Medical Weight Loss: It’s not just about “fat shots.”
In the ever-evolving landscape of medical weight loss, new treatments are emerging with promising results which may help us to cure the obesity epidemic. Here we briefly discuss the latest developments in weight management, from a holistic point of view that includes injectable medications like semaglutide (Ozempic and Wegovy) and terzepatide (Mounjaro).
Cutting-Edge Treatments
Revolutionary weight management medications have changed how we view obesity. Medications like semaglutide is called GLP-1 Agonists. GLP-1, or glucagon-like peptide-1 agonists, work by stimulating receptors in the stomach and throughout the body, to stimulate fullness, decrease cravings, and slow gastrointestinal motility. Beyond GLP-1 agonists, there's a growing emphasis on medications with fewer side effects. Terzepatide works on 2 receptors GLP1 and GIP and may be even more effective. Semaglutide (Ozempic) and tirzepatide (Mounjaro) have shown remarkable efficacy in weight management. Studies reveal that semaglutide can result in a maximal weight loss of approximately 15%, while tirzepatide has demonstrated an impressive 15.9% reduction in body weight12. This is much more than older weight loss medications. With proper management, some studies have shown 20% body mass weight loss over a sustained period.
Despite our best efforts, not everyone responds to these medications. These medications may have side effects or contraindications. There are other options. Widely recognized weight loss medications like naltrexone/topiramate (Contrave) and phentermine continue to be popular choices. The SCALE Obesity and Prediabetes trial demonstrated that individuals taking naltrexone/topiramate achieved significant weight loss, with some participants experiencing up to a 9.3% reduction in body weight3. Phentermine, an appetite suppressant, remains a common option for short-term weight loss. Others medication optsions include metformin and HCG injections, and various custom compounded medications.
However it’s not all about miracle drugs; it’s a balancing act. Research shows the importance highlighting the importance of maintaining a caloric balance through a combination of dietary adjustments and regular exercise; it’s not just about a “fat shot.” Research focus is shifting towards understanding how overall energy intake, expenditure, and metabolism contribute to a sustainable weight management. By increasing our metabolic activity we can burn the calories we take in.
Lifestyle changes, such as adopting mindful eating practices and incorporating regular exercise, have become a cornerstone of weight loss. These straightforward yet effective approaches are often considered as valuable alternatives or complements to medications.
Medicaiton Side Effects to Monitor
GLP-1 Agonists and a new class of drugs, SGLT-2 inhibitors, while generally well-tolerated, may cause increased urination and yeast infections. Patients should monitor for signs of dehydration and kidney function is advised, given their impact on fluid balance. GLP1 agonists can cause nausea, constipation and even gastroparesis (decreased stomach emptying); it’s important your Doctor tells you what to watch out for and gives medications to decrease expected symptoms. Other older weight loss medications like Naltrexone/topiramate can have side effects like dizziness and difficulty concentrating, while phentermine may lead to increased heart rate and insomnia. Regular check-ins with healthcare providers are essential to monitor and manage these potential effects.
Medical Weight loss is not one size fits all; it requires a physician who works closely with the patient, reviewing past medical history, lifestyle, current medications, does lab work and works with the patients’ PCP to meet weight loss goals. Recognizing that individuals respond uniquely to medications, it's crucial to remain vigilant for side effects.
Losing weight affects all aspects of health. By losing weight, patients have been able to decrease or stop their blood pressure, lipid or diabetes medications. Did you know losing weight can also help treat PCOS (polycystic ovarian syndrome ) and Fatty Liver Disease, and decrease the risk of some types of cancer? Of course losing weight can also help prevent severe osteoarthritis, joint replacements, and improve the ability to exercise and avoid heart attacks!
Navigating the path to weight loss involves a balanced combination of lifestyle adjustments, exercise, and, when necessary weight loss medications. By embracing a comprehensive approach, and working with a well educated provider, individuals can work towards sustainable weight loss, to live longer, better and healthier lives.
BOOK A MEDICAL WEIGHT LOSS CONSULTATION
References:
The Obesity Society: https://www.obesity.org/
Footnotes
Wilding, J. P., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., ... & Hollander, P. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 384(11), 989-1002. ↩
Frias, J. P., Nauck, M. A., Van J. P., Wilding, J., Hallén, N., Pétursson, H., ... & Buse, J. B. (2021). Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes. New England Journal of Medicine, 385(6), 503-515. ↩
Garvey, W. T., Ryan, D. H., Look, M., Gadde, K. M., Allison, D. B., Peterson, C. A., ... & O'Neil, P. M. (2015). Two-year sustained weight loss and metabolic benefits with controlled-release phentermine/topiramate in obese and overweight adults (SEQUEL): a randomized, placebo-controlled, phase 3 extension study. The American Journal of Clinical Nutrition, 102(6), 1336-1346. ↩
