Beyond the Bedside: A New Cure for Obesity?
By Lori Blanchard Eaton
Social media has increased public interest in a class of medications called GLP-1 agonists. Celebrities and other influencers are posting on TikTok, Facebook and Instagram about losing weight with prescriptions for medications like Wegovy, Saxenda, Ozempic and Mounjaro. I admit I’m not a big follower of social media, except maybe an occasional post to family and friends or searching for good humored posts about dogs or a new recipe. However, our culture is significantly influenced, good and bad, by social media. In light of these new weight loss trends, I thought it would be timely to make use of this month’s Beyond the Bedside blog post to provide a medical perspective on obesity and weight loss.
Obesity is a medical diagnosis. It is a chronic, relapsing medical condition that can lead to heart disease, diabetes, insulin resistance, hypertension, certain cancers, liver disease, sleep apnea, joint pain and reflux. In general, obesity is defined as having a body mass index (BMI) of 30 or greater. As a medical provider, I use BMI as one tool to identify risk that can be associated with these complications. BMI is not a perfect tool and does not do the best job at differentiating between muscle mass within weight. However, it helps me begin to identify patient risk associated with weight. It’s necessary to further review weight trends of individual patients to determine if their weight is a concern of their overall health.
SPC is not a weight loss clinic. We approach obesity and unhealthy weight with the same prevention focus as other primary care health concerns. We evaluate your weight along with your blood pressure, heart rate, oxygen saturation, temperature, medical history, family history and individual problem list to determine your future health risks. It’s important to identify other underlying factors that may be contributing to weight gain, such as hormonal imbalances, sleep issues, lifestyle behaviors and emotional barriers. Some people lose weight through fad diets and weight loss programs, but more often than not, weight is gained back and long-term goals fail. Success in any medical weight loss treatment requires accountability, discipline and lifestyle change. No fad diet is a substitute for quality, well-balanced, nutritious foods that help our bodies develop and function. We don’t think about the cells and tissues working constantly for us as we go about our daily activities. Our bodies need energy from carbohydrates, fat and protein found in a well-balanced diet. Restrictive diets trigger our well-designed bodies to restore itself through a sophisticated feedback system which results in secretion of hormones and other chemicals to save us from starvation associated with dieting.
The new GLP-1 agonist medications address neuroregulatory hormones associated with appetite, hunger and help improve how the body responds to food. As stated previously, obesity is a chronic condition. Like many other treatments for chronic conditions, GLP-1 agonist medications are intended for long-term use for obesity or BMI above 26 (classified overweight) with another cardiovascular risk. Many patients tolerate the dosing schedule without bothersome side effects and reach their goal weight. Once goal weight is achieved, the medication is usually continued at a reduced dose.
Medical management for weight loss can help many patients who have failed dieting and unsuccessful attempts to lose weight. Patients have individual needs and weight loss goals. Many include short-term goals for the benefits of weight loss, but often forget the long-term goals of improving quality of life, reducing future health risks and complications. I am excited to have this class of medications to offer patients who meet the indications and eligibility. Considering the low side-effect profile, GLP-1 agonists are very appealing and rank high on my preferred list of weight loss medications available. However, they are not a weight loss solution for every patient. I challenge you to be well informed and talk with a medical provider before beginning a weight loss plan. If you are interested in beginning a discussion about GLP-1 agonists or other medical treatments, determine medical eligibility, and establish goals for a healthy weight, please schedule an appointment with a SPC provider.
