What to know about prescription drugs promising weight loss

My physician prescribed Ozempic, as I am elderly and arthritic, and have a hard time exercising. It has only been a few weeks, but I notice a decrease in appetite, and already have shed a few pounds. It would be wonderful if it works.

I was more referring to the part about the body's efforts to 'maintain body mass,' rather than hunger.

But the text you quoted explicitly mention the increase of hunger as the mechanism to maintain body mass.

 The body needs to burn a certain amount of calories just to stay alive (there's a reason there is a daily required caloric intake) and it's ridiculous to say that it'll stop using that energy just because you are eating a little less. By that logic, no one would lose any weight, ever.

Nobody in the article said such a thing, the experts clearly say the reactions involve saving energy AND increasing the appetite to ensure a higher caloric intake. You are criticizing the expets in the article for saying somethng they never did.

I am saying the quoted text is a total overstatement.

That is the consensus of the medical specialists involved in treatment of nutrition, metabolism, endocrinology problems. What evidence do you have that they are wrong in the responses of the body and how they are responsible for the frequent failure of lifestyle changing measures?

Is it dependency or gluttony? I would love to eat a Big Mac and drink a giant coke every day but I don't. I take responsibility for my health and wellness.

That would apply the same for every other dependency, and the experts clearly say it is not as simple as just having not enough strenght of will. For people who do not drink it is very easy to think alcoholism is just people choosing to drink uncontrollably, that is not what the disease is and weight loss in now considered similar in the way that some people are simply at a huge disadvantage and can't keep a different life style because of many different factors including their own physiological processes. Saying "it is as easy as just eating less" is precisely what let the problem become as important as it is right now.

That attitude is part of the problem. You're simply swapping one dependency for another.

The experts clearly disagree with you, pretending everybody can achieve the same results with the same amount of effort is not a useful approach, and the current understanding is that the "solution" you propose is not realistic nor useful.

If you stop dieting and exercising, you gain weight again. But some people are advocating for a lifetime of weekly injections, rather than eating salads and going for walks.

Just ignore those "some people" and instead listen to the experts, that say that for some patients (that have special difficulties to follow changes in lifestyle because of many different factors) the drugs can help them stick to eating salads and going for walks without being in constant torture from hunger.

Not "rather" than changes in lifestyle but on top of them, so they can persist with them.

I guess we are reading it differently. I see it as two separate things, or else the author would have used 'in order to,' rather than 'and.' ("to increase hunger and maintain body mass.) In fact, you emended it yourself: as the mechanism to.

Why would that be the case? no expert is saying what you are shoosing to read, so why would this one be different? The obvious interpretation is that the reactions he is talking about are those that he is clearly mentioning.

See above. It is a common, but debunked, belief that your body enters what is known as "survival mode" when you restrict caloric intake through dieting. It seems, to me, that the doctor has bought the disproven theory.

Again, the only one talking about "survival mode" what the experts in the article are talking about is the well characterized fatigue and increase in hunger that explain the failure of lifestyle changes in many patients. You can refute all you want your strawman, but unless you can prove the doctors are wrong in what they are actually saying then the only rational option is to accept they are right even if you believed something different.

Because it is not true for everybody

And the drugs are not meant for everybody, once again you are making a claim nobody else is making, the text clearly says this is a situation that happen for some of the patients, not for the general population, and those are the patients that would benefit from the treatment.

I drank A LOT at college and for years after. Now I have a beer or two on non- 'school nights' and none on school nights. It's not a disease, I just drank less.

Sorry but your badly characterized, uncontrolled N=1 study is not even a microscopic fragment of the evidence you need to prove the specialist are wrong in considering adictions a disease for a lot of patients. Generalizing from your personal case only means you don't actually have the evidence to refute the scientific consensus so you have to use an invalid generalization, in a way recognizing you don't have an argument. Just an irrelevant appeal to your own authority without the evidence to support that appeal.

But you are saying that for some people it's impossible to lose weight because they feel hungry.

Again, not me, the scientific and medical consensus (as easy to confirm as just reading what the different organizations of medical professionals have to say about the topic) and no, not impossible just incredibly more difficult than for other people, which explain the failure that comes from just telling them to try harder as you do.

Again, your personal case do not represent everybody else, either you have epidemiological evidence that can contradict the consensus or accept that other people can have a different physiology so they can do easily what you find impossible and vice versa.

