Results of a clinical trial released in the New England Journal of Medicine on Wednesday September 2nd, 2022, found that adolescents who got a weekly injection of Semaglutide, a drug that reduces appetite lost an average of 14.7% of their starting body weight, while those who got placebo and counseling on diet and exercise gained 2.7% of their initial body weight.  This study is one of several that have shown conclusively that medication management is far superior to diet and exercise alone.

The fight to lose weight and keep it off can feel like a losing battle. According to some statistics, 97% of people who lose weight on diet gain it back over a few years.  Long-term weight loss happens only to very few dieters.  That is until now.  A new class of drugs call GLP-1 analogs used to treat diabetes also result in significant weight loss.  GLP-1 are hormones made in the gut that help to regulate appetite.  The GLP-1 analogs are drugs that work just like the natural hormones to suppress appetite and regulate energy balance.  Semaglutide which is marketed as Wegovy has been very successful which has led to very high demand.

There are several studies which show that adding medication to diet and exercise can double or even triple the weight loss from lifestyle change alone. Despite the high demand for Wegovy, a great majority of dieters frown at the idea of taking weight loss medications. Even those who take them almost feel like they are cheating the process and should not be on them long term.  This is borne out of the misconception that weight loss struggle is one of willpower. The implication is that you should be strong enough to push back at the table and exercise.  It is however no longer in doubt the biological impulses that control body weight are not easily overcome by shear will. 

Imagine a diabetic with uncontrolled blood sugar being asked to control their blood sugar with just willpower.  Diabetics not only willingly take medications, but they also actively seek them.  They have the support and sympathy of friends and family.  This is not usually the case for patients struggling with excess body weight.  Yet the biological basis for obesity is perhaps stronger than that for diabetes.  Also, the potential payoff from weight loss includes control of blood sugar and a myriad of other chronic diseases including heart disease and cancer. 

If you are struggling to lose weight, this could be the best of times.  There are so many more tools available to help you lose weight and keep it off.  There are four main pillars for an effective weight loss program.  These include nutrition, activity, behavior modification and medications.  They are tools that complement each other and are not mutually exclusive.  Do not be reluctant or feel guilty about using safe medications for weight loss.  They make it easier to implement the lifestyle rituals for long term success.  Make it your responsibility to get informed and find a provider who knows what to do to help you.

Ife Ojugbeli, MD, MBA.