with seven products. Ephedra was removed from the US market in 2004 over concerns that it raises blood pressure and could lead to strokes and death. Medication Some patients find that diet and exercise is not a viable option; for these patients, anti-obesity medications can be a last resort. In the United States, semaglutide (Wegovy) is approved by the FDA for chronic weight management. Some other prescription weight loss medications are stimulants, which are recommended only for short-term use, and thus are of limited usefulness for patients who may need to reduce weight over months or years. GLP-1 analogs and agonists Glucagon-like peptide-1 (GLP-1) are peptide incretin hormones involved in blood sugar control. In 2021, one review concluded that "Currently, gut peptide analogues such as semaglutide [...] and [...] tirzepatide are the furthest advanced in clinical development". In 2022, a further review found that these two peptides are "the most promising candidates for the upcoming battle in the anti-obesity market". An article in The New York Times notes the high costs for semaglutide and potentially tirzepatide, suggesting that many people "who could most benefit from weight loss may be unable to afford such expensive drugs". Semaglutide Semaglutide (Ozempic) is a GLP-1 analogue, administered once weekly. It is more effective than exenatide. In June 2021, the US Food and Drug Administration (FDA) approved semaglutide injection sold under the brand name Wegovy for long-term weight management in adults. Wegovy was approved for medical use ("used together with diet and physical activity") in the European Union in January 2022. Tirzepatide A phase III clinical trial indicated that tirzepatide could be used for substantial weight loss. Specifically, phase-3 clinical trials found that after 71 weeks patients had lost 16% of their starting body weight on average. On 13 May 2022, it was approved under the name Mounjaro for type-2 diabetes (though not specifically for weight loss) . Exenatide Exenatide (Byetta) is a long-acting analogue of the hormone GLP-1, which the intestines secrete in response to the presence of food. Among other effects, GLP-1 delays stomach emptying and promotes a feeling of fullness after eating. Some people with obesity are deficient in GLP-1, and dieting reduces GLP-1 further. Byetta is currently available as a treatment for Diabetes mellitus type 2. Some, but not all, patients find that they lose substantial weight when taking Byetta. Drawbacks of Byetta include that it must be injected subcutaneously twice