Resham Uttamchandani
American Board of Obesity Medicine, United States
Title: Obesity Medications: The new wonder drugs
Biography
Biography: Resham Uttamchandani
Abstract
According to the Framingham Heart Study, adults who were obese at 40 years of age lost 6 to 7 years of expected life! Weight loss, as low as 5% of body weight, can lead to improvement in metabolic diseases such as diabetes, hypertension and hyperlipidemia. Evidence has demonstrated that Diabetes medications such as GLP-1 agonists, such as semaglutide, are gaining a lot of recognition for their weight loss effects, equivalent to weight loss rates seen with bariatric surgery!. Studies found people using semaglutide and making lifestyle changes lost about 33.7 pounds (15.3 kilograms) versus 5.7 pounds (2.6 kilograms) in those who didn't use the drug. Clinicians need to be cautious when prescribing these medications. Some contraindications include personal or family medical history of medullary thyroid cancer or recurrent pancreatitis. If the patient is on another anti-diabetes medication that can cause hypoglycemia, such as insulin or a sulfonylurea, they will need to be carefully monitored. There are newer weight loss medications as well - tirzepatide (dual GIP and GLP-1 agonist). Common side-effects of this medication include gastrointestinal-related side effects such as nausea, vomiting, and generalized abdominal discomfort as well as pancreatitis. Overweight or obese participants without type 2 diabetes who took the drug, called tirzepatide (sold as the diabetes drug Mounjaro), lost an average of nearly 21% of their body weight at the highest dose studied. It can take more than a year for the drug to reach full effectiveness, although some patients hit their plateau earlier than that. The goal for physicians is to see a benchmark of 5% total body weight loss in the first three months, which is a good predictor of whether the medication will continue to work. It is also important to remember that medications don’t replace physical activity or healthy eating habits as a way to lose weight. Studies show that weight management medications work best when combined with a lifestyle program - such as cessation of tobacco use/ alcohol intake, dietary changes and physical activity.