Contrave Weight Loss: How It Works, Side Effects, and What to Expect
Jul, 19 2025
Sometimes, losing weight feels like climbing a Texas hill with both legs tied together. You hear about new diets, fads, and magical pills everywhere, but what's legit? Contrave seems to make a lot of noise—doctors prescribe it, people talk about it at gyms, and some celebrities whisper about using it. But cut through the hype: what is Contrave, how does it actually work, and should you care? Welcome to the deep dive, minus the sales pitch.
What is Contrave and How Does It Work?
Contrave is a weight loss medication approved by the FDA, and it isn’t just one drug—it's a combo of naltrexone and bupropion. Both of these sound like words from a chem class, but they're actually well-known in the world of medicine. Naltrexone is often used to help people stop drinking, while bupropion is an antidepressant that also helps folks stop smoking. Seems random, right? But together in Contrave, they target parts of your brain involved in hunger and cravings.
Picture your brain as a busy city. Hunger and pleasure signals zoom through like electric cars. Now, imagine naltrexone blocks off some shortcuts, while bupropion gives certain traffic cops a nudge so fewer cravings get through. That’s the concept. The combination reduces appetite and the desire to eat, especially snacking on high-calorie foods. Real science stands behind it: studies showed that people using Contrave lost about 5% or more of their starting weight over a year, compared to about 1% for those on a placebo.
It’s not for everybody. The FDA approved Contrave for adults with a BMI of 30 or more (technically obese) or 27+ if you have another weight-related problem like type 2 diabetes, high cholesterol, or high blood pressure. It’s not magic in a bottle. You’ll need to stick with diet changes and get moving. If you've tried building healthy habits but just can’t shake off the weight, some doctors think Contrave can push things along. As for how long it takes? Most folks notice appetite changes in a couple weeks, but it takes at least three months to really see the scale move.
Contrave is usually started low and then slowly increased to the normal dose (two pills in the morning and two at night). That's to help your body adjust and minimize side effects. The dosing plan is important. Jumping to the full dose too fast is a one-way ticket to feeling miserable—or upset stomach, at least. Take it exactly how your doctor suggests. Don’t crush, chew, or split the pills. Swallow them whole with a glass of water.
Contrave Side Effects: What You Might Notice
No medicine comes without some baggage. With Contrave, the most common side effects hit your gut: nausea, vomiting, constipation, or diarrhea. That’s especially true in the first few weeks, so eating smaller, simpler meals can help until your stomach gets used to it.
Some folks report headaches, trouble sleeping, feeling jittery, or a dry mouth. Sometimes, bupropion causes anxiety or raises heart rate and blood pressure, so doctors tend to keep an eye on that. Naltrexone, on the other hand, can cause dizziness or liver problems, but that’s rare at standard doses. You’ll probably have some blood tests before starting Contrave just to be sure your liver and kidneys are working fine.
One thing to know—Contrave isn’t for everyone. If you have a seizure disorder, uncontrolled high blood pressure, opioid dependence (including drugs like oxycodone or heroin), or are pregnant, you should steer clear. And if you’re taking other meds that interact with bupropion or naltrexone, make sure your doctor knows.
For a lot of people, side effects fade after a few weeks. But if you’re still feeling off or the side effects get serious—like chest pain, severe headaches, or mood changes—get help, fast. Some people using bupropion experience mood swings or suicidal thoughts, especially in the first months, so stay in touch with your doctor if you notice anything like that.
Here’s how the numbers break down from a big 56-week trial published in the journal Obesity:
| Side Effect | Contrave (%) | Placebo (%) |
|---|---|---|
| Nausea | 32 | 6 |
| Constipation | 19 | 7 |
| Headache | 17 | 10 |
| Dizziness | 10 | 5 |
| Dry mouth | 11 | 7 |
It’s not just about knowing the numbers though. If you try Contrave and a side effect hits you hard, you’re not alone, and you’re not stuck. There are tons of tips that help: drinking plenty of water, getting enough fiber for constipation, and taking meds with food (unless your doc says otherwise). Also, avoid high-fat meals when taking Contrave, since those can actually amp up the risk of seizures.
Don’t mix Contrave with alcohol or certain antidepressants. And always double-check with your doc or pharmacist if you want to add a new med, even something you buy over the counter. Watching the details keeps you safe.
Tips for Getting the Most Out of Contrave
Alright, so you want to try Contrave or maybe you’re already on it. How do you make it count? Like everything else, it works best as part of a bigger plan—think about it as one tool in a toolbox, not a standalone fix. You still need to think about what and how much you eat, and move your body as much as you reasonably can.
Start slow and steady. Contrave is usually eased in over four weeks so your body isn’t blindsided. Here’s how a typical starter schedule looks:
- Week 1: One pill in the morning
- Week 2: One in the morning, one at night
- Week 3: Two in the morning, one at night
- Week 4 and after: Two in the morning, two at night (the standard dose)
Stay honest with yourself. People who check in weekly with a doctor or coach tend to lose more weight and keep it off compared to folks going solo. Jot down what you eat and your activity level—even phone apps count. The point isn’t to shame yourself, but build self-awareness. It’s easy to forget what you ate when you’re rushing through another crazy Thursday.
Don’t expect to lose 20 pounds in a month. That’s not how Contrave—or any safe, meaningful weight loss—works. Most see 1 to 2 pounds lost per week, and that’s actually really solid progress. Doctors use a 5% rule: if you don’t lose at least 5% of your baseline weight by the fourth month (while using Contrave and improving your habits), it might be time to try something else.
If you hit a rough patch, talk to your doctor. Sometimes adjusting the dose, changing the timing, or adding support with therapy or a group can make a difference. Connecting with others who get what you’re doing helps—there’s nothing wrong with needing backup. There’s even new research suggesting people who use digital health programs or in-app guidance lose as much weight as those who go to clinics in person.
To set yourself up for success, here are a few no-nonsense pointers:
- Take Contrave with a light, low-fat meal or snack.
- Keep an honest food diary.
- Weigh yourself once a week, at the same time, wearing similar clothes.
- Don’t stop Contrave suddenly—work with your doctor if you want to quit.
- Let someone you trust know you’re starting the med—they might notice mood or energy changes before you do.
Contrave isn’t for vanity weight loss or a quick fix before a wedding. It’s about long-term health and breaking patterns that feel stuck. If endless hunger or cravings sabotage your efforts, talk to someone who understands the medicine, and get a second opinion if you’re curious but unsure. No one solution fits everyone, but having all the facts puts you ahead in the game.