The “New” Weight Loss Drugs: Friend or Foe – Part 2

Introduction to the New Weight Loss Medications

The obsession with weight loss is nothing new, but with the recently developed class of medications touted to make “weight loss” easier than ever before, as promised last month, I have additional information I want to provide to my readers. While we will discuss specifics about the drugs, first some food for thought.

As a nutrition expert in private practice, who happens to also be a trained chef, I work with individuals to help them achieve their number one goal, which is usually “weight loss”. I do this through science and evidence-based nutrition education as well as teaching cooking basics, and thankfully I often shift mindsets that elevate “health” as the primary driver for my clients over time. For this I am grateful. That doesn’t mean at times that clients don’t fall back into unhealthful habits, but in the end, they always desire to “come home” to all I have taught them because they have experienced the benefits and joys of a healthy eating pattern.

Benefits of the New Injectable Medications

We all have heard of the strengths of the new injectable medications which include lowering blood pressure and blood lipids, improving fatty liver disease, reducing risk of heart and kidney disease, and delaying diabetes complications. While the exact mechanisms are still being researched, these benefits likely come from the weight loss which ultimately leads to blood sugar control. 

Understanding Semaglutides: Ozempic and Wegovy

One class of injectables is the semaglutides, known under the brand names Ozempic and Wegovy. These medications are glucagon-like peptide-1 receptor agonists (GLP-1RA), which help to reduce appetite, calorie intake, and hunger while increasing satiety. They have minimal side effects and promise weight loss benefits of 6-12%.

Tirzepatide: A Solution for Type 2 Diabetes Patients

The other class of injectables is tirzepatide, a GIP (glucose-dependent insulinotropic polypeptide) and GLP-1RA combo, which was designed for patients with type 2 diabetes. It is often used “off label” for weight loss, with up to 25% reduction with the highest dosage. Because those with type 2 diabetes have double the risk of cardiovascular disease, these medications can literally save lives.

Concerns and Costs of Weight Loss Medications

So what exactly are the issues with these medications…well there are many. Monthly costs range from $900-1400 per month, with coupons providing initial cost reductions that are short-lived. Given the medication likely needs to be taken long-term to prevent weight regain, the cost can be prohibitive for many. That being said, at this point, we have no idea of the potential long-term side effects of these drugs.

Too many medical providers are handing out these drugs like candy, without proper counseling to their patients. The next line of defense comes from the pharmacists, who are happy to provide guidance to patients when they are prescribed these new drugs, but many refuse the consultation, and others don’t seriously take the advice given. 

Obesity: A Complex Condition

We understand obesity is a complex condition, otherwise, more than 40% of humans would not be affected by it. The connection between food addiction and obesity is still not understood well, but until then, effective management of one’s weight will come down to lifestyle shifts including a healthy eating pattern, moderate exercise, and potentially utilizing behavior modification therapies, along with these medications. Some want to include weight loss surgery in the mix, but I don’t recommend this route due to the concerning outcomes I have seen. 

All this being said, given that those who are making the decision to take these medications are usually desperate to lose weight and improve their health, we must then take seriously the need to make ourselves aware of the multifold responsibility that comes from what seems to be an easy fix.

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