Why Experts Are Now Recommending Weight Loss Medications in Addition to Lifestyle Changes

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Experts say diet and exercise alone may not be enough for long-term weight loss. Anchiy/Getty Images
  • The American Gastroenterological Association has released new guidelines recommending prescription medication along with lifestyle changes to treat obesity.
  • Officials at the association say diet and exercise alone may not be enough to achieve long-term weight loss.
  • Experts say childhood obesity, chronic inflammation, and food addiction are some of the factors that inhibit the long-term success of lifestyle changes.

Medication could be an important item that’s missing from your weight loss plan.

Four recently approved medications for treating obesity are now being recommended by the American Gastroenterological Association in addition to lifestyle changes.

Officials at the association say the medications, when used alongside other lifestyle changes including diet and exercise, are showing results more effective than lifestyle changes alone.

How much more effective?

A study done in conjunction with the recommendations reported these weight loss reductions by body weight percentage when compared to a control group.

  • Semaglutide (Wegovy🙂 10%
  • Phentermine-topiramate ER (Qsymia): 8%
  • Liraglutide (Saxenda): 4%
  • Naltrexone-Bupropion ER (Contrave): 3%

Dr. Eduardo Grunvald, a study author and the medical director of the weight management program at UCSan Diego Health, explained in a press release that these medications work by treating a biological disease, not lifestyle issues.

Obesity rates in the United States have increased over the past 20 years from 30% to nearly 42%, leading to health complications, according to the study authors.

“Using medications as an option to assist with weight loss can improve weight-related complications like joint pain, diabetes, fatty liver, and hypertension,” Grunvald said.

Limitations of lifestyle changes

Dr. Amy Lee, the chief medical officer at Lindora Weight Loss and Wellness Clinics in Southern California, told Healthline there are many factors that affect the way people lose weight.

“From my experience, diet and exercise alone may not be enough,” she said.

Lee explains there are several other factors that can play a role in making weight loss difficult.

Here are some of the most common factors she says she’s come across in her work.

Childhood obesity

Lee says if someone grew up overweight since their childhood, their metabolic foundation has already set them up for a more difficult weight loss journey in their adulthood.

Chronic inflammation

Inflammation is an underlying condition of health that could be related to one being overweight or it could be associated with an unrelated medical condition that keeps the body in a state of inflammation, Lee says.

“Conditions such as diabetes, chronic pain, arthritis, insomnia (just to name a few) can be very inflammatory, which can change the way the body stores fuel and fat,” she explains.

Hormonal changes related to age

Lee said that hormone disruptions that occur as our bodies age can directly impact our metabolism.

The changes could be “as straightforward” as sex hormone decreases related to female menopause or male andropause.

“But other hormones that could be disrupted include thyroid hormones which play a role in metabolism as well,” Lee said.

Impact of the increase in technology

“As more and more people depend on technology, the complication could be one becoming more sedentary which results in less activity and increase in complacency, boredom, and effects of mental health,” Lee said.

“People can become more tired and unmotivated in general to stay on a weight loss program or even to go out to do things,” she added.

The role of food addiction

Joan Ifland, Ph.D., FACN, the chief executive officer of Food Addiction Reset LLC, tells Healthline the “primary reason people cannot lose weight is that we live in an obesogenic culture.”

Ifland says that in modern culture, processed foods are everywhere and we are surrounded by addiction stimulation, says Dr. Ifland.

“Processed foods act on the brain like drugs of abuse leading to loss of control over impulses,” she says. “In the absence of impulse control, people eat them helplessly. Diet and exercise don’t correct this.”

In addition, Ifland says weight loss programs might actually make the addiction worse by restricting calories, which wakes up the fear-of-famine food-seeking impulses in the brain.

What to consider about medication for treating obesity

You’re not alone if lifestyle changes just aren’t working for long-term weight loss.

Lee says that “medications are not for all people, but if it does help, then one should embrace it.”

Here are some of her recommendations when considering medication to treat obesity.

Ask questions

Knowing what you’re taking is critical to your wellness journey.

“Patients should understand which classes of medications are available and be well-informed on potential side effects and contraindications,” says Lee.

“These are all prescription medications, so one must sit down with their medical provider to go over the details of each option,” she notes.

For example, says Lee, “some of the medications are purely stimulants and others could help with altering the way we metabolize food.”

Remain realistic

Ifland adds that no single medication can cure a processed food addiction that could be contributing to obesity.

Ifland adds there are other things to also consider:

  • As soon as the medication is discontinued, the weight comes back.
  • Side effects may be serious so medications cannot be continued indefinitely.
  • Insurance companies may not pay for weight-loss medications indefinitely.
  • The actual weight loss might be small in comparison to the discomfort of the side effects of the medication.

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