Naltrexone for Weight Management
Food Addiction, LDN & Contrave®
Naltrexone is an opioid receptor antagonist that targets the brain’s food reward pathways. A non-stimulant option for patients struggling with hedonic eating, food addiction, or binge eating. At low doses it also modulates inflammation, and combined with bupropion it forms Contrave®, an FDA-approved weight management medication.
How Naltrexone Modulates Food Reward
Naltrexone is an opioid receptor antagonist FDA-approved for alcohol and opioid use disorder. Its role in weight management comes from its effects on the mesolimbic dopamine system, the brain’s reward and pleasure circuitry. Food intake activates opioid receptors in reward pathways, producing the pleasurable reward of eating. Naltrexone blocks these receptors, reducing the hedonic reward of food and diminishing compulsive or addiction-like eating behavior.
Naltrexone is used for weight management in two ways: as part of the Contrave® combination (naltrexone 8mg + bupropion 90mg, FDA-approved for chronic weight management), and at low doses (LDN, 1.5–4.5mg) which modulates immune function and inflammatory pathways relevant to weight and metabolic health. Brand-name Contrave® can be prescribed when clinically appropriate, or, where access requires it, the individual components separately based on your clinical situation.
Naltrexone targets the brain’s reward centers, making it particularly suited for patients whose weight struggle is neurological rather than purely metabolic. The PMHNP-BC certification of our Medical Director, Dr. Ashar, shapes how the Tactus Health team approaches naltrexone: as therapy that requires understanding food addiction, binge eating patterns, and reward-driven overeating at the neurochemical level. A full medication reconciliation is required before prescribing to ensure naltrexone is safe for your current clinical profile.
For patients who have plateaued on GLP-1 therapy or who struggle with the reward-based component of eating, our medical team may combine semaglutide or tirzepatide with low-dose naltrexone. GLP-1 medications address metabolic hunger and gastric emptying. Naltrexone addresses neurological food noise and reward-driven eating. Together they target both pathways simultaneously, often producing results neither medication achieves alone.
Naltrexone is a daily oral tablet. For patients with needle concerns or who cannot tolerate GLP-1 injections, it provides a non-stimulant, non-injection path to clinically meaningful weight management when used within a structured treatment plan. The Wegovy® pill (oral semaglutide) is another oral option discussed at consultation when relevant.
Many patients are unsure whether LDN, Contrave®, or other naltrexone-based treatment pathways are the right fit. Our team helps determine the best path based on your clinical profile, insurance situation, and access goals.
With evolving manufacturer programs and alternative access pathways, naltrexone has become more flexible to access. The right approach still depends on your clinical profile, dosing needs, and long-term treatment plan.
Low-Dose Naltrexone for Inflammation-Driven Weight
Standard weight loss approaches often fail patients with underlying inflammatory or autoimmune conditions because the root obstacle is systemic inflammation rather than caloric surplus. Low-dose naltrexone (1.5–4.5mg) has been studied for patients with Hashimoto’s thyroiditis, fibromyalgia, and other inflammatory conditions where conventional treatment leaves weight stalled despite diet and exercise compliance.
At these low doses, naltrexone modulates glial cell activity and cytokine production, reducing the chronic low-grade inflammation that disrupts hormone signaling, metabolic rate, and fat storage. Evidence is emerging rather than established. See PubMed research on LDN. LDN candidacy is evaluated individually based on your full clinical picture, inflammation markers, and any existing autoimmune diagnoses.
Dr. Ashar N.
Dr. Ashar holds a Doctor of Nursing Practice and two national board certifications, one in family practice and one in psychiatric mental health.
She founded Tactus Health to close the gap she watched her own family fall through: symptoms that were real, labs that came back normal, and no one willing to connect the two.
She is responsible for the protocols our medical team follows, and for the training of the clinicians who deliver them. Holding both certifications is why those protocols treat hormones, mood, sleep and metabolism as one system rather than five separate appointments.
Naltrexone FAQ
Absolutely not. Naltrexone is a complete opioid antagonist and will precipitate severe opioid withdrawal in anyone currently using opioid medications. This is an absolute contraindication. You must be fully opioid-free (typically 7–10 days minimum) before starting naltrexone. A full medication reconciliation is required to ensure naltrexone is safe for your current clinical profile before prescribing.
LDN refers to naltrexone at doses of 1.5–4.5mg, significantly lower than the standard 50mg addiction treatment dose. At these low doses, it modulates immune function and inflammatory pathways rather than fully blocking opioid receptors. LDN has been studied for autoimmune conditions including Hashimoto’s and fibromyalgia, chronic pain, and inflammatory weight gain. Evidence is emerging, and your provider will advise whether LDN is appropriate for your clinical situation.
Contrave® (contrave.com) combines naltrexone (opioid antagonism reducing food reward) with bupropion (dopamine and norepinephrine reuptake inhibition increasing satiety and energy). The combination targets two distinct reward and appetite pathways simultaneously. Brand-name Contrave® can be prescribed when clinically appropriate, or the individual components separately depending on your insurance situation and clinical profile. It is FDA-approved for chronic weight management in adults with a BMI of 30 or higher, or 27 or higher with a weight-related condition.
No. Naltrexone is a non-stimulant medication. It does not increase heart rate, blood pressure, or cause the jitteriness associated with stimulant weight loss medications like phentermine. This makes it an appropriate option for patients who cannot tolerate stimulants, have cardiovascular concerns, or who have had negative experiences with stimulant-based appetite suppressants.
If you eat when you are not physically hungry, or if certain foods feel like an addiction you cannot quiet even when full, your weight struggle is likely hedonic. Metabolic hunger responds to GLP-1 medications that regulate appetite signaling. Hedonic eating responds better to medications like naltrexone that target the brain’s reward centers. In practice, many patients have both components. Your provider will help you differentiate between the two during your consultation to determine whether naltrexone, a GLP-1, or a combination is the better fit.
Naltrexone is contraindicated in patients currently using opioid medications, including those for chronic pain. Hepatotoxicity has been reported at higher doses; liver function may be monitored as part of your protocol. Common side effects include nausea, headache, dizziness, and fatigue. The Contrave® combination carries additional warnings including increased blood pressure, seizure risk from bupropion, and a boxed warning for suicidal thoughts and behaviors. Not recommended during pregnancy or breastfeeding. Individual results vary. Read full naltrexone safety information →
Already taking naltrexone or exploring LDN? Our providers can guide dosing, combine approaches when appropriate, and help you get the most from your treatment.
Book Your Weight Loss Consultation
Free consultation with our licensed providers · No obligation
Book Free Consultation