Obesity in the United States has been steadily incr
easing and is now at 41.9% according to the 2020 National Health and Nutrition Examination Survey. Obesity related conditions include heart disease, stroke, diabetes, cancer, liver disease, PCOS, and joint pain to name a few. It is a serious and chronic disease and is affected by genetics, environmental factors, and biology. It therefore requires a multifactorial treatment approach. Beyond diet and exercise the use of medications plays an important role in the treatment of obesity.
Medications like GLP-1 Agonists (more commonly known by the brand names of Wegovy, Saxenda, Ozempic, Rybelsus) have been found to be more effective than previous weight loss medications. These GLP-1 medications improve sugar control by increasing insulin production and decreasing glucagon which results in slower gastric emptying. It also accesses parts of the brain that are important for appetite regulation and may help diminish cravings. This all leads to increased sensation of fullness, reduced appetite, and lastly weight loss. The average weight loss varies from each individual and medication tolerance. Patients on Wegovy can have an average 16% weight loss.
Chronic weight loss medications like Contrave and Qysmia are medications that were found to have significant weight loss when combined together. Contrave combines naltrexone- a medication that is used to block the effect of pain medicine or alcohol with bupropion – an antidepressant. Together it curbs craving, decreases hunger and appetite. The average weight loss on contrave is 8%. Qysmia combines phentermine- an appetite suppressant and stimulant with topiramate- an anti-seizure medication. This medication works on the areas of the brain that can decrease appetite, increase energy levels, and increase the sensation of being full. The average weight loss is 6%.
Appetite suppressants like phentermine (Adipex) and diethylpropion (Tenuate) work to decrease hunger and cravings. Average weight loss can be 3-5%.
All weight loss medications should be coupled with a healthy diet and routine physical activity. Treatment for obesity is complex and medications can be a useful tool but shouldn’t be the only tool.