You read it the same way as I did, hence your emendment to fit your argument. Your body doesn't simply "maintain body mass" when you start to diet. It uses reserves for energy. Hunger is a separate issue,

That is the point where your argument stops making sense, you are refuting a point only you are making, the article says the problem is letargy and hunger as a reaction to caloric restriction. So instead of arguing against what the experts are saying you are arguing against what only comes from your own assumptions. In short, you have successfully refuted a wrong opinion only you came with, but have done nothing with what the experts in the article are talking about.

Fair enough, I'll take everybody who has ever had a drink and not become an alcoholic as my evidence.

As evidence of what? that you can't refute the fact that alcoholism is considered a disease by the experts in the field that have a much more valid appeal to authority on it?

Sure. Just telling someone to do anything doesn't guarantee that they will. They actually have to do it. Until now, I guess, when they don't even have to try, they just take a weekly drug that stops them from wanting to eat. Win!

Again, since you choose to repeat only your personal opinion without offering any evidence that the experts are wrong when they contradict you you are accepting you are the one in the wrong. And no, it is explicitly mentioned in the article that the first attempt of treatment is lifestyle changes, which are enough for many of the patients, but are realistically impossible for others, which lead to failure that is not corrected just by telling them to try harder, because that does not work for addictions.

The addiction is a disease idea is an excuse for laziness and indiscipline.

No, that is just your personal opinion that can be proved wrong by the experts and their data on thousands over thousands of patients. Weight Watchers are not the experts in the field that contradict your personal belief, so it is irrelevant what they say. Experts in metabolism, endocrinology, nutrition, etc. are simply much more likely than nameless people in the internet to be correct, and just repeating that they must be wrong because you have to be right is not an argument against their expertise, it is just not being able to accept that people can know and understand a problem much better than you.

Not all people are overweight from overeating and under-exercising. I became overweight in my post-cancer period. Low cal diet and exercise. After 4 years losing some weight but not enough. But I won't be taking any drugs.

It doesn't mention lethargy, it does mention hunger, and it also mentions 'maintain body mass' as a separate issue, one which I am saying is close enough to not being a real thing that it makes no difference.

Which is again something you have not proved, hunger as a mechanism to maintain body mass is an argument you have not refuted. What you believe has no relevance when it is confronted with the evidence actual experts have to disprove those beliefs. You can repeat them as much as you want, that do not make them less of a personal and irrational belief.

There is nothing incorrect with the quoted text, at least nothing that you can prove as incorrect, you just claim it is, which obviously is not an argument.

Where? Again, I suspect you've misread or misunderstood the article.

In the article it is mentioned clearly

These new medications could be an effective part of a multifaceted approach to weight loss

So are the primary sources with the results of the clinical trials

https://www.novomedlink.com/obesity/products/treatments/wegovy/efficacy-safety/clinical-trial-1-results.html

At this point you are the only one that says the drugs replace the changes in lifestyle and do it based on absolutlye nothing, the same as every other "argument" you have used. Those are still personal beliefs that are clearly contradicted by the experts in the field and the data that guide their conclusions.

Uh oh. Don't tell their 3.5 million subscribers that Weight Watchers don't know anything about weight watching.

Again making false arguments? the actual argument is that the experts that contradict your personal belief are not Weight Watchers but the best specialists on scientific fields related to health and weight. You have yet to provide any actual argument against those valid authorities, pretending Weight Watchers are the ones contradicting you is not an argument, is another strawman.

Because the article didn't make that argument. You did. And I agreed with you. But because you couldn't accept your comprehension error, we are still discussing this.

You claimed that the body do not maintain body mass when diet begins, this is one of the baseless claims you keep making without supporting it with anything else that your supposed authority, which of course does not exist. You agreed only with your own misrepresentation which still makes no sense and it is contradicted by the experts including in the article.

As to the article, in my first post I said, "While I wouldn't go so far as to say that 'survival mode' is a myth, it only really occurs in extreme circumstances such as malnutrition or severely (unhealthily) restricting calories over the long term." Neither of which are a problem for obese people.

Which again is irrelevant to the article so there is no point in making this claim in relation to it. The content of the article is clear and disproves many of your baseless claims, including that it is all reduced to will power and that the experts explanations about why measures fail are just excuses, once again all based on nothing but that you want to believe it so.

Does not equal, "And no, it is explicitly mentioned in the article that the first attempt of treatment is lifestyle changes, which are enough for many of the patients, but are realistically impossible for others, which lead to failure that is not corrected just by telling them to try harder, because that does not work for addictions." Not even close.

