Can a Dietitian Prescribe Weight Loss Medication?

Can Dietitians Prescribe Weight Loss Pills?

No, dietitians cannot prescribe medications, including diet pills and injections. However, working with a registered dietitian (RD), alongside taking weight loss medications, is generally recommended.

Per the American Nutrition of Dietetics (AND), nutrition care by a dietitian is a “vital part of the comprehensive obesity management,” whether weight loss medications are used or not.

Overview of Anti-Obesity Medications

Weight loss medications, officially known as anti-obesity medications (AOMs), require a prescription. As a whole, these medicines have been available for decades, but have become increasingly popular due to more effective medications coming out in recent history.

There are currently several AOMs available, including:

Zepbound (tirzepatide)
Wegovy (semaglutide)
Saxenda (liraglutide)
Adipex-P (phentermine)
Contrave (naltrexone-bupropion)
Qsymia (phentermine-topiramate)
Xenical (orlistat)

Who Can Prescribe AOMs?

While dietitians cannot prescribe these meds, there are other healthcare providers who can. In the United States, a variety of provider types can prescribe medications, which include:

Physicians (MDs and DOs)
Nurse practitioners
Physician assistants
Certified registered nurse anesthetists
Clinical nurse specialists
Certified nurse-midwives

Prescribing authority is governed by both federal and state law, so all provider types may not be able to independently prescribe in every state.

What to Do When Your Doctor Won’t Prescribe

Unfortunately, some people report that their primary care providers will not prescribe these medications, even when appropriate. This could be for a variety of reasons, including the doctor’s lack of familiarity with these drugs or their office struggling to successfully get them covered by insurance companies.

Generally speaking, AOMs are for people with a body mass index (BMI) of 30 or more or a BMI of 27 or greater with a comorbid condition such as high blood pressure, sleep apnea or heart disease. These medications are not for people that are pregnant or breastfeeding.

If you are struggling to get a prescription, even when you meet the criteria, not all hope is lost. You may be able to get a script without changing your primary care doctor. Think about your other specialists – many OBGYNs, endocrinologists and cardiologists are more than happy to write a script for these meds.

If you do not have anyone on your current healthcare team that is able to write a prescription, you can find a physician or other medical provider that specializes in these medications. Many bariatric offices that used to exclusively do weight loss surgery, have also expanded to be “medical weight loss programs.” Some OBGYN offices and other clinics are doing this as well.

You can also search for an obesity medicine providers near you: Obesity Medicine Association Database

If you are still having trouble finding a provider in your area, there are some telehealth services available. Some include:

Depending on what telehealth provider you choose, they may or may not take your insurance or FSA/HSA card for payment.

Beware of Compounded Weight Loss Medications

When searching for weight loss medication prescribers in your area, you may come across providers that are giving compounded versions of semaglutide and/or tirzepatide. Semaglutide is the generic name of Ozempic and Wegovy while tirzepatide is the generic name of Mounjaro and Zepbound.

When using these compounded medications, instead of picking up a medication pen at your pharmacy, you most likely will go into the office weekly to get an injection. You could also be sent a vial of medication to your home to be used with a syringe.

Unfortunately, there have been reports of adverse events after patients have been using these compounded medications. They are not regulated the same way and may not contain the same ingredient that the branded, FDA-approved medications have.

The FDA recommends only getting medicines from state-licensed pharmacies or facilities that are registered with the FDA. All of these will come in pen form, not vial and syringe.

Why You Should See a Dietitian While On Weight Loss Meds

Your Insurance Company May Require Proof of Weight Loss Attempts

If your insurance plan covers weight management medications, a prior authorization is normally required. This form will need to be filled out by the prescribing provider and includes information such as your height, weight, BMI, etc. to make sure you fit the criteria for the medication.

Prior authorizations for weight loss medications usually include a requirement that there have already been weight loss attempts. Nutrition counseling with a dietitian often meets this criteria.

Better Results

While both weight loss medications and lifestyle modifications can help with weight loss individually, doing them both together yields better results.

In a year-long randomized control trial, subjects that received both a weight loss medication and lifestyle modification counseling lost about twice as much weight compared the subjects that just did one or the other.

Management of Side Effects

Some of the weight loss medications can cause gastrointestinal side effects such as nausea, vomiting, diarrhea and constipation. A dietitian can help you manage these side effects by providing various strategies and nutrition therapies.

Prevention of Malnutrition and Nutrient Deficiencies

While these medications can lead to significant fat loss, they can also cause a decrease in lean body mass, which includes muscle and bone. Working with a professional can potentially help minimize this loss.

In addition, taking these medications can significantly decrease food intake, therefore also decreasing nutrients intake. A dietitian can assess overall intake and help you get what you need to prevent nutrition deficiencies.

Summary

Dietitians cannot prescribe weight loss medications. However, working with a dietitian while taking them can provide better outcomes.

There are many other healthcare providers that can write a script including primary care physicians, various specialists, obesity medicine providers and both local and virtual medical weight loss programs.

Ready to work with a registered dietitian? Ask your doctor who they recommend, visit your insurance company’s website, or go to eatright.org/find-a-nutrition-expert to find one. An online search for someone in your area works too!