Are Weight Loss Drugs the Miracle Cure for Obesity?

Drug companies think they might have a miracle cure for obesity.

The new “craze” in weight management are type 2 diabetes drugs called Semaglutides, like Ozempic.

Celebrities and the ultra-rich started using the drug to lose weight, and now it has seeped into mainstream culture.

Studies have shown positive signs that this drug, historically used for diabetes treatment, can help people lose weight.

But is it safe, and should you consider taking these medications?

More Research Needed

From a medical perspective, CHRISTUS Health focuses on treatments that have been medically shown to work for long periods, said Dr. Jerome Schrapps, a CHRISTUS Health bariatric surgeon in Beaumont, Texas.

A 68-week study was concluded in 2021 and showed positive results for people with obesity using these drugs.

Although a 5-year study has yet to be done to show long-term results, Dr. Schrapps sees potential positives for using Ozempic, a Semaglutide.

“We need to know what happens if you take a Semaglutide like Ozempic for a couple of years, and then you're off it for two or three years. What does that five-year result look like?” Schrapps said. “We need to evaluate results as longer-term studies become available, but the initial results certainly show promise.”

Comparing Semaglutides to Bariatric Surgery

The 2021 study found that individuals using Ozempic experienced an average weight loss of 15% or 33 pounds within a year.

The study specifically examined people with an average BMI of 37 and included those with BMI as low as 27 if they had obesity-related comorbidities like hypertension.

However, comparing different bariatric surgeries is like comparing apples to oranges, Dr. Schrapps said.

Gastric bypass was found to have the best results, with an average of 30% weight loss five years after surgery. Sleeve gastrectomy, the most common bariatric surgery, resulted in an 18-20% weight loss in five years.

Dr. Schrapps predicts that for people with a BMI of 40 or less, there could be a choice between sleeve gastrectomy and Ozempic in the future.

However, he suggests that individual goals and circumstances must be considered.

Cost Analysis

The retail cost of an Ozempic prescription without insurance coverage is around $1,300 per month. Insurance companies are not allowing coverage for weight loss since the drugs are prescribed for diabetes patients.

The drug requires an injection once a week, and the long-term implications of such frequent doses are also still under examination.

These findings underscore the need to consider long-term health and financial implications when deciding between weight loss treatments.

Known Side Effects

According to the study, the most common side effects of drugs like Ozempic were nausea and diarrhea.

Around 35 to 40% of patients experienced these side effects to some degree, and about 5% of participants had to withdraw from the study because of the severity of these side effects.

Multi-Modality Treatment for Obesity

Dr. Schrapps said he already prescribes medications for obesity. New medications on the market are not the issue.

The underlying issue of a promising new medication is how everyone views obesity treatment. The way American culture views the treatment of obesity “pigeonholes” everyone into accepting only a few treatment options.

As a global problem and pervasive disease, this might be an opportunity to change how the public views treatment options for obesity.

With cancer, the public and medical community have accepted many different methods or modalities for treatment.

“When we treat cancer, we use multi-modality therapy,” Schrapps said. “We use surgery, we use chemotherapy, we use radiation, we use hormonal therapy, we use meditation, we use multi-modality therapy, and it is completely accepted by everyone that it's what's best for the patient.”

Regardless of taking only medication or seeking bariatric surgery, if a patient doesn’t make behavioral modifications and supportive medical staff, then symptoms of obesity will return.

Even if this is a “miracle drug” taken without changing behavior, early indications state that you would need to take it for the rest of your life. That would be an expensive alternative with a monthly price tag of $900 to $1,300.

“What we should be doing is following the cancer model and using multi-modality therapy, Schrapps said. “So I think if you're a bariatric surgeon who doesn't prescribe medication, you're not doing the best that you can for your patients.”

Comprehensive Care is What Treats Obesity

Comprehensive care is already in place for those undergoing bariatric surgery at certified centers. This care includes dietitian visits, follow-up appointments, and mental health evaluations.

Comprehensive care is integral to any weight loss process in all certified centers.

Behavior modification is a set of techniques to help people adjust their thoughts and actions to achieve a desired outcome.

Before and after surgery, behavior modification can help patients adjust their activities, diet, lifestyle, and other habits that may affect their recovery.

This could include eating more nutritious meals, using relaxation techniques to reduce stress, or avoiding activities that could cause complications. By adjusting behavior and habits, patients can improve the rate at which they heal and recover from surgery.

Additionally, behavior modification can help with weight management after surgery and address any issues that may arise due to lifestyle changes. Ultimately, behavior modification is a great tool for helping people adjust to life after surgery and is an important part of recovery.

A Long-Term Approach Works Best

Patients looking to lose weight should consult their doctor and a nutritionist before starting any diet or exercise regimen. Most obesity is diet-related, so it's important to understand one's diet and consider realistic goals.

Quick fixes are generally not sustainable and do not lead to long-term success in weight loss. Taking a long-term approach to weight loss is often the best option.

The Future of Comprehensive Care for Obesity

Dr. Matias Nauts, a bariatric surgeon in Lake Charles, Louisiana, said Semaglutides drugs do have promise. But they are not miracle drugs for obesity.

“You're not going to take this and have a six-pack in a year,” Dr. Nauts said.

Once more research is completed, he sees the bariatric world using it to help patients start losing weight, especially patients who are very obese.

The medication will act as a bridge into surgery.

“The smaller the patient is, the easier the surgery will be from a technical standpoint,” Nauts said. “So trying to get them to lose 50 pounds before we get the surgery will be helpful.”

How to Find a Physician Who Can Help with Obesity

Best way to find a program or physician who can help you with comprehensive care for obesity:

• Find a doctor that is certified in obesity.
• Receive proper education from the physician prescribing any medication.
• Some pharmacies create medications with fillers, so make sure you're getting the real drug.
• Find a doctor who focuses on comprehensive care for obesity.
• Find a weight-loss program focusing on mental health, behavioral changes and nutrition.