foods to avoid on contrave

Foods to Avoid on Contrave to Get the Best Results

Double-bacon burgers and beer might be in your rearview mirror.

30-Second Takeaway

  • Contrave is a prescription weight loss drug designed to help those who have a BMI of over 30 or a BMI of 27 and one weight-related health condition, such as diabetes.
  • Experts suggest making lifestyle changes, primarily tweaks to your diet, can not only help you optimize your results, but also help avoid certain side effects.
  • Enjoying high-fat foods and alcohol in moderation and prioritizing lean protein sources will help you achieve your goals on Contrave.

If you’re taking Contrave, or considering going on the prescription weight loss drug, you may be wondering if you’ll need to make some serious changes to your diet. More specifically, are there any foods to avoid on Contrave to get the results you want? 

To boost the effectiveness of the medication, you will want to consider revamping your breakfast, lunch, and dinner. Or, if you generally eat healthy, maybe portion control is the issue at play. Ahead, two doctors and one registered dietitian explain how the drug works and why what you eat while on it matters for hitting your health goals.

Learn everything from what foods to avoid on Contrave (for the most part, anyways) to whether or not you need to scale back on your boozy nights out.

About the Experts: 

Nina Crowley, Ph.D., R.D.N., L.D. is a registered dietitian and health psychologist. The Professional Affiliations and Education Manager at SECA Precision for Health, she’s also a member of The Obesity Society.

Caroline M. Apovian, M.D. is a physician who specializes in endocrinology, diabetes, and Hypertension. Co-Director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital, she’s also a professor of medicine at Harvard Medical School. Formerly, Apovian served as president of the Obesity Society.

Lydia C. Alexander, M.D. is a physician with certifications from the American Board of Obesity Medicine and the American College of Lifestyle Medicine. She is also the chief medical officer of Enara, which is building a network of clinics offering insurance-covered obesity care.

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. 

Healthy Weight Loss

What Foods Should You Eat on Contrave?

In general, if you want to lose weight, you need a diet high in protein, fruits and vegetables, and healthy grains,” says Apovian. The Mediterranean diet is a great place to start, which emphasizes lean protein sources such as chicken and tofu.

“With any weight loss, it’s important to make sure the loss is coming more from fat than muscle,” stresses Alexander. “So, protein intake is important.” 

Aim for 1.5 grams of protein for every kilogram of body weight daily, recommends Apovian.

Along with protein, foods that are chewable (as opposed to liquid) and high in fiber will help you stay fuller longer, points out Crowley. This is because solid foods with rich sources of protein take a longer time to move through your gastrointestinal tract than protein-rich liquids do. 

For instance, whey protein is considered fast-acting because it only takes about 2 hours to fully digest one 20-gram serving (5). A slow-acting protein like an egg omelet that consists of the same amount of protein would take 7 hours to completely digest (5). Enjoying a chicken breast, for example, will likely satiate you more than a serving of yogurt, Crowley explains.

And because fiber isn’t digested by your body, it slows down the digestion process in your stomach, which enables you to feel fuller for longer (6). That’s why a bowl of oatmeal often feels more filling than a slice of fiberless white bread with jam, Crowley notes. 

Finally, remember to drink plenty of water throughout the day, Alexander says. Constipation is one of the most common side effects of Contrave, she notes (3).

Can You Drink Alcohol While Taking Contrave? 

Guzzling alcohol is a no-go while taking this medication, says Alexander. That’s largely because excessive drinking can worsen the side effects of bupropion in Contrave, which include dizziness, nausea, drowsiness, and even seizures in some cases (7, 8). 

However, the American Addiction Centers notes there aren’t any imminent dangers associated with alcohol consumption and taking naltrexone (9). In fact, you may feel less of an urge to drink while taking Contrave, as naltrexone is designed to help quell alcohol cravings. 

In short, it may be best to cut down on your weekly beverages, but drinking in moderation shouldn’t cause any serious side effects. 

Moderate drinking looks like two drinks or less a day for those assigned male at birth and one drink or less a day for those assigned female at birth, according to the Centers for Disease Control and Prevention (10). Just keep in mind that alcohol does contain calories, so if you’re trying to shed some pounds, a beer or glass of wine could work against that goal.

The Bottom Line

Contrave is a solid option among the various anti-obesity medications out there. As with the GLP-1 agonists, you have to take it for life in order to lose weight, and keep it off. To maximize its benefits, commit to a healthy diet, with an emphasis on fruits, vegetables, high-fiber carbs, and lean proteins. Curb your consumption of alcohol and processed, fatty fare to avoid side effects.