Weight Loss That Works on Cravings, Not Just Appetite

Contrave is an FDA-approved prescription weight loss medication that combines two drugs in a single pill: naltrexone and bupropion. You may recognize bupropion as an antidepressant (sold as Wellbutrin), and naltrexone from its use in addiction medicine. Together, they work on the parts of the brain that drive cravings, compulsive eating, and the reward cycle around food.

It is not a GLP-1. It does not slow digestion or suppress appetite the way Ozempic or Wegovy do. Contrave works through a different pathway entirely, which is exactly why it may be the right fit for some patients and not others.

1. 1

   Before you come

   Bupropion activates pathways that reduce appetite and increase energy expenditure. Naltrexone blocks the reward signals that reinforce overeating. Together, they interrupt the cycle where eating feels like relief, comfort, or compulsion rather than hunger.

2. 2

   The visit

   For patients who describe eating in response to stress, boredom, or emotions rather than physical hunger, this mechanism matters. It is not that willpower was missing. The brain's reward wiring was working against the effort. Contrave addresses that directly.

3. 3

   Follow-up and adjusting as you go

   Contrave is typically titrated over four weeks, so your first few follow-up visits are about making sure the dose is working for you and that you're tolerating it well. If cravings are easing and side effects are manageable, we stay the course. If something feels off, we talk about it and adjust. You'll always be seeing Dr. Gougian, not a rotating face.

Contrave may be a good fit if you prefer a pill over an injection, if GLP-1 medications like Ozempic, Wegovy, Mounjaro, or Zepbound are not covered by your insurance or are not the right match for you, or if emotional and reward-driven eating is a significant part of your pattern.

It is also worth considering if you have tried phentermine or Qsymia and want a different approach, or if you are curious about how your mental health history might intersect with weight. Dr. Gougian's family medicine background includes mental health, and she is well-positioned to look at the full picture before recommending any medication.

No one here will ask you to prove you are sick enough or heavy enough. The conversation starts with where you are and what you have already tried.

Our office is at 6300 Baltimore Ave, University Park, MD 20782, on Route 1 between Hyattsville and College Park, a short drive from Washington, DC and close to Metro’s Green Line.