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More than a third of people in the United States are classified as obese, which equates to over 60 million individuals. For those who take medication that causes weight gain due to mental or physical conditions, it is easy to accumulate enough weight to be clinically obese. Thankfully, there is a new wave of medication options available to address this issue. One such drug is Ozempic, which has gained popularity for its ability to help people lose 30 to 40 pounds quickly. Originally approved to treat diabetes, it has also been found to be highly effective for weight loss. However, the high demand for Ozempic has led to shortages, sparking debates about access and allocation.

Obesity is now recognized as a medical disorder due to its association with various health complications. While body size is often stigmatized, there is growing awareness that weight gain is a complex issue and cannot be solved simply by telling people to eat less and exercise more. Determining if someone is obese and needs medical intervention for weight loss can be done by calculating their body mass index (BMI). An individual with a BMI equal to or greater than 30 is considered obese. Online calculators exist to help determine BMI, but a general formula involves multiplying your weight in pounds or kilograms by 703, divided by your height in inches or meters squared.

It’s important to note that being obese is not as difficult as some may think. For example, an average-height American woman at five feet four inches tall would be considered obese if she weighs 174 pounds or more. Similarly, a six-foot-tall man would be classified as obese if he weighs 221 pounds or more. However, it is important to consider factors such as muscle mass and variations among different ethnic groups. While BMI is a useful general measure of health, it does have limitations.

The connection between mental health and obesity cannot be ignored. Many individuals with mental health disorders struggle with weight issues, even without the influence of medication. Conditions such as depression, insomnia, and a history of trauma can contribute to weight gain through changes in appetite, hormonal fluctuations, and increased fat storage. Furthermore, medications commonly used to treat mental health disorders, such as atypical antipsychotics and antidepressants, are known to cause weight gain. These medications often increase appetite for carbohydrates, affect glucose processing, and lead to insulin resistance. Understanding the impact of mental health on weight is crucial in providing effective treatment options.

Over the years, various medications have been developed to address obesity. One notable example is fen-phen, a combination of phentermine and fenfluramine. This drug worked by reducing appetite but was later withdrawn from the market due to severe lung and heart complications. The negative experience with fen-phen left many with reservations about using medications for weight loss. However, newer medications have emerged, such as Contrave (a combination of naltrexone and bupropion) and metformin (a diabetes drug), which have shown modest weight loss results. These drugs typically lead to a 5 to 10% reduction in body weight, which, while significant, may not be enough for some individuals.

Recent advancements have introduced a new generation of medications that specifically target weight loss. These drugs, known as glucagon-like peptide-1 receptor agonists (GLP-1s), work by reducing appetite, slowing down stomach emptying, increasing insulin secretion, and stimulating brown fat activity. Saxenda (liraglutide) and Wegovy (semaglutide) are FDA-approved GLP-1s for obesity treatment. These medications have shown remarkable weight loss results, with studies indicating a 10 to 22% reduction in body weight compared to the previous generation of drugs. Wegovy has been particularly effective, potentially surpassing other GLP-1s in terms of weight loss.

Although GLP-1s offer promising results, they do come with potential side effects. Common side effects include nausea, vomiting, diarrhea, and gastrointestinal discomfort. Rapid weight loss can also increase the risk of developing gallstones. It is important to consider potential interactions between GLP-1s and other medications, especially antidepressants and antipsychotics. Consulting with a healthcare professional is crucial to ensure the safe and appropriate use of these drugs. Additionally, individuals with liver or kidney disease may not be suitable candidates for GLP-1 medications.

The weight loss benefits of GLP-1s extend beyond shedding pounds. These medications have shown positive effects on metabolic markers such as lipid profile, glucose levels, and blood pressure. Before and during treatment, doctors should monitor these parameters to assess overall health improvements. It is important to note that GLP-1s are considered safe but should not be used without proper medical supervision. Initial blood work to evaluate liver and kidney function is essential before starting treatment.

While GLP-1s may seem like a perfect solution, there are certain considerations to keep in mind. Like any medication, there is a risk of rare but serious side effects, emphasizing the need for personalized risk-benefit assessments. Injection-based administration can also be a deterrent for some individuals, although an oral tablet form (Rybelsus) of semaglutide is available for diabetes treatment, albeit at a lower dosage. Cost is another significant barrier to treatment, as insurance coverage may require proof of medical necessity and previous attempts with other medications. The cash price for GLP-1s can range from $1,000 to $1,400 per month, and dose titration over several months is necessary. It is important to note that weight loss may occur rapidly at first, but the intended long-term use of these medications is essential for sustained results.

To maximize the benefits of GLP-1 medications, it is recommended to make significant dietary changes alongside treatment. GLP-1s can adjust appetite, making it easier to adopt healthier eating habits. Rather than focusing on calorie restriction, emphasis should be placed on consuming nutrient-rich, real food. These changes in diet can help reshape taste preferences and reduce the likelihood of reverting to carb cravings after discontinuing medication.

In conclusion, GLP-1 medications offer a promising approach to combat obesity and achieve significant weight loss. These drugs are designed to be taken long-term and provide metabolic benefits beyond shedding pounds. However, careful consideration of risks and benefits, as well as medical supervision, is crucial. While GLP-1s may not be suitable for everyone, those who qualify and are committed to making lifestyle changes can find effective support in their weight loss journey. Remember to consult a healthcare professional to determine the best course of action for your specific needs.