Weight Loss Medications: Pros and Cons

Pros

1. Weight loss when traditional methods to lose weight have not worked

2. Risky surgical options like gastric bypass can be removed

3. Risk factors for lifestyle illnesses like hypertension and diabetes can be decreased

4. Off-label prescriptions for hormonal diseases like PCOS for effective treatment of symptoms 

Cons

1. Expensive

2. Drug shortages for diabetes leading to backlash for obesity patients asking for treatment

3. Going off the medication could mean gaining the weight back without lifestyle changes

4. Side Effects leading to other problems like pancreatitis, and losing of appetite long-term even after losing the desired weight

Medications Currently Prescribed for Treating Obesity:

1. Ozempic/Wegovy - Ozempic is an semaglutide injectable originally marketed for the treatment of diabetes. Wegovy is the same composition as Ozempic but approved for use in treatment of obesity. 

2. Saxenda - a liraglutide injectable specifically marketed to managing obesity in adults and teens aged 12-17

3. Mounjaro/Zepbound - Tirzapatide injectible approved for treating diabetes. Zepbound is the same medication approved for the treatment of obesity.

4. Contrave - a compound medication in pill form that is composed of Naltrexone and Buproprion. It is marketed to obesity treatment and helps to increase food satiety and decrease cravings.

Pros: Weight loss when traditional methods to lose weight have not worked

For most people who have struggled with weight loss and weight management, the problem isn't willpower. It's that there is a chemical imbalance within the body that is shutting off hunger and satiety cues. Many people who struggle with weight often have mental health challenges exacerbating the problem of emotional eating. Their relationship with food is toxic, and cycles of bingeing and starvation dieting can create eating disorders. 

While many people will start a new diet, new exercise routine, or new lifestyle, 95% of people will stop at some point and gain the weight back and usually more than what they started at. 

Obesity is a complex disease and while many people blame over-eating for the cause, it may have started that way, but it is certainly not the reason that people continue to struggle with obesity after implementing "moving more and eating less". 

The medications listed above are the most commonly prescribed for the treatment of obesity and they trigger the hunger and satiety cues in a way that the body naturally does not. In the past, people have tried supplements, hypnotherapy, and other alternatives but these options are not permanent. The medications can help remove the challenges of our bodies not knowing when they are full to not reacting to cravings.

Since our bodies are designed to hold on to weight as we gain more over our lifetimes, it becomes harder to lose the weight as our bodies seek to maintain equilibrium. Many people report that they feel fuller sooner from eating, don't have cravings, and have changed their relationship with food after going on these medications. 

Pros: Surgical options no longer necessary

Gastric bypass surgery has long been used to treat obesity but it comes with side effects. Not only is the surgery risky, it also hasn't worked in a lot of patients to lose weight or keep it off. 

From the Mayo Clinic:

"gastric bypass, is a type of weight-loss surgery that involves creating a small pouch from the stomach and connecting the newly created pouch directly to the small intestine. After gastric bypass, swallowed food will go into this small pouch of stomach and then directly into the small intestine, thereby bypassing most of your stomach and the first section of your small intestine."

Within 1-2 years, patients may lose 70% of excess weight. However, over the next 5-10 years, some patients may gain back some if not all the weight they lost.

For many patients, they can keep at least 50% of the excess weight off over the next 20 years but it's not guaranteed if lifestyle changes have not been implemented or maintained post-op.

Like with all surgeries, there is a level of risk that patients need to be aware of before deciding to go through with the surgery. You could bleed out and die with any surgery, but other risks include not being able to eat as much food as you once did, hair thinning or hair loss, feeling cold, dry skin, and weight re-gain. 

Weight loss medications are a relief from experiencing the risks of surgical intervention and don't require being on a long wait list.

Pros: Risk factors for lifestyle illnesses like hypertension and diabetes can be decreased

When people lose weight after going on these medications, their risk factors for developing high blood pressure, diabetes, high cholesterol, joint aches and pains, chronic insomnia, acid reflux and heartburn, and heart disease all decrease. 

Since many lifestyle illnesses are caused by being overweight, when people lose even 10% of the excess weight, their health immediately improves.

Medications for the treatment of any lifestyle disease may or may not be covered by employer drug plans. If any pre-existing condition exists, life insurance can also get expensive or you may not even get coverage. So losing the weight can not only help your health, but it also helps your wallet.

Pros: Off-label prescriptions for hormonal diseases like PCOS

Poly-cystic Ovary Syndrome (PCOS) is a hormonal condition that affect approximate 8-13% of women and 70% are undiagnosed according to the World Health Organization (WHO).

PCOS is characterized by the following symptoms (from the WHO website): 

Possible symptoms include:

• heavy, long, intermittent, unpredictable or absent periods
• infertility
• acne or oily skin
• excessive hair on the face or body
• male-pattern baldness or hair thinning
• weight gain, especially around the belly.

People with PCOS are more likely to have other health conditions including:

• type 2 diabetes
• hypertension (high blood pressure)
• high cholesterol
• heart disease
• endometrial cancer (cancer of the inner lining of the uterus). 

PCOS can also cause anxiety, depression and a negative body image. Some symptoms such as infertility, obesity and unwanted hair growth can lead to social stigma. This can affect other life areas such as family, relationships, work and involvement in the community.

Losing weight while being diagnosed with PCOS is difficult. Common advise like moving more and eating less simply isn't enough. In some cases, women are prescribed medications like Orlistat to help with managing weight. Nowadays, doctors are prescribing weight loss medications off-label to assist women suffering from PCOS regain their health.

Cons: Expensive

Unfortunately, most drug insurers have not come around to the idea that weight loss medications are needed for the effective treatment of obesity when traditional methods have not worked. In Canada, the cost for going on medications could start at $300/month. This is cost prohibitive to a lot of people and thus treatment is not sought. 

Cons: Drug shortages for diabetes leading to backlash for obesity patients asking for treatment

Thanks to celebrities touting the benefits of weight loss medications, the surge in popularity has lead to a chronic shortage in the drug supply chain for diabetes. 

Anyone using weight loss medications are harassed and blamed for seeking treatment for vanity. People suffering from obesity are unfairly stigmatized for both wanting to do something about their condition and also for being overweight in the first place.

Cons: Going off the medication could mean gaining the weight back without lifestyle changes

Without lifestyle changes alongside the medication, people will regain the weight if they go off the drugs. This is going to be the same as if you are on diabetes or high blood pressure medication and go off of it without having implemented a diet and exercise plan to maintain your weight. 

Cons: Side Effects 

Unfortunately, like all pharmaceuticals, sometimes the cure is worse than the disease. For some people, they may experience mild side effects like headaches, nausea, too much lack of appetite, stomach pain, changing the taste of food, developing anxiety and depression, diarrhea or fatty/oily stool, vomiting, pancreatitis, and increased heart rate. It is up to the individual to understand these side effects and decide if going on medication is right for them.

The other issue is losing weight too quickly can lead to loose skin that will require surgical removal. This can happen in both people who exercise and those who do not exercise. However, individuals who exercise may be able to shrink the amount of loose skin by building muscle that the skin wraps around.

Medications need lifestyle changes for permanent change

Even if you are on a medication for treating obesity or any lifestyle illness, you need to implement lifestyle changes if you want to see permanent change. Personal training and nutrition are required to maintain your results. Medication is simply one of many tools we have to manage weight and obesity. 

To help you make permanent lifestyle changes, contact us at Rage Fitness at 1-825-945-7733 or fill out the online contact form and develop a program that will lead to sucess long term.