What You Need To Know Before Starting Weight Loss Medications

Table of Contents

Individual Response to Weight Loss Medications
Long Term Use of Weight Loss Medications
Drug Costs
Route and Frequency of Administration
Side Effects of Weight Loss Medications
Availability of the Weight Loss Medication
Directions for Use
References

In the world of health and wellness, weight loss medications still reside at the top of the list of methods to optimize weight loss. Weight loss medications, also known as anti-obesity drugs, have become powerful pharmaceutical solutions designed to help people in their efforts to lose weight effectively. These medications work through various complex mechanisms, including reducing appetite, altering how the body absorbs nutrients, and boosting metabolic processes.

While the usage of weight loss medications can lead to more significant weight loss compared to lifestyle changes alone, it is imperative that they are employed in conjunction with a healthy diet and exercise plan. These medications are not a standalone solution, but rather a complementary tool in the journey towards achieving and maintaining a healthy weight.

Before you think about trying weight loss medications, it’s important to take a moment and think things through. These anti-obesity drugs can be helpful on your journey to a healthier weight, but you need to be aware of what they can do and what the possible risks might be. It’s worth noting that weight loss medications may not be the best path for all patients.

The choice to explore these options should be guided by individual factors, including medical history, preferences, specific weight loss goals, and out of pocket expenses. Seeking the expertise of a comprehensive weight loss program can provide invaluable guidance and support, ensuring that the chosen approach aligns with an individual’s unique needs and circumstances. Let’s discuss key considerations before starting weight loss medications!

Individual Response to Weight Loss Medications

Different individuals may respond differently to weight loss medications, and their effectiveness can vary. Clinical studies often present data indicating the percentage of patients who achieve a weight loss of ≥5% or ≥10% of their initial body weight. However, it’s crucial to understand that these statistics do not guarantee that you will necessarily reach the upper limit of weight loss. Weight loss outcomes are influenced by various factors, including individual differences in metabolism, lifestyle, and adherence to treatment.

For example, let’s review the data provided on semaglutide (Wegovy)¹ The percentage of weight loss found in clinical studies is provided as follows:

83% of adults taking Wegovy^® lost 5% or more weight, compared to 31% taking placebo.

What this tells you is that of all the participants in the study, 83 out of 100 people lost at least 5% body weight, whereas 27 out of 100 did not meet this threshold. Compared to the placebo group (no medication), only 31 out of 100 lost at least 5% of body weight.

66% of adults taking Wegovy^® lost 10% or more weight, compared to 12% taking placebo.

66 out of 100 adults lost at least 10% of their weight.

48% of adults taking Wegovy^® lost 15% or more weight, compared to 5% taking placebo.

48 out of 100 adults lost at least 15% of their weight.

30% of people taking Wegovy^® lost 20% or more weight, compared to 2% of people taking placebo, in a supportive measure.

30 out of 100 people lost at least 20% of their weight.

So that you better understand, placebo is a substance or treatment that has no therapeutic effect but is used in medical research or clinical practice. It is often used in controlled experiments, such as clinical trials, to compare the effects of a real treatment with the psychological or physiological effects of an inactive substance.

The main point to remember is that individuals had different weight loss outcomes, and some didn’t lose any weight at all. The results varied because of personal factors, why most manufacturers have the disclaimer “Individual results may vary” below the weight loss results. Additionally, it’s crucial to understand that weight loss medications aren’t magic solutions. To see the best results, they need to be used alongside a reduced diet plan and an increase in physical activity.

Another question to consider is, “What amount of weight do I need to lose to achieve a normal body mass index (BMI)?” Can you realistically achieve the weight you want and need to lose with the medication? This is where a comprehensive weight management program becomes key! To gain a deeper understanding of BMI and explore normal ranges, visit Dr. Eric Velazquez’s Page. You will find two methods of calculating your BMI in the article.

Let’s consider this example:

Jane currently weighs 300 lbs with a height of 5’5, resulting in a BMI of 49.9 (considered outside the Normal BMI Range of 18.5-24.9). If she incorporates Ozempic into her routine and achieves a 20% reduction in body weight, approximately 60 lbs, her final weight would be approximately 240 lbs, resulting in a new BMI of 39.9.

For Jane to reach a BMI within the normal range, she would need to weigh around 149 lbs, requiring a loss of 151 lbs. This example aims to offer insights into estimating potential weight loss with a specific medication. It’s important to note that, in some cases, patients may experience additional benefits from these medications, making their use even more advantageous. Your healthcare provider can provide personalized guidance based on your unique health considerations and goals.

