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Editor’s note: In “Hey, Health Coach,” Sarah Hays Coomer answers readers’ questions about the intersection between fitness and overall wellness. Do you have any questions? Send them a message (and don’t use a detective pseudonym!).
Hello, Coach,
I have some friends who are taking new prescription weight-loss medications. One of them takes pills and the other receives injections. I have 40 or 50 pounds to lose, but I’ve burned myself with so many quick weight-loss fixes. What are the studies of these new drugs? Are they safe and do they work?
– Wishing for a Magic Pill
I appreciate your technique for this problem. Weight exerts a lot of undue social pressure. This is a touching topic for many other people and as you mentioned, the topic of how to lose weight can lead to all sorts of confusing and misleading data and methods.
As a fitness trainer, my task is to help others establish lifestyle, behavioral, or clinic-like systems they discover (in communication with their physical care providers or other caregivers) that will contribute to their fitness and well-being. . Like you, I am wary of false promises and long-term protection of new treatments, so our most productive path forward is to build on existing science and studies and consult with experts along the way.
Since we’re talking about prescription weight-loss drugs here, your doctor would be the most viable resource for determining if the new features are right for you. They are the new drugs and their protection and effectiveness.
In 2021, the Food and Drug Administration approved Wegovy for weight loss. This is an injectable drug called semaglutide, the same active element in Ozempic, which was approved for the remedy of type 2 diabetes in 2017. They are given by weekly injections, usually at home.
According to the FDA, Wegovy mimics a hormone that targets areas of the brain that stimulate appetite and food intake, allowing users to feel full faster. It should not be used with other prescription weight-loss medications or over-the-counter weight loss supplements. Wegovy is approved for others with a body mass index (BMI) of 30 or higher, as well as for others with a BMI of 27 or higher, plus an additional health threat such as central disease, high cholesterol, or high blood pressure.
Research shows that with low-calorie nutrition and exercise, semaglutide can be effective for weight loss. The New England Journal of Medicine published a 68-week study of approximately 2,000 participants in which other people who took semaglutide lost an average of 34 pounds compared to five pounds in the group[1]Wilding JPH, Batterham RL, Calanna S. et al. Semaglutide once weekly in obese or obese adults. New England Journal Medicine. 2021;384:989-1002.
However, semaglutide has a long list of conceivable side effects, the most of which are nausea, diarrhea, constipation, headaches, and fatigue, among others. The clinical trial reported that those side effects became underspected over time. The drug is also accompanied by warnings about an increased threat of thyroid cancer, pancreatitis, gallbladder problems, kidney disease and suicidal thoughts.
Harvard Health confirms that Wegovy is approved for long-term use, and researchers are still conducting a study on the drug’s long-term effects on heart disease and stroke in obese and obese patients.
Overall, Wegovy is helping many other people lose weight, but this requires injections and carries a noticeable risk of side effects.
Mounjaro is another medicine called tirzepatide. As of October 2022, it is only FDA-approved for the treatment of type 2 diabetes. However, in a phase 3 trial involving another 1879 people with type 2 diabetes, this drug showed even more significant effects for weight loss than Wegovy, with patients losing five to 12 pounds more than patients taking Wegovy, depending on the dose[2]Frías JP, Davies MJ, Rosenstock J, et al. Tirzepatide instead of semaglutide once weekly in patients with type 2 diabetes. New England Journal of Medicine. 2021;38five:five03-five1five. . . It works with two other receptors to decrease appetite and stabilize blood sugar instead of just one.
Mounjaro is also given through a weekly injection. The side effects are similar to Wegovy, the comparative New England Journal of Medicine study discussed above noted that serious adverse events were reported in 5% to 7% of participants who won Mounjaro and in 3% of those who won Wegovy.
This drug has been shown to be effective in the treatment of type 2 diabetes, and some doctors prescribe it for weight loss, it is not officially approved for this purpose.
Several nutritional tablets are available by prescription, but the last one I know of is Plenity, which is manufactured through the biotherapeutic company Gelesis. Approved in 2019 for other people with a BMI of 25 or higher, Plenity is a superabsorbent hydrogel tablet that expands into the abdomen with food and water to create a greater feeling of satiety and satiety.
In a double-blind study of 436 obese or obese adults, participants were asked to exercise for 30 minutes a day and eat three hundred calories below their calculated energy needs. The placebo organization lost 4. 4% of its body weight. The side effects for the organization that took Plenity were none other than those of the placebo organization, the most common being diarrhea, bloating, constipation, nausea and flatulence. [3] Greenway FL, Aronne LJ, Raben A, et al. A randomized, double-blind, placebo-controlled study of Gelesis100: a new non-systemic oral hydrogel for weight loss. The Obesity Society. 2019; 27 (2) :205-216.
According to the National Institutes of Health, other oral prescriptions for weight loss come with Xenical, Qsymia, and Contrave.
Gelesis’ online page reports that its hydrogels are “designed to mimic some of the effects of eating raw vegetables,” which begs the question: Why not eat more raw vegetables to satiate yourself?It’s that simple. Some other people don’t have access to new products, and others simply don’t have the bandwidth or ability to replace entrenched behavior without further support.
When other people are faced with significant considerations about their fitness, their physical care providers will likely think those remedies are the best way to reduce the risk of serious fitness complications. What patients do with this information is up to them.
Everyone has the right to decide, without judgment or recrimination by others, what medical remedy he receives and when to refuse such care.
Some other people will continue to take those medications for a few months while continuing their nutrition and exercise routines. Others will remain there indefinitely, and many will decide on behavior and lifestyle changes without medical support.
Regardless of what you decide, exercise and nutrition are part of any healthy life, and small adjustments can make a big difference. In fact, studies show that walking at a moderate intensity for 15 minutes a day can increase your life expectancy for 3 years. and this is just one example[4]Wen CP, Wai JP, Tsai MK, et al. Minimal amount of physical activity to decrease mortality and prolong life expectancy: a prospective cohort study. Lancette. 2011 Oct 1;378(9798): 1244-53. . .
If you’d like to learn more about expanding healthy behavior beyond those medications, check out my previous column. Hey, Health Coach, how can I keep up with my goals?
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