds lost can vary significantly, with some individuals experiencing more pronounced results and others seeing less progress.
Lifestyle Changes are Crucial: Contrave is most effective when used alongside a reduced-calorie diet, consistent exercise, and improved sleep habits.
12-Week Assessment: If a patient does not achieve at least 5% weight loss after 12 weeks on the full dose, it's often recommended to stop the medication, as it may not be the right treatment.
Mechanism of Action: The medication combines naltrexone and bupropion, which work together to reduce appetite and manage cravings by affecting the brain's reward centers.
Common Side Effects: Common side effects include nausea, headache, constipation, and insomnia, which often decrease over the first few weeks of treatment.

Understanding Average Weight Loss on Contrave

Contrave, a combination of naltrexone and bupropion, is an FDA-approved medication for chronic weight management in adults. It is not a magic pill, and its effectiveness is directly tied to its use alongside a reduced-calorie diet and increased physical activity. The amount of weight loss experienced varies significantly from person to person.

Clinical Trial Data on Pounds Lost

To understand the potential weight loss, it's best to look at the results of large-scale clinical trials. The Contrave Obesity Research (COR) trials provide specific percentages and data points based on 56-week studies:

COR-I: Participants on Contrave lost an average of 5.4% of their starting body weight, or about 12 lbs, compared to 1.3% (3 lbs) for the placebo group.
COR-II: This study involved more intensive behavioral modification. Participants lost an average of 8.1% of their starting body weight, or 18 lbs, versus 4.9% (11 lbs) for the placebo group.
COR-BMOD: This trial involved intensive behavioral modification sessions. An impressive 80% of participants taking Contrave lost at least 5% of their body weight, compared to 60% of the placebo group, among those who completed the study.
Overall Average: Across multiple studies, the average weight loss for patients taking Contrave ranged from approximately 5% to 10% of their initial body weight over a year.

For an individual, this means if you start at 200 pounds, a 5% to 10% weight loss would be 10 to 20 pounds. However, these are averages, and some individuals may experience more significant weight loss while others may lose less.

Factors Influencing Your Results

Many elements can affect the amount of weight you lose on Contrave. The medication works by targeting appetite and cravings, but it is not a standalone solution. Your adherence to lifestyle changes is crucial for maximizing its effects.

Lifestyle Adherence

Diet: Contrave works best when combined with a nutritionally balanced, reduced-calorie diet. Continuing to eat high-calorie, processed foods can counteract the medication's appetite-suppressing effects.
Exercise: Regular physical activity, including both aerobic exercise and strength training, is vital for boosting metabolism and burning calories. Without a consistent exercise routine, weight loss may stall.
Consistency with Medication: Taking Contrave consistently as prescribed is essential. Missing doses can disrupt the balance of the medication in your system and reduce its effectiveness.
Sleep Hygiene: Poor sleep habits can disrupt metabolic functions and weight loss progress. Getting adequate, consistent sleep is an important part of the overall treatment plan.

Individual Biological Differences

Metabolism and Genetics: Each person's body responds differently to medication based on their unique metabolism, genetics, and hormonal balance.
Underlying Health Conditions: Conditions like hypothyroidism, diabetes, and polycystic ovary syndrome (PCOS) can affect weight loss and may influence how well Contrave works for an individual.
Emotional Eating: For some, emotional eating and stress-induced bingeing can override Contrave's effects, especially if not addressed through additional therapy or support.

Common Contrave Side Effects

When starting Contrave, a gradual dose increase is used to help the body adjust and minimize potential side effects. The most common side effects are often mild and may subside over time.

Nausea: This is one of the most frequently reported side effects, especially during the initial dosing phase.
Headache: Mild headaches are common but can often be managed with over-the-counter pain relievers.
Constipation: Increasing fiber intake and staying hydrated can help manage this side effect.
Vomiting and Dizziness: These can occur, especially in the early stages of treatment.
Insomnia: Due to the bupropion component, trouble sleeping can occur, particularly if taken too late in the day.
Dry Mouth: Staying hydrated is the best way to address dry mouth.

Contrave vs. Other Weight-Loss Medications

For those considering pharmacological options for weight loss, it's helpful to compare Contrave's performance with other available treatments. Newer drugs, like GLP-1 agonists, often yield more significant average weight loss but also differ in administration and cost.


Feature	Contrave (naltrexone-bupropion)	Wegovy (semaglutide)	Qsymia (phentermine-topiramate)
Average Weight Loss	5-10% of body weight over 56 weeks	Up to 15% of body weight over 68 weeks	7-11% of body weight, depending on dose
Mechanism	Targets appetite and reward centers in the brain	Mimics GLP-1 hormone to control appetite and blood sugar	Stimulates central nervous system (phentermine); increases feelings of fullness (topiramate)
Administration	Oral tablet, taken daily	Weekly subcutaneous injection	Oral capsule, taken daily
Cost	Generally lower than GLP-1 agonists; may be covered by insurance	Often higher; insurance coverage varies	Cost varies; potentially lower than Contrave or GLP-1s
Key Risks	Seizures, increased blood pressure/heart rate, liver problems	Nausea, vomiting, diarrhea; potential for more serious side effects	Heart rate increase, potential cardiac risks, birth defects if taken during pregnancy

The 12-Week Assessment

An important milestone in Contrave treatment is the 12-week assessment. According to the FDA and clinical trial protocols, if a patient has not lost at least 5% of their initial body weight after 12 weeks on the maximum dosage, the medication should be discontinued. This is because it indicates the medication is unlikely to be effective for that individual, and a different treatment approach may be necessary.

Conclusion

For those wondering how many pounds can you lose on Contrave?, the answer is that it varies, but clinical data suggests a range of 5% to 10% of starting body weight over approximately one year, assuming consistent adherence to a healthy lifestyle. While the weight loss may be more modest compared to newer injectable medications, Contrave can be a clinically meaningful tool for many, especially when combined with diet, exercise, and behavioral modifications. It is crucial to set realistic expectations and understand that individual responses differ. Close monitoring with a healthcare provider is essential to ensure the medication is both effective and safe for your specific health profile, with a clear checkpoint at 12 weeks to assess progress.

To learn more about the research behind Contrave's efficacy, you can explore detailed clinical trial data, such as this study on naltrexone-bupropion.

Frequently Asked Questions

While some people may notice initial changes in appetite and cravings within the first few weeks, it can take up to 12 weeks to determine if Contrave is truly working for you. The most significant weight changes are typically seen over several months.

If you have not lost at least 5% of your initial body weight after 12 weeks on the maximum dosage, your doctor may recommend stopping Contrave, as it is unlikely to be effective for you in the long term.

Yes, clinical trials have shown that patients taking Contrave with diet and exercise lost 2 to 4 times more weight than those who only made lifestyle changes. It is meant to be a tool to augment, not replace, these efforts.

The most common side effects include nausea, headache, constipation, dizziness, dry mouth, and insomnia. These are often most prominent during the initial dose-titration period and may improve over time.

It is generally advised to avoid or limit alcohol consumption while taking Contrave. The bupropion component can increase the risk of seizures and may also cause changes in mood or behavior, especially with excessive alcohol use.

Contrave works on the brain's reward system. The combination of naltrexone and bupropion helps to reduce food cravings and control appetite, making it easier to stick to a reduced-calorie diet.

Contrave generally results in more modest weight loss (5-10%) compared to newer injectable GLP-1 agonists like Wegovy (average 15%). However, Contrave is an oral medication and may have a lower cost, making it an attractive option for some.