Long Term Use of Weight Loss Medications

Weight loss attained through medication might not be lasting, requiring individuals to either sustain the treatment or embrace enduring lifestyle adjustments to uphold their achievements. Over time, some individuals might encounter diminished responsiveness to weight loss medications, influencing their overall effectiveness. It’s crucial to highlight that stopping the use of most of these medications has been linked to a phenomenon termed ‘rebound weight gain.’ This implies that individuals who discontinue these medications might undergo a regain of weight, emphasizing the significance of adopting long-term strategies for maintaining weight in a sustainable manner, extending beyond the period of medication usage.

The STEP 1 study² found that one year after withdrawal of once-weekly subcutaneous semaglutide 2.4 mg (also known as Wegovy) and lifestyle intervention, participants regained two-thirds of their prior weight loss. This underscores the importance of recognizing the potential for weight regain once the medication and intervention are no longer in effect. The study’s outcomes emphasize the need for a sustained, long-term approach to weight management, indicating that simply relying on the medication and intervention without ongoing efforts may result in a substantial portion of the lost weight being regained over time.

Drug Costs

The long-term costs of weight loss medications should be a significant consideration. While these medications may provide short-term benefits in terms of weight reduction and potential health improvements, individuals should be aware of the ongoing financial commitment. Many weight loss medications are not typically covered by insurance plans, which means that individuals may need to bear the full cost of their prescriptions over an extended period. Monthly drug costs can range from $40 out of pocket for Adipex to roughly $1500 for the new GLP-1 Agonists, Wegovy and Saxenda.

Additionally, factors such as potential side effects or the need for periodic medical check-ups can contribute to the overall expenses associated with weight loss medications. Therefore, individuals should carefully assess the financial implications and consider them as part of their long-term weight management strategy.

Route and Frequency of Administration

The choice of formulation for weight loss medications is of utmost importance. Different formulations, such as oral pills, extended-release options, and injectables, come with varying levels of convenience and dosing frequency. Consider liraglutide and semaglutide as examples, both requiring subcutaneous administration. Liraglutide entails daily dosing, whereas semaglutide provides the convenience of a weekly regimen. When consulting with your physician, it’s crucial to evaluate your comfort level with injections, taking into account the potential benefits these medications could offer in supporting your weight loss journey.

Side Effects of Weight Loss Medications

Weight loss medications carry potential side effects, and in this conversation, we will explore the similarities and differences among the latest weight loss medications approved by the Food and Drug Administration (FDA).

Phentermine, phentermine/topiramate ER, naltrexone/bupropion SR, liraglutide, and semaglutide share common side effects such as constipation, diarrhea, dizziness, dry mouth, headache, nausea, and vomiting.

Noteworthy differences include:

Phentermine is associated with difficulty sleeping, so it’s advisable to avoid taking it close to bedtime.
Liraglutide and semaglutide can lower blood glucose through their unique mechanisms of action, and both medications may lead to fatigue and abdominal pain. A recent study³ revealed a rare but heightened risk of pancreatitis, gastroparesis, and bowel obstruction with GLP-1 agonists for weight loss compared to the naltrexone/bupropion SR combination.

Orlistat’s side effect profile stands out due to its impact on fat absorption. Common side effects encompass oily spotting on underwear, gas, fatty or oily stool, frequent bowel movements, and occasionally, difficulty controlling bowel movements. Due to reduced absorption of fat-soluble vitamins (A, D, and E) and beta-carotene, a daily multivitamin is strongly recommended when using orlistat.

The consideration of weight loss medications involves a thoughtful evaluation of potential side effects. It is crucial for individuals to be aware of these distinctions, including the potential impact on sleep with phentermine, the blood glucose effects and associated risks with liraglutide and semaglutide, and the unique fat absorption-related side effects with orlistat. Understanding these side effects allows for informed discussions with healthcare professionals to tailor weight loss strategies effectively, considering both the benefits and potential drawbacks of each medication.

Availability of the Weight Loss Medication

One of the biggest considerations, “Is the medication commercially available?” Meaning, can the medication be obtained from a state licensed pharmacy. As I scroll through social media or drive into the parking lot for my regular Target visit, I can’t help but notice the widespread “get your weight loss medication from us” ads from various companies. These advertisements are everywhere, playing a substantial role in the financial success of these businesses. While some of these self-proclaimed “Pharmacies” may be trustworthy, others can be misleading. My aim in sharing this information is to provide you with the knowledge necessary to distinguish between reputable and misleading companies, empowering you to make informed decisions on your weight loss journey.

