Could Taking a Weight-Loss Drug Be Right for You?

It’s not unusual for Fatima Cody Stanford to see patients who have tried dozens of different diets and exercise routines for years only to find that the needle on the scale still won’t move—or if it does, it won’t stick.

“Unfortunately, we have this idea that diet and exercise solve obesity,” says Stanford, MD, an obesity medicine physician scientist at Massachusetts General Hospital in Boston and an associate professor of medicine and pediatrics at Harvard Medical School. But for many people it is more complex than that.

Everything from genetics to stress to competing health conditions—even age—can make it difficult to shed excess pounds. And when diet and exercise don’t work, a prescription might help.

A new generation of drugs is helping some people with obesity (defined as a body mass index, or BMI, of 30 or more) lose more weight and, in turn, other related health conditions associated with obesity, such as heart, reverse disease, diabetes and sleep apnea.

Experts say the potential of these medications could be dramatic and far-reaching, as obesity affects more than 40 percent of American adults and puts a $173 billion strain on the health care system each year. Among adults ages 60 and older, obesity is even more common, accounting for about 43 percent of the older population.

Here’s what you need to know about weight loss medications and whether you should talk to your doctor to see if one might be right for you.

There is a new generation of drugs

Several prescription drugs have been approved by the US Food and Drug Administration (FDA) for long-term use to help treat obesity. But it’s a class of injectable drugs that mimic a hormone called glucagon-like peptide-1 (GLP-1) that has “generated a lot of enthusiasm,” says Dina Griauzde, MD, an assistant professor of internal medicine at the University of Michigan Medical School and an internist at the VA Ann Arbor Healthcare System. And that’s because they can be about twice as effective as some of the older drugs on the market.

For example, people taking semaglutide (brand name Wegovy), which is one of these new GLP-1 drugs, lose an average of about 15 percent of their body weight over the course of a few months — that’s about 30 pounds for a 200 — pound person. Losing just 5 to 10 percent of body weight can improve blood pressure, cholesterol and blood sugar, according to the Centers for Disease Control and Prevention.

The drug works by targeting the areas of the brain that regulate appetite and food intake. Semaglutide also helps lower blood sugar levels, which is why it and liraglutide (brand name Saxenda), another GLP-1 medication approved by the FDA for weight loss, have been used for years as a treatment for type 2 diabetes.

Another GLP-1 medication, known as tirzepatide, has not yet been cleared by the FDA for obesity treatment, but like liraglutide and semaglutide, it is an FDA-approved diabetes drug. A recent study published in The New England Journal of Medicine found that this resulted in clinical trial participants losing an average of about 20 percent of their body weight.

However, it is important to note that these newer drugs do not work wonders on everyone, and that some of the weight loss drugs that have been around longer are still very effective in certain individuals. “With all these medications, there is great variability in outcomes,” says Griauzde. “We’re never going to have a one-size-fits-all approach to obesity.”

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