Ozempic-like drugs aren’t making the progress for which doctors had hoped
By Deborah Jeanne Sergeant
Shortly after the FDA approved medications like Ozempic, Wegovy and Zepbound, obesity rates began to decrease as these weight loss medications helped patients drop pounds.
The medication works by helping patients feel satisfied sooner so they eat less.
More recently, obesity rates are on the rise, according to physician Wendy Scinta, medical director of Fayetteville-based Medical Weight loss of New York and founder of BOUNCE pediatric obesity program.
“What’s happening is everyone is trying to get on GLP-1s but the abandonment rate is 50% at one year,” Scinta said. “We see people start to change and improve their health but either they’re not being used appropriately or the side effects aren’t being dealt with. They may not have a nutrition plan and lack muscle mass.
“I don’t think we’re going to see a massive reduction in the obesity epidemic with just these prescriptions unless we have appropriate physicians writing them. We’re starting to see obesity doctors like myself are taking charge and combining not just GLP-1 but exercise, behavior and nutrition plan to help that person.”
In addition, obesity medication had not been prescribed to the right patient cohort. For people with a BMI of 40 or more, the medication isn’t as effective. Those who have a lower BMI and who can tolerate the medication’s possible effects of gastrointestinal upset, diarrhea, vomiting, constipation and pain, do well.
The long-term cost for the medication is much higher than bariatric surgery. Most people take Wegovy or Zepbound for life to maintain weight loss, costing up to $1,000 monthly out-of-pocket, but bariatric surgery’s effects can last indefinitely.
Physician Kenneth Cooper practices at the Center for Weight Loss & Surgery at Oswego Health. He said that the lack of weight loss medication has hampered progress in reducing obesity.
“Supply chain availability of weight loss medications would help it make inroads,” Cooper said. “The medication companies struggled with production as demand exploded. We had an inability to prescribe it in the past year. Both companies have invested billions around the world to increase production. For all of my 20 years of weight loss career, weight loss surgery was the only effective treatment, but these medications have shown tremendous promise with obesity epidemic.”
Cooper added that surgery is also helpful, but medication is a better fit for some people, such as older adults, people who are ill and those who have had weight loss surgery but need additional help.
In addition to using weight loss medication, Cooper’s patients work with dietitians to develop a healthful eating plan and learn about how activity can help them lose weight.
“The first step is having the conversation with your doctor,” Cooper said. “You can’t treat a disease until you start talking about it. There are steps we can take to do something about it.”
He blames stigma about the condition and lack of awareness that patients can seek medical treatment.
Physician Jordana Gilman, board certified in women’s health and assistant professor of clinical OB-GYN with Highland Hospital, cautioned that women who have not been ovulating may begin once they start taking weight loss medications.
“They may be surprised that their periods will become more regular and their fertility will increase,” Gilman said. “If you become pregnant, you should stop the medication and let your doctor know.”