At first glance, the new oral and injectable weight-loss drugs sweeping the developed world appear to be the long-sought answer to the growing overweight and obesity crisis. As a physician with over 40 years of experience with patients and their diseases, I am convinced that these drugs are not the best approach to this problem, except in specific cases.
To understand the scope of the problem itself, we need to look at the facts. In our country, the prevalence of overweight or obesity (defined as BMI >25 and 30, respectively) approaches 75%. In the 1960s, the average weight of an adult male in the United States was 166 pounds. Today, that figure is £200. One in three American adults has prediabetes, and 80% of them don't know they have diabetes.
Ultra-processed foods, which make up about 58% of our diet, put us on the path to chronic disease and disability. Add to this a population that is more sedentary than ever before in history, putting people at risk for developing chronic cardiovascular, autoimmune, joint, respiratory, sleep-related, neoplastic (cancer) and other diseases. The number of people with high This is putting a severe strain on an already overburdened healthcare system. Within the next 10 years, there will be more people in this country over the age of 65 than there are under 18. These older, sicker Americans will suffer even more from the impending shortage of doctors, nurses, and other health care workers, and as we continue to pour money into this problem (in the federal budget) (about 20% annually is spent on health care), the situation will worsen. Eventually it becomes unsustainable.
Yet, we cling to drugs instead of making lifestyle changes to resolve our illnesses. 20% of Americans are taking five or more of their prescription drugs, and 85% are taking at least one prescription drug. We are people who have received high doses.
Now that certain oral and injectable medications have been proven to quickly and dramatically reduce weight in many patients, people can't seem to get enough of them. But do we really know the long-term effects of these substances? What does the science show?
These new drugs, including Jardiance (empagliflozin), Monjauro (tirzepatide), Ozempic, and Wigovy (both semaglutide), were originally designed to help people with type 2 diabetes and associated comorbidities (comorbidities). it was done. But then things got really hot for them when doctors started using them off-label to lose weight. Patients cried out for them, whether they weighed 15 pounds or 150 pounds. And therein lies the problem.
In patients who are significantly overweight and have concomitant cardiovascular disease, these drugs have been shown to be beneficial, and the New England study found that cardiovascular-related deaths were reduced when patients took the drugs. – Proven in a November paper in the Journal of Medicine. Comparison of semaglutide and placebo.
But for patients looking to lose small or moderate amounts of weight, is it really worth the risk found in a recent study published in October in the Journal of the American Medical Association from the University of British Columbia? There are also reports that this has happened. GLP-1 agonists (Monjauro and Zepbound belong to this class) are associated with a 9-fold higher incidence of pancreatitis, a more than 4-fold higher risk of intestinal obstruction, and a 4-fold higher risk of intestinal obstruction (gastroparesis) when compared to body weight. paralysis) is associated with a 3.67 times higher risk. Loss treatment bupropion and naltrexone.
Additionally, these agents' costs can reach approximately $1,200 per month and are often not covered by insurance. This is combined with the fact that many patients have to continue taking the drug indefinitely, as the weight simply comes back when the drug is stopped.
Unless we change our culture in how we eat, how we use (or don't use) our bodies, and how we approach medicine to correct bad habits, we will never have an impact on poor health. Despite spending more money on health care than many other Western European countries combined, calculations that will shock many in the near future due to upcoming doctor and nurse shortages and skyrocketing health care costs. we will be forced to.
Dr. David Sherer (www.drdavidsherer.com) is a retired physician and author. His latest book is Hunger Hijack, How Your Eating Habits are Changing Your Brain and Making You Sick (Armin Lear Press, April 2024).
