What’s the Skinny on Weight-Loss Meds?

Obesity is a serious and common health issue that has historically been misunderstood. In fact, the American Medical Association did not recognize it as a disease until 2013. As this issue details, there are a lot of new data on the use of the injectable weight-loss medications semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro), to name a few. Many of my patients are asking me, “Am I a good candidate, and what are the benefits and risks?” These medications increase the sense of satiety, and they also cause some mild nausea and constipation that makes it a bit harder to overeat. In addition, Wegovy has already been shown to lower the cardiovascular risk associated with obesity (this is still preliminary, but accepted data). If your doctor prescribes any of these medications, he or she will likely recommend calorie restriction and exercise as part of your weight-loss treatment plan.

Clearly, we have known for some time that obesity is a risk factor for diabetes, heart disease, and some cancers. If a person’s weight is more than what’s considered healthy based on their height, it’s classified as overweight or obesity, and the body mass index (BMI) is the screening tool used to determine that. If you have type 2 diabetes or obesity, with a BMI over 30, your risk justifies asking your doctor whether one of these medications may be right for you.

The field of obesity treatment and research is rapidly expanding. We expect that in the next several years, we will have data on the duration of treatment, new oral options, and even completely new medications. Right now, what we know is that this class of drugs makes the brain feel “full” and therefore sends a signal to stop eating. For some patients, the side effects mentioned above are significant enough that the drugs cannot be tolerated.

Needless to say, these medications have become somewhat abused by patients who use them for cosmetic weight loss. But these drugs are lifesavers for many patients, so be sure to ask your physician if you qualify. We hope that one of the unspoken benefits of these medications is that obesity will be accepted as a disease of metabolism, not a weakness of willpower.

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