There is no other way to interpret this as that the drug come only as part of the treatment, which obviously means it has to include those things that you baselessly claim are not even considered.

So not in the article we are discussing. Thanks.

This still makes it wrong to assume the measures are not being used, you are not justifying your baselesss assumption, you are just trying to explain why you mistakenly did it by not reading the primary sources that are the basis for the artcile.

The first three paragraphs do exactly that:

Not at all, They are mentioning WW as interested in adquiring the drugs, in no part of your quote say the drugs are replacing anything.

These aren't patients being prescribed anti-obesity drugs by doctors. They're not even approved yet. These are people looking for an easy solution.

What you failed to prove is that they are getting this easy solution, or that anybody is saying this is one.

Why are you assuming that in that study, the drugs come on top of other measures? Where does it say that?

The link to the article has been provided already, and the recomendations and following of the patients is described, there is no assumption except the mistaken one you made, other people can simply read the description and confirm there is no group that only had the drugs as the therapeutic option used.

Most people suffer from metabolic syndrome which in most case people don't even realize they have it. If you suffer from a fatty liver good luck weight loss. Also in the presence of insulin (a fat storing hormone not just a hormone to shuttle glucose and nutrients into cells) makes it nearly impossible to burn stored fats (lipids). keto diet does wonders for weight loss but make sure your not a a diabetic to begin with and your medically fit to go on a keto diet as it has the potential to do harm. Always consult a doctor before attempting a weight loss program/strategy for your safety.

I forgot to mention many also suffer from insulin resistance which is another factor that makes you gain weight easily.

No, the focus of the article is about losing weight. The first sentence describes how WeightWatchers bought a company that prescribes anti-obesity drugs.

At no point the description of the treatment of the patients say they exclusively lose weight, in fact they are described as undergoing other medical interventions that also improve their health. At no point there is a description of a patient that would be only prescribed drugs without the rest of the measures, it is even explicitly described only as a part of the tools necessary to reach the purpose.

Exactly--that is not only the medical consensus by the experts, it is also common sense.

Which is included in the article, the only one assuming the contrary are those with an antiscientific bias that pretend this is the case without proving it first.

I think Dr. Louis Aronne is trying to sell more drugs. The equation is simple and always has been: Fewer calories in, more calories out.

The biological reactions that explain the difficulty of losing weight do not depend on breaking the laws of physics, your own quoted text clearly explains they increase hunger, making it realistically impossible for the person to keep the lifestyle changes.

Other forms of physical dependency have equivalent reactions, it is not like a drug addict's body learns how to produce the drug itself, but that the reactions lead the person to consume the drugs even after it becomes clear to him they are a negative influence in his life.

For some people it is easy to defeat the hunger and lethargy that come from those biological responses, but for many it is not a real possibility and the lifestyle changes end up in failure, telling them they are failing without giving them an alternative to that failure gives no benefit. For those people just saying "try harder" is as useful as saying it to a drug addict or alcoholic.

But I'm still curious about how these people feel and their overall health.

As long as you can recognize that blindly assuming the drug is replacing something instead of complementing it was completely wrong.

And I still feel very strongly that through exercise and diet, if done properly, obese people can effectively lose weight and greatly improve their overall health and fitness, without the need to regularly inject something that can cause "thyroid tumors, cancer, inflammation of the pancreas, kidney and gallbladder and eye problems."

This is again a baseless assumption you are making that the measures are not being done properly, the whole point is that for some people there is no realistic way to make the intervention effective for many different factors, so a drug that can support that intervention can lower the risks for their health even if it has some risks of its own.

Obviously a doctor seeing the patient will be the one making that determination.

My point is that we should not only focus on weight

Which is not what the article is about as demonstrated by the patients being subjected to measures to improve their general health AND losing weight, which is improved pharmacologically.

Not only does the article not talk about the effects of these drugs on the patients' health and fitness,

Yes it does, weight is the main health problem that these people have, and since they are also changing their lifestyle (facilitated by the pharmacological help if necessary) it is easy to understand this will have a positive effect on their health. The article also explicitly talks about the risk of the drugs, which is also an effect on the patients health.

My other point is that one should make every effort to find a qualified and honest doctor, not someone that just wants to prescribe expensive drugs...

Which is not what is being described in the article, with all the patients being subjected to other measures and the drugs being explicitly called a help in conjunction with those measures. The only one assuming any doctor would just prescribe those drugs is you.

I'm curious about how these people feel. Does simply reducing weight without exercise and improved diet provide much benefit?

