Hey, Health Coach: Are Weight Loss Medicines Safe?

How are you doing, Health Coach?

A few of my close friends have recently started taking one of the new weight loss medications available by prescription. Both of them are self-medicating, but one of them is administering shots to herself while the other takes pills. I need to get rid of at least 40 or 50 pounds, but I’ve tried so many different quick fixes for weight loss that they’ve all let me down. What kind of research went into the development of these new drugs? Are they reliable and do they function properly?

Dear One Who Is Hoping That There Is a Magic Pill,

I am appreciative of the manner in which you are approaching this matter. Weight carries so much undue societal pressure. Many people find it to be an emotionally charged subject, and as you pointed out, the inquiry of “how to lose weight” can lead to a wide variety of information and approaches that are unclear or intentionally deceptive.

My role as a health coach requires me to assist individuals in the implementation of lifestyle, behavioral, or clinical support systems that they determine (in conversation with their health care providers or other caregivers) will contribute to their overall health and well-being. Because I share your skepticism regarding new treatments’ potential for long-term efficacy and safety, I believe that the most prudent way forward for us is to rely on the established body of scientific knowledge and research, while also maintaining an open dialogue with seasoned professionals.

Since we are discussing prescription medications for weight loss in this particular context, your primary care physician is the best person to consult with in order to find out which, if any, of the newly available choices are suitable for you. Having said that, I do get this question a lot, and because of that, I’ll do my best to explain what these new drugs are and how safe and effective they seem to be.

Wegovy

Wegovy was granted approval by the Food and Drug Administration (FDA) as a weight loss aid in the year 2021. It’s an injectable medication called semaglutide, and it’s the same active ingredient that’s in Ozempic, which got FDA approval in 2017 to treat type 2 diabetes. Both of these treatments require an injection once per week, which can typically be given at home.

According to the Food and Drug Administration, Wegovy imitates a hormone that focuses on regions of the brain that control appetite and the amount of food that is consumed. This causes users to feel fuller more quickly. It should not be used in conjunction with any other weight loss medications, whether they are prescribed or purchased over the counter. People with a body mass index (BMI) of 30 or higher, as well as people with a BMI of 27 or higher who also have an additional health risk such as heart disease, high cholesterol, or high blood pressure, are eligible to take Wegovy.

Semaglutide has been shown to be effective for weight loss when combined with a calorie-controlled diet and regular physical activity. People who took semaglutide in a study that lasted for 68 weeks and included nearly 2,000 participants lost an average of 34 pounds, while those in the control group only lost 5 pounds [1]. The study was published in the New England Journal of Medicine.

On the other hand, semaglutide is associated with a long list of potential adverse effects, the most common of which include nausea, diarrhea, constipation, headache, and fatigue. According to the clinical trial, these adverse effects typically disappeared over the course of the study. There is an increased risk of developing thyroid cancer, pancreatitis, gallbladder problems, kidney disease, and suicidal thoughts when taking this medication, all of which are cautioned against in the product packaging.

Wegovy has been confirmed to be safe for long-term use by Harvard Health, and researchers are currently in the process of designing a study to investigate the medication’s potential long-term effects on the risk of cardiovascular disease and stroke in patients who are overweight or obese.

Although it is true that Wegovy assists a significant number of individuals in achieving their weight loss goals, the treatment does call for regular injections and is associated with a sizeable risk of adverse effects.

Mounjaro

Tirzepatide is the name of a different drug that is known as Mounjaro. The FDA has only granted approval for its use in the treatment of type 2 diabetes as of October 2022. However, in a phase three trial involving 1,879 people with type 2 diabetes, this drug showed even more significant results for weight loss than Wegovy. Depending on the dosage, patients taking this drug lost an additional 5 to 12 pounds more than patients taking Wegovy. Instead of acting on just one receptor, it suppresses appetite and stabilizes blood sugar by acting on two distinct receptors simultaneously.

In addition, Mounjaro is given to patients through once-weekly injections. Mounjaro has side effects that are comparable to those of Wegovy, despite the fact that the comparative study that was published in the New England Journal of Medicine and discussed previously found that serious adverse events were reported in 5% to 7% of participants who received Mounjaro as opposed to 3% of those who received Wegovy.

This medication has been shown to be effective in the treatment of type 2 diabetes. In addition, some medical professionals are recommending it for weight loss, despite the fact that this use of the drug has not been formally approved by the Food and Drug Administration (FDA).

Plenity

Plenity, which is manufactured by biotherapeutics company Gelesis, is the most recent weight loss pill that I am aware of and is available only with a doctor’s prescription. Other weight loss pills are available. Plenity is a superabsorbent hydrogel pill that was approved in 2019 for use by people with a body mass index (BMI) of 25 or higher. The pill expands in the stomach when combined with food and water, resulting in a greater feeling of fullness and satiety.

Participants in a study involving 436 adults who were either overweight or obese were told to exercise for half an hour every day and to reduce the number of calories they consumed by 300 compared to their estimated daily energy needs. The group that took Plenity experienced a reduction of 6.4% of their body weight, while the placebo group experienced a reduction of 4.4% of their body weight. Diarrhea, constipation, nausea, and flatulence were the most common side effects experienced by both groups. Neither group was spared from experiencing a distended abdomen.

Other prescription weight loss medications that can be taken orally include Xenical, Qsymia, and Contrave, as stated by the National Institutes of Health.

And What About Your Diet and Workout Routine?

According to the website of Gelesis, its hydrogels are “designed to mimic some of the effects of eating raw vegetables.” This raises the obvious question: Why not just consume a greater quantity of raw vegetables to achieve the same goal? In general, eating more vegetables is a good idea, but unfortunately, life isn’t always that easy. Some people do not have access to fresh produce, and others simply do not have the bandwidth or ability to change ingrained habits without additional support. Both of these factors make it difficult for some people to make healthier choices.

It is possible for people’s health care providers to decide that these treatments are the best way to reduce the likelihood of serious health complications for patients who are experiencing significant concerns about their health. It is up to the patients to decide what to do with the information they have been given.

Everyone has the right to decide for themselves, free from the scrutiny or repercussions of others, which medical treatments they will undergo and when they will opt out of receiving care.

Some individuals will continue to take these medications for several months while they make changes to their eating habits and fitness routines. Others will continue to take them indefinitely, and many will opt to make changes to their behavior and lifestyle without the support of a medical professional.

No matter what you decide, physical activity and proper nutrition are necessary components of a healthy lifestyle, and even modest adjustments can result in significant improvements. In point of fact, studies have shown that simply increasing the amount of time you spend walking at a moderate intensity for fifteen minutes per day can add three years to your life expectancy, and this is just one example.

If you would like more information about how to build healthy habits beyond the scope of these medications, you can read my previous column titled “Hey, Health Coach,” which can be found here. How Can I Make Sure I Don’t Get Sidetracked from My Goals?

It is important to note that the “Hey, Health Coach” app is only intended to provide information and is not intended to replace professional psychological or medical advice, diagnosis, or treatment. If you have any questions regarding your personal circumstances, health, or medical condition, you should always consult with your primary care physician or another qualified healthcare provider.