Bupropion/Naltrexone Weight Loss Reviews: Does It Work?

What Is Bupropion/Naltrexone?

Bupropion/naltrexone, also known by its brand name Contrave®, is an FDA-approved prescription medication used for chronic weight management. It combines two drugs, bupropion (originally an antidepressant) and naltrexone (originally used to treat alcohol and opioid dependence), into a single tablet.

The FDA approved Contrave® in 2014, but with specific criteria. It was FDA-approved for adults with a BMI of 30 or higher, or 27 or higher with at least one weight-related health condition, such as high blood pressure, type 2 diabetes, or high cholesterol. 

It’s worth noting, however, that it’s not intended as a standalone option. Instead, it’s meant to be used alongside a reduced-calorie diet and regular physical activity. 

But does the bupropion/naltrexone combination actually work for weight loss? Or is it all just hype? 

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How Does Bupropion/Naltrexone Work for Weight Loss?

This combination doesn’t work by “speeding up” metabolism or blocking calorie or fat absorption. Instead, it influences the brain regions associated with appetite, cravings, and reward.

Bupropion for weight loss works by activating certain neurons in the brain’s appetite control center (the hypothalamus) that may help reduce hunger and may influence appetite-regulating pathways.

With naltrexone, weight loss may arise from its ability to block opioid receptors involved in the brain’s reward and feedback pathways. By inhibiting this feedback response, naltrexone is thought to help sustain bupropion’s appetite-regulating effects, which may support reductions in hunger and food cravings. 

But, again, each medication on its own is not approved for weight management. Contrave® is the only FDA-approved medication that combines these two ingredients, with eligibility based on specific criteria.

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Bupropion/Naltrexone Weight Loss Reviews: What Users Report

When considering a new health regimen, supplement, or medication, reviewing real-world user experiences can help you cut through the hype. So, what do people say about the bupropion/naltrexone combination?

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Positive Experiences

Users who respond well to bupropion/naltrexone describe a noticeable shift in how they think about food. Instead of just feeling less hungry, many say their cravings, especially for sugar and processed foods, dropped within the first few weeks.

Some reviewers report steady weight loss when taking the medication alongside dietary changes and exercise. Clinical data also demonstrate that some individuals lost more weight on this combination than with a placebo. 

At the same time, a recurring theme across many positive reviews is that the medication made it easier to maintain healthier habits. In other words, it’s not a magic pill, and it won’t do the work for you.

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Negative Experiences

In contrast, some individuals experience side effects. The most commonly reported issues include:

• Nausea
• Constipation
• Headache
• Vomiting and dizziness

Some users have even discontinued treatment due to these effects. 

Beyond physical side effects, some users report mood-related changes such as increased anxiety, irritability, vivid dreams, or disrupted sleep. These effects are documented in clinical and post-marketing data and also appear in user reviews. However, individual experiences may vary.

Additionally, suicidal thoughts and behaviors have been reported with bupropion-containing medications, and Contrave® actually carries a boxed warning for this risk. Thus, it’s very important to discuss mental health history with a licensed healthcare provider before starting treatment and to monitor for new or worsening mood changes throughout your treatment.

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Mixed Reviews

Between glowing reviews and poor ones, some users report mixed experiences. Some common factors across these reviews include:

• Lifestyle habits: Users who combine the medication with dietary changes, such as reducing processed foods, increasing protein intake, or staying physically active, consistently report better outcomes than those relying on the medication alone.
• Early side effects: Some users who push through the first two to four weeks of nausea or discomfort say symptoms ease over time. Those who stop early often never reach that turning point.
• Individual differences: Some people may experience a significant reduction in appetite and cravings from the start. However, other individuals may notice little difference. Unfortunately, there’s no reliable way to predict which camp you’ll fall into before trying it.
• Expectations: Users who treat the medication as a tool, not a quick fix, often report more positive experiences. Those hoping for fast, effortless weight loss are more likely to be disappointed.

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What Else You Should Know

Here are a few other factors you should be aware of before bringing up Contrave® with your doctor:

• Alcohol may feel different. Since naltrexone was originally designed to reduce the rewarding effects of alcohol, you may find that drinking doesn’t feel as good as it once did, or that side effects intensify while on this medication. This may be more relevant for regular drinkers.
• Drug interactions are possible. Bupropion/naltrexone can interact with certain antidepressants, blood pressure medications, and diabetes drugs. Always share your full medication list with your prescribing provider.
• It’s not for everyone. This medication isn’t recommended for pregnant women, individuals with uncontrolled high blood pressure, those with a history of seizures, or anyone currently using opioid medications.

At the end of the day, bupropion/naltrexone doesn’t replace behavioral changes. But it may make it easier to build healthier habits. If your underlying behaviors haven’t changed by the time you stop the medication, appetite and cravings can return. Many users who maintain their results long-term credit the habits they built while on the medication. This is why it’s often referred to as a tool and not a quick fix.

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Final Thoughts

Bupropion/naltrexone weight loss reviews suggest a mixed but informative picture. Some individuals may report meaningful benefits, but others may experience more limited results. Differences in outcomes often reflect factors such as expectations, adherence to lifestyle changes, and individual responses to the medication.

Approaching treatment with the understanding that the medication is intended to support—rather than replace—dietary and behavioral efforts may help set more realistic expectations. Overall, a licensed healthcare provider can help determine whether this option aligns with your health history and goals.