Should You Prescribe Weight Loss Drugs?

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Summation

  • And, while patients may need to remain on weight loss drugs for years or even for their whole lives, it can be worth it for many patients to finally feel in control of their weight, not to mention avoid some of the many serious side effects of obesity.
  • The history of using drugs to treat obesity goes all the way back to the 1800s, but the weight loss drugs of the past had a tendency to cause serious side effects.
  • The truth about obesity is that it's a complex metabolic disease – in fact, it may be the result of a combination of many diseases, and it likely has different causes for different patients.

It’s true that drugs for weight loss, or “diet drugs” as they’re often called, have a sordid history. The history of using drugs to treat obesity goes all the way back to the 1800s, but the weight loss drugs of the past had a tendency to cause serious side effects. As late as the early 21st century, weight loss drugs like fen-phen were doing people permanent damage. In fact, past diet drugs have turned out to be so bad for patients that many doctors just don’t want to prescribe medications for weight loss.

And that’s a shame, because modern weight loss drugs are safer than past formulations, and they’re effective for weight loss. Weight loss drugs alone often aren’t enough to treat obesity – they may not work for everyone, and they work best when used in conjunction with lifestyle changes and other medical interventions, like surgery. And, while patients may need to remain on weight loss drugs for years or even for their whole lives, it can be worth it for many patients to finally feel in control of their weight, not to mention avoid some of the many serious side effects of obesity.

Obesity Is a Complex Disease

Many people – even many doctors – don’t think of obesity as a medical condition. They think of it as a moral failing – something that the obese person should be able to overcome with willpower alone. But it’s not that simple.

Human bodies have evolved over millions of years to retain excess fat. Hormones, neurotransmitters, different parts of the brain, the guts, and even the body’s fat cells are all working together to keep excess body fat right where it is, as a hedge against times of starvation. To make matters worse, when an obese person tries to diet to lose weight, his or her body thinks that time of starvation has arrived, and lowers its metabolism even more to retain extra weight.

The truth about obesity is that it’s a complex metabolic disease – in fact, it may be the result of a combination of many diseases, and it likely has different causes for different patients. Researchers don’t yet understand all the physiological mechanisms that cause obesity and make it difficult for obese people to lose the weight and keep it off. But they do know some things; for example, Harvard endocrinologist Jeffery S. Flier M.D. has found that consistently eating more calories than you burn could damage your hypothalamus, causing increased feelings of hunger and a lowered ability to feel satiated by food.

Obesity researchers also know that people’s bodies have a “set point,” or a specific body weight range that the body strives to maintain. In obese people, this set point is higher than it is in normal-weight people. That’s why it’s so hard for obese people to lose weight, and even harder to for them to keep it off. It can take years of successfully maintaining a lower weight to lower the body’s set weight point. The goal of modern weight loss drugs is to bring that set point down, by introducing hormones and neurotransmitters that convince the brain that its body’s set point should be lower. These hormones and neurotransmitters can affect the patient’s appetite and feelings of satiety, so they eat less and lose weight more easily.

A New Generation of Weight Loss Drugs Is Available

Diet drugs of the past caused so many terrible side effects, it’s not hard to understand why many doctors don’t want to prescribe weight loss medications. But today’s new generation of weight loss drugs are much safer than the drugs of the past, and they’re effective, too. A new once-weekly gastric inhibitory polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, tirzepatide, has been found in clinical trials to cause patients to lose 20 percent of their body weight. Though it has been approved by the Food and Drug Administration (FDA) for the treatment of type 2 diabetes, tirzepatide has not been approved for the treatment of obesity.

However, other weight loss drugs have been approved by the FDA. The drug semaglutide is available under the brand names Ozempic and Wegovy for weight loss in June 2021. Semaglutide is self-injected weekly under the skin. It doesn’t work for all patients, but those who do benefit from semaglutide can achieve weight loss of up to 15 percent, or about 30 pounds for a 200-pound person. That’s enough weight loss to significantly reduce a patient’s chances of serious complications from obesity, like heart disease, high blood pressure, and type 2 diabetes.

Semaglutide works because it mimics GLP-1, a hormone responsible for feelings of satiety after eating. People who suffer from type 2 diabetes secrete lower amounts of GLP-1, and it’s believed that so do people with obesity. Taking semaglutide decreases appetite and lowers the body’s weight set point, making it easier for obese patients to lose weight. Patients who have tried the drug say the weight just melts right off. You check here what is semaglutide.

Diet Drugs Can Effectively Treat Obesity, If Only Doctors Would Prescribe Them

Obesity is one of the biggest public health problems facing the modern world, and continuing to treat it as a simple lack of willpower does a disservice to patients battling this difficult condition. Obesity is complex in its causes and typically requires a multi-pronged solution; while a healthy diet and regular exercise are important for controlling obesity, medication and surgery also have their place. Obesity is much easier to treat and manage with the new generation of weight loss medications. New drugs in development may soon be able to replicate the results of common bariatric surgeries, making it possible for obese patients to lose 25 to 30 percent of their body weight without a drastic surgical solution. And, even with weight loss drugs, treating obesity requires permanent lifestyle changes – and could require lifelong treatment with so-called diet drugs.

If you’re looking for a way to offer your patients real treatment for obesity, you need to consider prescribing drugs for weight loss. Weight loss drugs like semaglutide and tirzepatide can produce real results, and help some of your patients gain control over their weight, perhaps for the first time in their lives.

 

 

 

 

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