If you’ve peeked at the internet lately, you know there are all kinds of medical weight loss solutions being touted, ranging from moderately effective real medicines to absolute snake oil. And there’s a good reason for that- About 42% of American adults are now obese! And the obesity epidemic continues to grow, largely fueled by the Standard American Diet (the SAD Diet) and our overall lack of physical movement. So it’s no wonder that one of the most common requests we get is for medication to help with weight loss. Today, I want to take a look at a class of medicine that actually does work to help patients lose weight. In fact, the drugs in this class are the most effective weight loss medicines ever created! I’m talking about the GLP-1 agonists.
First, let me make something 100% crystal clear- There is no magic bullet for weight loss! While some medications can help the process along, meaningful weight loss takes dedicated, sustained, permanent lifestyle changes. There’s no substitute for healthy eating habits and regular, consistent exercise. In short, you have to put in the work to get the results!
Now, with that out of the way, let’s take a look at the GLP-1 agonists. The first medicine in this class, Byetta, hit the market in 2005. Since then, several others have become available, such as Trulicity, Victoza, Ozempic, and most recently Wegovy. All of these drugs are indicated for the treatment of Type 2 Diabetes, with the exception of Wegovy, which is the only one on this list that is officially approved for weight loss. While each of them is a little different from the others in structure or dose, they all work essentially the same way. They mimic a natural hormone produced in the human gut called glucagon-like peptide-1, or GLP-1. This hormone is produced in the body when we eat, and it has several important effects, such as boosting insulin secretion, slowing down gastric emptying, and signaling satiety in the brain. In other words, it helps control blood sugar, slows down the passage of food through the stomach, and helps tell your brain that you’re not hungry.
Those last two effects are really where the weight loss benefit comes in. These medicines slow down the emptying of your stomach, so you literally stay full longer after you eat! They also work in the brain to tell you that you’re no longer hungry, so the net effect is that you tend to eat less while taking them. Sounds great, right? It is! And it works. In fact, studies have shown an average of up to 14.9% body weight loss with GLP-1 agonists, compared with just 2.4% with placebo. No other class of medicine has shown such a dramatic weight loss effect. Add that to the fact that they are outstanding diabetes treatments and offer some protection from heart disease, and you’ve got yourself a pretty amazing class of drugs.
The GLP-1 agonists come in both oral and injectable forms, but the injectables are the most commonly prescribed ones. The older ones, like Victoza, require a daily injection, while the newer ones, like Trulicity, Ozempic, and Wegovy, are only once a week. They come in pens and are injected subcutaneously, just under the skin of the belly, using a teeny tiny needle. I know some folks have issues with needles, but these really aren’t bad.
As with anything, there are a few downsides. First and foremost is cost. These meds are expensive! If you’re paying cash price, you’ll likely be looking at $800-900 per month for the GLP-1’s, which makes them cost-prohibitive for most. Even if you have insurance, most plans won’t cover medications for weight loss, so it’s going to be tough to get these covered unless you also have Type 2 Diabetes. There are some patient assistance programs offered by the manufacturers, so you can always check with your doctor to see if you might be eligible for those. Next is the potential for GI side effects, namely nausea. Because they slow down the emptying of your stomach and keep you full longer, if you try to keep eating the same amount that you’re used to, you’re going to feel sick! The key here is that you have to learn to stop eating when you feel full. Once you’ve got that habit down, the nausea tends to disappear.
To sum it up, the GLP-1 agonists are outstanding medicines for both weight loss and Type 2 Diabetes. If you’re struggling to lose weight, it’s definitely worth talking with your doctor about this option. But always remember- There’s no substitute for a clean, healthy lifestyle!
-Kyle Adams, MD
Dr. Adams practices Family Medicine at Auburn Direct Primary Care. He is actively accepting new patients, and we would love to have you join the ADPC family. If you’re ready to get started, click Here to enroll with us now!
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