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Contrave is a prescription [[weight loss]] medication that has been approved by the [[Food and Drug Administration|FDA]] for use in treating [[obesity]] and overweight. The [[Centers for Disease Control and Prevention]] (CDC) reports that over 69% of adults in the United States are overweight, including obesity.

==Body Mass Index (BMI)==
[[Body Mass Index]] (BMI) is a measure of body fat based on an individual's weight and height, and is used to define the categories of obesity and overweight. According to the CDC, more than one-third of adults in the United States are obese (defined as a BMI of 30 or over), and another third are in the overweight category. The following are the statistics on obesity and overweight among different age groups in the United States:
* Adults age 20 years and over who are obese: 35.1% (2011-2012)
* Adults age 20 years and over who are overweight, including obesity: 69.0% (2011-2012)
* Adolescents age 12-19 years who are obese: 18.4% (2009-2010)
* Children age 6-11 years who are obese: 18.0% (2009-2010)
* Children age 2-5 years who are obese: 12.1% (2009-2010)
==Composition==
Contrave is a combination of two FDA-approved drugs, [[naltrexone]] and [[bupropion]], in an extended-release formulation. Naltrexone is typically used to treat alcohol and opioid dependence, while bupropion is used to treat depression and seasonal affective disorder and as an aid to smoking cessation. The combination of these two drugs has now been approved for weight loss.

==Indications==
Contrave is approved for use in adults with a [[body mass index]] (BMI) of 30 or greater (obesity) or adults with a BMI of 27 or greater (overweight) who have at least one weight-related comorbidity such as high blood pressure (hypertension), type 2 diabetes, sleep apnea, metabolic syndrome, or high cholesterol (dyslipidemia).

==Mechanism of Action==
The exact mechanism by which Contrave promotes weight loss is not yet fully understood. However, it is believed to work by regulating the levels of certain neurotransmitters in the brain that control hunger and cravings. By reducing hunger and cravings, Contrave makes it easier for people to stick to a reduced-calorie diet and regular physical activity, which are essential components of any weight loss program.

==Clinical Trials==
The effectiveness of Contrave has been evaluated in multiple [[Clinical trial|clinical trials]] involving over 4,500 obese and overweight patients. In these trials, patients received lifestyle modification, consisting of a reduced-calorie diet and regular physical activity, in addition to the medication.

The results of one clinical trial showed that patients had an average weight loss of 4.1% over treatment with placebo at one year. In this trial, 42% of patients treated with Contrave lost at least 5% of their body weight, compared to 17% of patients treated with placebo. Another clinical trial involving patients with type 2 diabetes showed that patients had an average weight loss of 2% over treatment with placebo at one year. In this trial, 36% of patients treated with Contrave lost at least 5% of their body weight, compared to 18% of patients treated with placebo.

==Maintenance Dose and Monitoring==
Patients using Contrave at the maintenance dose should be evaluated after 12 weeks to determine if the treatment is working. If a patient has not lost at least 5% of their baseline body weight, Contrave should be discontinued, as it is unlikely that the patient will achieve and sustain clinically meaningful weight loss with continued treatment.
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