Contrave®: An Oral Weight Loss Option for Emotional Eating and Food Cravings

Updated June 2026

Many people think of weight loss medications as injections such as Wegovy® (semaglutide) or Zepbound® (tirzepatide). These medications can be very effective, but they are not the only prescription options for obesity treatment.

Contrave® (naltrexone/bupropion extended release) is an FDA-approved oral medication used for chronic weight management. It may be especially helpful for people whose weight problems are strongly connected to food cravings, emotional eating, stress eating, or reward-driven eating.

Why Do Food Cravings Happen?

Food cravings are not simply a lack of willpower. The brain areas involved in reward, pleasure, dopamine signaling, and addictive behaviors also play a role in eating.

Some patients experience strong urges to eat even when they are not physically hungry. Others may eat in response to stress, anxiety, boredom, sadness, or habit.

This type of eating pattern is sometimes called hedonic eating, meaning eating for pleasure, reward, or emotional comfort rather than true physical hunger.

What Is Contrave®?

Contrave® combines two medications into one extended-release tablet:

• Naltrexone — an opioid receptor antagonist that affects reward pathways in the brain.
• Bupropion — a norepinephrine-dopamine reuptake inhibitor that affects appetite and reward signaling.

Together, these medications affect brain pathways involved in appetite, cravings, reward, and food-related behavior.

Which Type of Obesity May Contrave® Help?

Obesity is not the same in every patient. Some people are hungry all the time. Some feel hungry soon after meals. Some have a slower metabolism. Others struggle most with emotional eating or food cravings.

Based on the article and expert commentary, Contrave® may be particularly useful for people with:

• Emotional eating
• Stress eating
• Strong food cravings
• Reward-driven eating
• Difficulty stopping once eating has started
• Frequent thoughts about food

This does not mean Contrave® is right for everyone. It means it may be a reasonable option to discuss when cravings and emotional eating are major drivers of weight gain.

How Much Weight Loss Can Occur?

In phase III clinical trials, patients who responded to Contrave® had an average body weight reduction of about 11.7% at 56 weeks.

Even a 5% to 10% weight loss can improve blood pressure, blood sugar, cholesterol, sleep apnea, joint pain, and overall health.

How Does Contrave® Compare With GLP-1 Medications?

GLP-1 medications such as Wegovy® (semaglutide) and Zepbound® (tirzepatide) generally produce greater average weight loss than older oral medications.

However, not every patient needs a GLP-1 medication, can tolerate one, or has insurance coverage for one. Contrave® may be a more affordable oral option for selected patients.

For people whose major issue is emotional eating or cravings, Contrave® may be especially worth considering.

Can Contrave® Be Combined With GLP-1 Medications?

In some obesity medicine practices, Contrave® may be combined with medications such as Wegovy® (semaglutide), Ozempic® (semaglutide), Zepbound® (tirzepatide), or Mounjaro® (tirzepatide).

This is considered off-label use and should only be done under medical supervision. Side effects such as nausea and constipation may overlap.

Common Side Effects

Common side effects of Contrave® may include:

• Nausea
• Constipation
• Headache
• Dizziness
• Dry mouth
• Insomnia

Some patients stop the medication because of side effects. The article noted that discontinuation can occur, often because of tolerability issues.

Bottom Line

Contrave® (naltrexone/bupropion extended release) is an oral anti-obesity medication that may be especially useful for patients with emotional eating, food cravings, and reward-driven eating patterns.

While newer injectable medications receive much of the attention, oral medications like Contrave® remain useful tools for selected patients. Obesity treatment works best when medication is combined with lifestyle changes, structured nutrition, physical activity, and long-term follow-up.

References

1. Lazarus E. Appropriate use of the fixed-dose, extended-release combination of naltrexone and bupropion as treatment for obesity in primary care. Obesity Pillars. 2025. DOI: 10.1016/j.obpill.2025.100170.
2. Contrave® (naltrexone/bupropion extended-release) Prescribing Information.
3. Obesity Medicine Association. Clinical resources on obesity treatment and anti-obesity pharmacotherapy.