According to the FDA, patients are advised NOT to use a compounded drug when an approved alternative is commercially available. In specific medical scenarios, certain conditions may necessitate the use of compounded medications. However, there is a noticeable misuse or overuse of this pharmaceutical service and there needs to be more clarity for the general public.

Compounded versions of drugs are NOT reviewed for safety, effectiveness, or quality by the agency. The FDA permits the compounding of medications when they are added to the “drug shortage list.” Even when a medication is listed, there are restrictions on how it should be compounded. To qualify for compounding Under Section 503A of the FD&C Act, a medication must satisfy the following criteria:

comply with an applicable United States Pharmacopeia (USP) or National Formulary (NF) monograph if one exists, and the USP chapter on pharmacy compounding;
are components of FDA-approved drug products if an applicable USP or NF monograph does not exist; or
Appear on the 503A Bulks List published by the FDA if such a monograph does not exist and the substance is not a component of an FDA-approved drug product.

Please note: If a company claims to be an outsourcing facility they compound under section 503B of the FD&C act and to verify they are registered with the FDA click here.

Why is all this so concerning? Recent reports have shown an uptick in adverse events following the use of compounded semaglutide, a GLP-1 Agonist and weight loss medication. Patients should be aware that some products sold as ‘semaglutide’ may not contain the same active ingredient as FDA-approved semaglutide products and may be the salt formulations. These specific salts have NOT been shown to be safe and effective.⁴

If it is absolutely necessary to acquire a compounded version of a medication online, it is advisable to utilize BeSafeRx, an online campaign that educates users on how to safely purchase prescription medications over the internet.

Other ways to verify an online pharmacy are through the National Association of Boards of Pharmacy and Safe Meds Online. I have provided the direct links to verify the online pharmacies on both platforms.

Also, other tips to consider provided by the Alliance of Pharmacy Compounding include:

Do NOT purchase a compounded medication from a pharmacy:

If you do not have a legitimate prescription for a compounded medication from a licensed prescriber; and
You cannot verify that the seller is a licensed U.S. pharmacy.

Questions to ask about the compounding pharmacy and also to verify online through your state board of pharmacy website:

Name of the compounding pharmacy?
Where it’s located?
Is it licensed to dispense in or ship to your state?

One additional step, I personally as a pharmacist would take, is asking the compounding pharmacist to show you a Certificate of Analysis. This is a thorough scientific report that will allow you to verify the identity of the medication being dispensed to you. Also, if the facility is an outsourcing facility, you can verify they are registered with the FDA here.

Directions for Use

6 Considerations Before Starting a Weight Loss Medication

In conclusion, starting on a journey with weight loss medications demands careful consideration of various factors. From understanding the potential side effects to recognizing the need for long-term strategies, each element plays a crucial role in shaping your path to a healthier weight. As you contemplate these considerations, remember that open communication with a healthcare professional is paramount. They serve as your guide, ensuring that your approach to weight management is not just effective but tailored to your unique needs. Depending on the amount of weight necessary to achieve your goal BMI, you may even be a better candidate for bariatric surgery.

🚀 Pass the pin and let’s elevate health together! 📌💚

The essential point to grasp is having knowledge and understanding of the available options, enabling you to make an informed decision. It’s not just about losing weight; it’s about adopting a sustainable lifestyle that aligns with your well-being. So, with these considerations in mind, take confident steps toward achieving a healthier, well-rounded you.

Make sure you follow and subscribe below to receive my ’12 Essential Steps Before Starting a Weight Loss Medication.’ This will put you on our email list for my next article “The Best Tips to Identify a Fake Semaglutide Injection.”

What are your biggest challenges in your weight loss journey? I would love to hear from you directly or in the comments!

References

Wegovy.com. Medication Guide; c2017; [August 2022; November 2023]. https://www.novo-pi.com/wegovy.pdf#guide.
↩︎
Wilding, JPH, Batterham, RL, Davies, M, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022; 24(8): 1553-1564. doi:10.1111/dom.14725 ↩︎
Sodhi M, Rezaeianzadeh R, Kezouh A, Etminan M. Risk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss. JAMA. 2023;330(18):1795–1797. doi:10.1001/jama.2023.19574 ↩︎
FDA.gov. Medications Containing Semaglutide Marketed for Type 2 Diabetes or Weight Loss. c2023. [October 2023; November 2023]. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss. ↩︎

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