A heavy burden, a promising solution

Subscription meal plans, exercise apps, influencers promoting smoothie recipes and must-have supplements… the list of weight-loss products is endless. On a global scale, it is estimated that the weight loss industry is already worth over $280 billion, with some estimates reaching over $500 billion by 2032.¹ This comes as no surprise, however. Obesity is a significant public health issue, especially in the United States (US). More than 40% of adults in the US are considered obese, equating to over 100 million people.²

People who are obese may have additional, obesity-related medical conditions, such as type 2 diabetes, hypertension, and cardiovascular disease, as well as a higher probability of needing expensive knee and hip replacements due to the strain excessive weight has on the body. As a result, the healthcare expenditures for obesity are substantial.³˒⁴ Obese adults spend an average of $1,800 more per year on medical costs compared to adults at a healthy weight. The combined economic burden of obesity exceeds $170 billion in annual medical costs.²

Here's where prescription weight loss drugs come in. Prescription weight-loss drugs are designed to decrease excess body fat, helping individuals achieve and maintain a healthy weight.⁵ In 2017, the FDA approved Ozempic® for treating type 2 diabetes, the first once-per-week, injection formulation that also happened to cause profound weight loss.⁶ The main ingredient is semaglutide, a GLP1 receptor, that suppresses appetite, helping patients feel full and potentially lose more than 10% of their body weight.⁵˒⁷

In 2021, just after its FDA approval for chronic weight management, Ozempic® took social media by storm, popping up in everything from influencers’ Instagram tags to healthcare professionals’ TikToks. The buzz created a contagious sense of hope for obese patients and an invigorating excitement for researchers.⁸˒⁹ In 2023, orforglipron, a pill-based GLP1, made headlines for achieving weight loss results similar to Ozempic®.⁸ An oral drug is much easier to administer than an injectable one, intensifying the competition to develop the most efficient and convenient weight loss drug.

The use of GLP1s combined with lifestyle modifications – such as eating healthier and exercising – is now considered to be the most effective approach to losing weight, with the exception of bariatric surgery.³

Losing more than numbers

GLP1 medications have revolutionized weight management, but research shows that most patients stop using them after about three months. Common reasons include cost, weight loss plateaus, and unwanted side effects. To help patients navigate their weight loss journey, comprehensive management (both during and after treatment) is crucial to address the physical and psychological challenges they may encounter.¹⁰˒¹¹

It's likely that when a patient takes GLP1s, they will not only lose weight but also muscle. Even after discontinuation, it is very probable that patients who use GLP1s will regain weight after use, especially without mindful behavior changes. But weight regain does not equate to muscle mass replacement. When a patient regains weight, they not only regain fat but may also replace some of their previously lost muscle mass with fat as well. Therefore, it is essential that patients implement healthy long-term lifestyle changes.¹¹

Losing weight is challenging, but maintaining a healthy lifestyle is an even greater struggle. Even with so-called “miracle” drugs, patients often struggle to do it alone, and most prescribing physicians lack the time for extensive follow-ups. That’s where a select team of medical professionals and health and well-being coaches (HWCs) come in.¹¹

Implementing the right care

Obesity is a complex chronic disease that requires personalized care and ongoing management. Optimal treatment outcomes are achieved when a patient’s medical team includes practitioners from multiple disciplines. This includes a dietician to improve healthy eating habits, an exercise physiologist to tailor and optimize fitness programs to the patient’s needs, and an HWC who can create an inviting and nonjudgmental atmosphere by practicing active listening skills, showing compassion, and focusing on all aspects of the patient’s life.¹¹

Obesity is often tied to addictive eating habits and compulsions, and a patient may still have established, underlying addictive behavioral patterns, even if they are having success using a GLP1.¹¹ Even within just a 3-month period, HWCs specifically can have a significant impact on obese patients by teaching them how to navigate such patterns in their everyday lives. Coaching tools, including appreciative inquiry, motivational interviewing, SMART goal setting, change-scales, and mindfulness, are key to leading a patient towards healthier habits and patterns. Obesity patients who receive this holistic approach often see a shift in their self-care. In addition to overall better mental health, they establish daily routines, become better at self-regulating eating behaviors, and create a healthier living environment for both them and their families.¹¹

Leveraging technology can enhance the treatment experience by using smartphones, connected scales, and wearable devices like activity trackers to improve patient compliance and collect valuable data. This data can connect the physical and psychological effects of GLP1 treatment and be shared with the healthcare team, including the HWC, dietician, and physiologist. Through monitoring tools and collaborative intervention, healthcare providers can create a holistic treatment plan to support healthy eating habits, maintain a healthy weight, and help the patient achieve autonomy in their well-being.¹¹

While these multidisciplinary approaches are improving individual outcomes, the widespread adoption of GLP1s is reshaping the entire healthcare landscape.

Changing the landscape

Even in its infancy, the impact of GLP1s has permanently altered the landscape of weight loss and other associated medical conditions.¹⁰

As noted earlier, obesity can lead to a range of serious medical conditions. With the increasing use of GLP1 medications, the need for other obesity treatments has diminished, along with obesity-related conditions. For example, GLP1s may lower the risk of heart attack and stroke by 20%, both of which are more common in overweight patients.⁷

As a result, this could reduce the demand for treatment and lessen obesity’s overall impact on the healthcare system.¹⁰ In fact, a study from 2022 to 2023, conducted by Brigham and Women’s Hospital, for instance, found that there was a 25.6% decrease in patients undergoing metabolic bariatric surgery to treat obesity, most likely due to the fact that the use of GLP1s had doubled during that time period.¹²

Beyond reducing obesity-related procedures, GLP1s may also have far-reaching impacts on addiction and compulsive behaviors. Since GLP1s work by suppressing a patient’s appetite, it is speculated that they can also suppress activation in the brain’s reward pathways. There is significant evidence to support this theory, including that some patients taking GLP1s have reported an improvement in addictive and compulsive behaviors, including drinking alcohol, smoking, gambling, shopping excessively, and nail biting.⁷

Conclusion

The emergence of prescription weight loss drugs like GLP1s marks a pivotal moment in public health. Not only are these medications offering an innovative solution to obesity, but they are also reshaping the broader healthcare landscape. By reducing obesity-related conditions and healthcare costs, GLP1s are making a meaningful impact on long-term health outcomes. Their potential to address addictive behaviors and treat life-debilitating diseases expands their influence far beyond weight management. As research continues to uncover new therapeutic uses, the transformative power of these medications may continue to shift paradigms in healthcare, offering hope and a new path forward for millions of people battling obesity and associated conditions.

Next time you scroll past an influencer’s exercise video or see a billboard for weight management, ask yourself: are we truly ready for the next evolution in healthcare?

References:

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