Nowadays, everywhere we look, there is talk of once-a-week injectable medications, obtained through various means, in order to lose weight. Conversations regarding weight loss and invariably about once-weekly slimming injections or pills have become dinner table conversations.
The opinions can vary on “how come you are not on Ozempic, Mounjaro, Wegovy, etc., etc.”, to “How can you take these toxic medications given the concerns over side effects?”
The narrative seems to spin out of control and patients present more confused than ever.
Sometimes patients tell me stories like, “My friend’s cousin lost seventy pounds, eighty pounds, etc. how come I am not losing any weight?” Sometimes patients have perfectly well-controlled diabetes and they would like to try a different medication to try to get more weight loss.
The true answer to all this chaos and conundrum is this. Every mind-blowing story of weight loss success has a before and after.
Let’s take the case of this said person who lost seventy-eighty pounds:
- Were they always obese or something caused the weight gain (like immobilization due to injury etc..)
- What is their diet and what dietary modifications have been undertaken?
- How much do they exercise?
- What’s their weight history, family history and genetics?
- What is the Job profile and demands of work and social life?
- Do they have diabetes? What is their degree of insulin resistance?
- Are they on any meds that worsen weight gain?
- What’s the age of the patient and their relative muscle mass and basal metabolic rate?
- Is this weight loss healthy? Was their recent infection or hospitalization?
- What’s the cardiac health status of the patient?
- What is their risk of not loosing weight? (are they overall healthy or have A1c of 10!)
- is there a component of depression or acute grief?
- Is there component of eating disorder or substance abuse?
These are just a few questions that come to my mind when I hear these stories. Every time an endocrinologist writes a prescription, he or she is doing risk benefit assessment, considering risk of side effects, thinking about long term benefits and then deciding the medications after discussing his or her assessment with you.
What is also important to understand, that whoever loses this kind of weight, do they have tools to maintain the said weight loss? The tools can involve motivation, diet strategies, exercise support and strategies or even ongoing pharmacotherapy under medical supervision.
I want patients to see that while our weight is important, it’s not the be all and end all when it comes to our health. It is important to talk to your Endocrinologist, who will consider all above mentioned factors and more and address your weight concerns, in context of your overall health. It is also important to realize, taking care of one’s metabolic health is like running a marathon and not a short-term sprint. Here at PBDES, we are invested in your long-term health and outcomes and we will address your concerns in caring, compassionate and scientific manner.