Weight Loss Drugs: Are They Worth It?

Written by Michael Reavis Jr. MS, RD, LDN

It has been a very interesting start to 2023 in the world of nutrition. In 2022 as RDs we saw a lot of controversy and confusion regarding supplements, new trends in diet patterns, and so much more.

Yet, in 2023 we have already gone completely away from the talk of 2022 and what I have seen the most focus on is weight loss drugs/medications. These have been around as part of a medical weight loss treatment for years. The most common ones I used to see were orlistat, phentermine, contrave and a handful of others. 

But, there is certainly a new front runner in semaglutide or to most people known as Ozempic/Wegovy. Lately it has been discussed on multiple entertainment and health platforms, receiving national attention primarily for its use by celebrities in their weight loss journey. Many celebrities say it helped them lose weight, was part of their “anti-aging” repertoire, or helped them change their body composition in some way. 

Yet, all this “glorification” is hiding some ugly truths. First, this is a drug approved by the FDA for the treatment of obesity as of 2021. I want to stop there and focus on this, it is approved for treating obesity, NOT to drop a few pounds before summer or your next social event. And, even before this Ozempic was primarily a medication to help those with diabetes control their blood sugars. 

With so much attention on these drugs currently we are creating a scarcity that is a real issue for those who actually need the medication to sustain their lives. Secondly, no one is asking how this drug works, what it actually does to promote weight loss. For the healthy individual when you eat there are thousands of internal processes that go on. Between putting the energy from the food into the bloodstream, moving that energy into the cell, and so much more. This is where semaglutide comes in. 

The medication does three primary functions. One, it slows gastric emptying or how fast food moves throughout the body. By doing so we feel full for longer and our body does not signal us to eat as frequently. This suppression of appetite is the second main effect. Finally it encourages the pancreas to secrete insulin to improve blood sugar levels and decreases our bodies ability/need to put blood glucose from the liver into the bloodstream. This last effect being the one that individuals with diabetes really benefit from.

So why does this all matter?

Well first, these effects only work as long as you take the medication. If you stop taking the medication your hunger and appetite will kick back in and it will be very difficult to maintain any weight loss and possibly even return to a higher weight. Secondly, weight loss medications are supposed to be a TOOL, not the answer. Along with this, nutrition, exercise, improved mental health, and habit changes can lead to a longer healthier life if weight loss is NEEDED. 

Finally, just as a disclosure, something I am very passionate about as a dietitian is that weight is not the sole determinant of health. Although there are some risks that could be elevated with higher weight status there are also plenty of other measures of health. Meeting with your doctor for general physicals and blood work can really let us “see under the hood” and check our health in a different way. Another great measure is daily activity. We want to live happy and active lives with our loved ones, so your ability to do exercise and move is another great metric!

Hope you found this helpful and as always…


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