Lifestyle Changes and Medications Are Crucial

  • A new study found that lifestyle changes and weight loss medication can help lead to a 10 percent drop in weight.
  • Losing weight in a sustained and healthy way is usually very difficult.
  • Experts say this new data could help people who want to lose weight work safely with their doctors.

New research finds lifestyle changes combined with weight loss drugs have enabled obese and overweight people to maintain a weight loss of almost 11 percent for up to five years.

Weight loss greater than 10 percent offers significant health benefits, according to researchers.

“If weight loss can be sustained, metabolic abnormalities can be reversed with significant benefits in patients with type 2 diabetes, cardiovascular disease, and many other diseases where obesity is the main cause,” lead study author Michael A. Weintraub, MD, lead author and fellow in the Division of Endocrinology, Diabetes and Metabolism at Weill Cornell Medicine, told Healthline.

Weintraub and the team presented their findings June 12 at ENDO 2022, the Endocrine Society’s annual meeting in Atlanta, Georgia.

“Our actual study,” Weintraub said. “Demonstrates that anti-obesity drugs combined with lifestyle changes can achieve significant weight loss of 10 percent body weight and that loss is maintained over the long term.”

The study analyzed data from 428 patients at an academic weight management center.

“This research can help guide medical practitioners to design personalized, accessible treatment regimens to help patients with long-term weight loss,” he said.

All patients received counseling about following a low-glycemic diet and exercise by the obesity medicine specialist during their office visits and were offered additional counseling with a registered dietitian.

Medical intervention included FDA-approved and off-label weight loss medications that included metformin, phentermine, and topiramate.

At their last visit, patients were using an average of two medications for weight management.

Followed for about 5 years, participants maintained an average weight loss of 10.7 percent.

“In our study, we were surprised at the magnitude of weight loss that was achieved and maintained,” Weintraub said. “By adding anti-obesity drugs, patients lost and maintained an average of 10 percent of their body weight, which in this group was 23 pounds.”

He added that a third of patients can maintain 15 percent or more long-term weight loss.

“If weight loss can be sustained, metabolic abnormalities can be reversed with significant benefits in patients with type 2 diabetes, cardiovascular disease and many other diseases where obesity is the main cause,” Weintraub said.

Brian Quebbemann, MD, FACS, bariatric surgeon and founder of The NEW Program in Orange County, California, said for many people who are overweight or obese, a 10 percent weight loss won’t mean they end up at moderate weight.

“Yes, a 10 percent weight loss provides some health benefits,” Quebbemann said.

He compared it to a person with a blood pressure of 200 over 140 who is better off if they get medication that lowers their blood pressure to 180 over 120. At that level they would still be considered high blood pressure.

“Yes, they are better off, but they are still a long way from achieving a healthy blood pressure,” Quebbemann said.

Suchitra Rao, MD, bariatric physician at O’Connor Hospital in San Jose, California, said that when used appropriately, weight loss drugs can help people reach their weight loss goals in a safe way.

“Although obesity is a chronic, complex and relapsing disease,” she noted. “It may be necessary to continue them long-term for maintenance of weight loss and prevention of weight gain.”

Rao added that beneficial lifestyle interventions to promote and maintain weight loss include behavioral changes to adjust our lifestyle to eat a healthy diet, stay active regardless of age, manage stress and get enough sleep.

According to Minisha Sood, MD, an endocrinologist at Lenox Hill Hospital in New York, while all medications have potential side effects, the real issue is whether the benefits of a medication outweigh its risks.

“In the case of obesity, the benefits often outweigh the risks,” she said. “Metformin, topiramate and phentermine have been used successfully and safely for many years.”

Sood pointed out that these medications have manageable side effects and can be easily discontinued if someone experiences intolerable adverse effects.

However, when the medication is stopped, weight may increase.

According to Weintraub, his findings show that it is possible to achieve “significant” long-term weight loss in overweight and obese people without surgery.

“Although it will require lifelong medication, the side effects of the weight loss medication used in this study are relatively mild,” he said.

Weintraub added that the health benefits of weight loss could lead to a decrease in serious weight-related illnesses, and thus a decrease in the cost of medication as well as a decrease in disability and future complications of these medical problems.

“The result will be a measurable improvement in the quality of life of those people who take the necessary lifestyle changes to heart,” he concluded.

New research finds a combination of weight loss drugs and lifestyle changes can result in significant long-term weight loss.

Experts say once the medication is stopped, weight can return.

They also encourage people trying to lose weight to thoroughly assess their lifestyle to make healthy changes that encourage weight loss.

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