Foods to Avoid On Contrave To Get the Best Results

What Is Contrave?

Contrave is a prescription anti-obesity medication, says endocrinologist Caroline M. Apovian, M.D. To qualify for a prescription, the National Institute of Health (NIH) guidelines say you need a BMI of over 30, or a BMI of at least 27 in addition to at least one weight-related condition, such as diabetes, sleep apnea, hypertension, reflux, or arthritis (1).

The brand name oral tablets consist of a combination of two drugs: bupropion (an antidepressant) and naltrexone (an anti-addiction drug). 

While bupropion hits neurons in the brain, causing you to feel full; the naltrexone blocks opioid feedback receptors, she explains. Research suggests naltrexone blunts the release of dopamine (2), which can help reduce cravings for unhealthy foods that give us a rush of the feel-good hormone.

“Some people lose a significant amount of weight on bupropion alone,” says physician Lydia C. Alexander, M.D. But when it’s combined with naltrexone, the weight loss effect is even more powerful, she explains. 

Think about it: One drug helps you feel satiated after eating reasonably sized portions of grub while the other helps silence those middle-of-the-night snack cravings. Since Contrave can help suppress appetite and thoughts about food when you’re not actually hungry, it’s particularly effective for those with addiction (food, smoking, and alcohol) or binge-eating habits, Alexander explains. 

Registered dietitian and psychologist Nina Crowley, Ph.D., R.D.N. concurs: “To me, Contrave is better suited to someone who has more of a complicated cognitive relationship with food, like food cravings.”

The average weight loss after 56 weeks (about 13 months) on Contrave is six to eight percent of total body weight—with some people in clinical trials dropping as much as 60-100 pounds, Apovian says (1). 

Another advantage of taking Contrave? It’s often less expensive than GLP-1 agonists, like Wegovy and Ozempic. Unfortunately, “most insurance companies don’t cover medication for obesity,” explains Apovian. Considering the average monthly cost of Contrave is $200 out of pocket, versus $1,300 or more for GLP-1 agonists, that can be a big part of your decision on which drug to take, Apovian adds. 

How to Start Taking Contrave

It’s important to ramp up slowly, beginning with one tablet in the morning for the first week, says Apovian. By the fourth week, you reach the maintenance dose: two in the morning and two at night. Then, you stay on this regimen for life in order to maintain the weight loss. 

“For the first month, about 50 percent of patients will have some side effects, like nausea or headache,” she warns. But, she adds that for most people, those symptoms will subside after the first few weeks.

Foods to Avoid on Contrave

 Nausea is the most common side effect of the drug, Alexander says. That’s why it’s key to steer clear of meals that could further upset your already queasy tum. This may include overly acidic, extremely spicy, and high-fat foods, she notes. 

“If you’re having a big fatty steak with something fried, it will take a long time for your body to process, which can make you nauseous,” Alexander explains. 

Plus, taking Contrave with—or soon after eating—fatty foods like greasy bacon, full-fat cheddar, and buttery pastries can increase your body’s absorption of the medication (1). This abrupt exposure to bupropion and naltrexone could put you at risk for side effects like seizures, according to the drug’s manufacturer (3). Even foods high in healthy monounsaturated fats, like avocados and nuts, can increase the risk of side effects (4).

Consider waiting a few hours after taking your morning dose of Contrave before grabbing that cheesy breakfast sandwich or XL chocolate chip muffin. Otherwise, feel free to take your medication with your meal.