Obesity, affecting nearly 42% of American adults, poses a significant health risk, according to the Centers for Disease Control and Prevention (CDC). The consequences include an elevated risk of heart disease, stroke, type 2 diabetes, certain cancers, severe outcomes from COVID-19, and adverse effects on mental health.
Acknowledging obesity as a multifaceted issue influenced by factors such as eating habits, physical activity, sleep routines, genetics, and certain medications, the CDC underscores the importance of addressing social determinants of health. Access to healthcare, affordable and nutritious food, and safe spaces for physical activity are recognized as critical components of successful weight loss strategies.
While the fundamental principle of weight loss remains a caloric deficit and increased physical activity, the reality is more complex, with many struggling to achieve and sustain weight loss. A study by Weintraub et al. in the Journal of Clinical Endocrinology and Metabolism on August 18, 2023, reveals the challenges of long-term effective weight loss with commonly used drugs, indicating that 51% of patients regained their prior weight after four years.
In an October 16, 2023 editorial in Nature Medicine, it is highlighted that weight loss, whether through drugs or lifestyle interventions, may lead to a loss of lean muscle, with weight regain predominantly as fat. Researchers have recently discovered potential weight loss effects in certain diabetes drugs, paving the way for new injectable weight loss medications discussed in an article by Berthold from the University of California, San Francisco, dated September 11, 2023.
Berthold raises a critical question in her article, “Are the Newest Weight Loss Drugs Too Good to be True?” Examining drugs like Wegovy, Ozempic, and Mounjaro, she notes that while Wegovy is FDA-approved for obesity, Ozempic and Mounjaro hold FDA approval for diabetes, with the latter seeking approval for weight management. These drugs, as reported by Powell in the Harvard Gazette on July 10, 2023, can facilitate a substantial weight loss of 10% to 22% in the first year by mimicking hormones that suppress appetite and improve insulin secretion.
However, the prolonged use of these drugs, priced at over $1,000 a month, may be necessary to maintain weight loss, and discontinuation can lead to rapid weight regain. Potential side effects, including nausea, constipation, and diarrhea, are common, with the American Medical Association reporting a new FDA warning on the risk of “potential intestinal blockage” as of October 4, 2023.
Recent developments reported by the New York Times on October 22, 2023, suggest that more weight loss drugs are on the horizon, potentially leading to market competition and reduced prices. Despite their efficacy, these drugs can have unpleasant side effects, such as undesirable buttock and facial changes, with rare but serious side effects occurring in less than 1% of patients, including reports of suicidal thoughts or behavior.
The American Medical Association emphasizes the need for caution, adding that these medications are not to be used as a “jump start” for weight loss. A study on Ozempic, as reported by Rosen in Science News on August 29, 2023, suggests potential benefits beyond weight loss, indicating a 20% reduction in the risk of serious heart or blood vessel problems.
While promising, the use of these potent medications should be under the guidance of a physician. Dr. Carl E. Bartecchi, MD, a Pueblo physician and clinical professor of medicine at the University of Colorado School of Medicine, advocates for a comprehensive approach to weight loss, including a low-calorie, low-gastrointestinal carbohydrate diet, ample protein intake, and increased physical activity.
