The US Centers for Disease Control and Prevention currently estimates that about 42% of American adults are obese. Defined as a body mass index of 30 or higher.
It’s a serious condition that can lead to type 2 diabetes, heart disease, some cancers, and major health care costs. I pay a lot of dollars in medical bills.
Diet and exercise continue to be the primary treatment for weight loss. However, many new diabetes medications show promise for people who continue to struggle after lifestyle changes.
To learn more about these drugs, we spoke with Kunal Shah, assistant professor of endocrinology at Rutgers University’s Robert Wood Johnson School of Medicine, who has specialized in treating obesity for more than a decade.
An effective obesity treatment is one that results in at least—I want to emphasize—at least 5% total weight loss.
I use that number because it is the threshold at which metabolic improvements are seen in your health. Improved blood pressure. For diabetics, improving blood sugar levels. Improvement of cholesterol. The more weight you lose, the better. But that’s exactly what we’re looking for as our first goal.
One type of drug basically acts as a stimulant, boosting metabolism and stopping cravings.The brand names are Qsymia and Contrave. Both are tablets and typically reduce weight by about 7% to 8%.
However, these drugs have some concerns. They are powerful drugs, and powerful drugs can cause powerful side effects.
Stimulants have side effects such as heart palpitations. Do not use if you have high blood pressure or heart disease as it may aggravate these conditions. It can put undue stress on the heart. And sometimes people don’t feel good about these drugs.
These new drugs were first prescribed [people with diabetes] Because they helped blood sugar. Subsequently, it was found that patients taking the drug lost a lot of weight.Available Now [by prescription] Anyone.
A once-daily injection, it has been marketed under the brand name Saxenda since 2016. Another drug approved in 2021 is Wegovy, a once-weekly injection. (Wegovy is basically the same diabetes-specific Ozempic, but in different doses.) Both work by making you feel full.
So far, these drugs are the most effective for weight loss. In trials, Wegovy resulted in his 15% total weight loss. About 10% to 12% weight loss was seen with Saxenda.
What really sets these two drugs apart is that while other obesity drugs have many side effects and are really only used to treat obesity, these drugs help with diabetes. about it. It has also been shown to lower the risk of heart attack and stroke.
These drugs work very well. Sometimes it can cause mild nausea and cramps. There is a rare risk of pancreatitis, which occurs in 1 in 1,000 people.
Another drug — branded Mounjaro — received approval from the Food and Drug Administration in May.
It is also closely related to Saxenda and Wegovy, but has been shown to be even more potent when it comes to treating diabetes, with early studies showing up to 20% to 25% total weight loss. Before this drug, it was a figure that could only be seen in bariatric surgery. This could be a game changer.
Currently, it is only approved for the treatment of diabetes. However, Eli Lilly, which makes it, is likely to seek FDA approval for weight loss.
First of all, these drugs are not the primary treatment for weight loss. It always comes down to proper diet, proper exercise. It has to be the foundation. These drugs can help you get there. But without the right lifestyle changes, even if you lose weight in the first place, you’ll just put it back on.
That said, these drugs should be used by many people trying to follow a proper diet and exercise regimen as a way to reach their weight loss goals.
However, insurance does not cover the cost of these drugs. Getting approval through Medicare or Medicaid is very difficult. It was a great frustration for prescribers. This is one reason why many patients do not take these drugs.
Patients without insurance will pay $1,200 to $1,400 per month for these drugs. We spend a lot of time arguing with insurance companies.
Another reason more patients are not using these drugs is that many doctors are not familiar with them and therefore do not prescribe them.
We need to make obesity an important diagnosis that deserves health insurance. Many companies pay for heart drugs, blood pressure drugs, and cholesterol drugs. But they don’t think obesity is a true enough diagnosis to cover the drug.
As these drugs become more widely available and covered, more people will use them. We could have a healthier population.
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