Tropical Weight Loss
Tropical Weight Loss
Photo: Tima Miroshnichenko
Indeed, weight gain after discontinuing the drugs is a concern; studies have found that two-thirds of patients gained the weight back after they stopped taking Wegovy.
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Read More »A new class of weight-loss drugs is giving some patients with obesity new hope that they’ll be able to lose excess pounds and improve their health without experiencing the dangerous side effects of older medications. But despite mounting evidence that the drugs are both safe and effective, doctors say relatively few of the country’s millions of eligible patients are taking them. “This drug is something that transforms lives for some people,” said Thomas Wadden, the director of Penn Medicine’s weight and eating disorders program in Philadelphia. But, he said, “I don’t think any of these weight-loss medications are being prescribed as much as they should be.” More than 70 percent of adults in the U.S. are overweight or obese, according to the Centers for Disease Control and Prevention. Obesity can lead to a variety of other medical conditions, including high blood pressure and cholesterol, Type 2 diabetes and stroke. The drugs mimic a hormone produced in the gut called GLP-1, which tells the pancreas to secrete more insulin to control blood sugar. They’re not new to medicine; they’ve been used to treat Type 2 diabetes for years. But when doctors noticed that patients also lost weight, drugmakers got on board, offering the medications in higher dosages specifically to treat obesity. It’s still unclear exactly how the drugs help with weight loss. Wadden said they seem to slow down stomach-emptying so people stop eating sooner and feel full longer. It’s also believed that the drugs target certain receptors in the brain that affect appetite. “It may be acting upon areas of reward in the brain,” Wadden said. So patients may eat less frequently for pure pleasure, which he calls “hedonic eating.” So far, two of the new drugs, both from drugmaker Novo Nordisk, have been approved by the Food and Drug Administration. Saxenda was approved in 2020. The most recent, Wegovy, was approved last year for patients with body mass indexes of 30 or greater or those with BMIs of 27 or greater plus at least one weight-related condition. Studies found the weekly self-injectable helped patients lose, on average, about 15 percent of their body weight over 16 months, making it twice as effective as older weight-loss drugs already on the market, such as Qsymia. A newer GLP-1 medication called tirzepatide, also a weekly injectable, appears to be even more effective. A study published last week in the New England Journal of Medicine found it helped patients lose more than 20 percent of their weight over 72 weeks. The medications do come with side effects. Most commonly, patients complained of nausea, vomiting, diarrhea and stomach pain.
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Read More »It took three weeks for her pharmacy to fill her prescription because of the drug shortages. Once she started it, however, she felt an immediate change. “One of the things I’ve always dealt with was a constant hunger in the back of your mind,” Drobnes said. “It’s always there. It went away. It allows you to focus on being a human being.” “One of the things I’ve always dealt with was a constant hunger in the back of your mind,” she said. “It’s always there. It went away. It allows you to focus on being a human being.” She lost 7 pounds in the first month, more than she’d lost after weeks working with a nutritionist, a wellness coach and a workout partner. But when it was time to get her monthly refill, the pharmacy told her the drug was on back order and that it was unclear when it would get it in again. She called dozens of pharmacies in the Philadelphia area, where she lives. None of them had the medication. Novo Nordisk says in a statement on its website that the company expects the supply of Wegovy to stabilize later this year. That doesn’t offer much comfort to Drobnes. “I feel as though without the Wegovy, I’m losing my lifeline,” she said. “I finally allowed myself to start picturing a happier and healthier me, but now that picture is slipping away.” Indeed, weight gain after discontinuing the drugs is a concern; studies have found that two-thirds of patients gained the weight back after they stopped taking Wegovy. But obesity experts disagree about how long a patient should stay on the drugs. Li, of UCLA, said more research is needed before the drugs are prescribed for the long term. Others, like Wadden and Butsch, argue that if obesity were treated like a chronic disease, like high blood pressure or diabetes, staying on the drugs for years wouldn’t be an issue. Li does prescribe the drugs for some of her patients but only after other lifestyle changes and treatments have failed. “This is a cane that’s going to help you walk,” she said. “But you’re going to have to do the walk yourself.” For Edwards, of Philadelphia, the “cane” changed her life. She’s in another clinical trial for a pill form of Wegovy, which she hopes will be more affordable. Since she started the study in November, she has lost 45 pounds.
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