Here you are assuming something not written on the article nor in the clinical trials it mention, the patients are already in life changing measures, drugs come on top of other measures, not replacing them.

Wow, since 2020 a number of very safe meds suddenly became strictly forbidden simply because they were generic. But these weight loss meds are very profitable so...

That is still a claim that is completely false, the drugs that you keep tryingto push (ivermectin and HCQI were forbidden because they provided no benefit against covid and instead only increased risks for the patients, stopping the unethical use of these drugs that are worse than useless is something anybody should support.

Yes, in the typical programs, but if one really knows what they are doing, they can effectively lose weight and greatly improve overall health.

But as the article clearly argue, they do not work for all patients, or even a majority of them. And since the drugs are used together with them (and not replacing them as the antiscientific propaganda like to misrepresent) there is no disadvantage on this aspect.

There is no assumption being made. There is a hypothetical question being posed.

The question do assume something, it is not hypothetical since it uses no conditional, it is not "how would these people feel if they had their weight reduced without exercise" it claims this is the case, which is completely false, the people are subjected to other measures.

And it is a question that science is interested in. The medical experts also ask the same question.

Where? there is no source where professionals asking how people feel about something that do not happen, can you quote where this supposed interest is expressed? because neither this article nor the primary sources even make that point.

Relevance is given to such question as is clearly articulated with this quote from the article:

“My hope is that they do their due diligence and have real monitoring of the patients taking the drugs,” she said.

That makes no sense, the quote clearly says the person is interested on doctors acting professionally, in no way it expresses interest on how people "would" feel about getting results without any other lifestyle change, mostly because that is not what the patients being treated are doing.

There are side effects. If the drug is stopped people gain weight again.

Very informative and complete article that hopefully will correct the deep misunderstanding of many commenters here that for some reason believe these are being promoted by the health experts as side effect free drugs that get you slim without any exercise or care in your diet.

The position of the health care professionals is that these drugs can help as part of the many different measures necessary to control weight, not as a blanket replacement of everything else.

In a clinical trial, adults who took Wegovy saw a mean weight loss of nearly 35 pounds, or about 15% of their initial body weight. Adolescents lost about 16% of their body weight.

I'm curious about how these people feel. Does simply reducing weight without exercise and improved diet provide much benefit?

Other possible side effects include thyroid tumors, cancer, inflammation of the pancreas, kidney and gallbladder and eye problems.

Wow, since 2020 a number of very safe meds suddenly became strictly forbidden simply because they were generic. But these weight loss meds are very profitable so...

In a typical weight-loss program where participants rely only on diet and exercise, about a third of people enrolled will lose 5% or more of their body weight

Yes, in the typical programs, but if one really knows what they are doing, they can effectively lose weight and greatly improve overall health.

I'm curious about how these people feel. Does simply reducing weight without exercise and improved diet provide much benefit?

Here you are assuming something not written on the article nor in the clinical trials it mention, the patients are already in life changing measures, drugs come on top of other measures, not replacing them.

Why are you assuming that in that study, the drugs come on top of other measures? Where does it say that?

A doctor did mention that "these new medications could be an effective part of a multifaceted approach to weight loss". But it does not mention anything about other measures or facets in the study.

Indeed, the trial was done "in conjunction with a reduced-calorie diet and increased physical activity". But I'm still curious about how these people feel and their overall health.

And I still feel very strongly that through exercise and diet, if done properly, obese people can effectively lose weight and greatly improve their overall health and fitness, without the need to regularly inject something that can cause "thyroid tumors, cancer, inflammation of the pancreas, kidney and gallbladder and eye problems."

My point is that we should not only focus on weight, but rather on overall health and fitness. Not only does the article not talk about the effects of these drugs on the patients' health and fitness, but they bring up important side effects that suggest their overall health and fitness might not have improved, just their weight.

Obviously a doctor seeing the patient will be the one making that determination.

My other point is that one should make every effort to find a qualified and honest doctor, not someone that just wants to prescribe expensive drugs...

I'm curious about how these people feel. Does simply reducing weight without exercise and improved diet provide much benefit?

Here you are assuming something not written on the article nor in the clinical trials it mention, the patients are already in life changing measures, drugs come on top of other measures, not replacing them.

There is no assumption being made. There is a hypothetical question being posed.

And it is a question that science is interested in. The medical experts also ask the same question.

Relevance is given to such question as is clearly articulated with this quote from the article:

“My hope is that they do their due diligence and have real monitoring of the patients taking the drugs,” she said.