Using Weight-Loss Medicines as a Tool to Treat Obesity

While weight-loss medicines are nothing new, they’re a hotter topic than ever before. That’s thanks to a new generation of medications that come with fewer side effects and bigger results.

“We can almost think of it as a new era of obesity management,” says Angela Magdaleno, DO, an endocrinologist and weight management specialist at Lehigh Valley Health Network (LVHN). “The GLP-1 agonists have sparked this new excitement and revolutionized the space of weight-loss medicines.”

GLP-1 agonists were first approved by the FDA in the mid-2000s, and they most often come in injectable form. They were initially developed to treat diabetes.

Some have also been shown to help with weight loss, including:

• Liraglutide
• Semaglutide
• Tirzepatide

While they are not free from side effects – including nausea, headaches and diarrhea – they are generally better tolerated than other weight-loss medicines.

The GLP-1 agonists are more effective at promoting weight loss due to a three-pronged approach: They slow down the rate at which food leaves the stomach so the person feels physically full for longer, they send signals to the brain that reduce feelings of hunger, and they keep blood sugar levels in balance.

It’s important to keep in mind that while weight-loss medications can be helpful in managing obesity, they are not an answer alone.

“There’s no quick fix, there’s no magic pill, and there’s nothing that can overcome the three pillars of weight management: nutrition, exercise and behavior change,” Dr. Magdaleno says.

Without those pillars in place, people risk losing too much muscle when they’re really trying to reduce body fat. This can be unhealthy, and they can potentially damage their metabolism.

If you’re considering prescribing a weight-loss medicine, be sure to share that this could be long term.

“What we know from studies is that when we stop a medicine, we do tend to see weight regain,” Dr. Magdaleno says.

This may be acceptable for some people, especially if it allows them to quit taking a host of medications for blood pressure, cholesterol and related issues. Others may not want to commit to taking a medicine indefinitely.

Dr. Magdaleno says referring someone to the LVHN bariatric medicine program makes sense “when a patient is motivated to lose weight and interested in having extra support and guidance from a multidisciplinary team.” Team members include doctors, nurse practitioners, behavioral health therapists, registered dietitians and lifestyle coordinators working together in innovative ways.

Dr. Magdaleno predicts that there are many exciting medicines in the pipeline – but cautions that they are only one tool.

“The pillars are still critical,” she says. “Nutrition, exercise, behavior change first, then adjunctive medications when appropriate.”