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Weight Loss Injectables

Weight loss injectables have exploded in popularity. While a healthy nutrition plan, exercise and behavioral modifications remain the cornerstone of weight loss and weight management, these medications can be another tool to help treat those with obesity. Pharmacotherapy is extremely individualized and frequent assessments are needed to yield maximum results, provide accountability and to monitor safety and efficacy. Here’s what you need to know about injectables and how to maintain a healthy weight long term.

Obesity is defined as an “abnormal or excessive fat accumulation that presents a risk to health” according to the World Health Organization. This disease affects more than one-third of U.S. adults. Causes include the complex relationship between genetics, the environment and many other factors. Obesity can decrease one’s lifespan by up to eight years and is linked to 236 other diseases, 13 of which are cancers. Current treatment for obesity includes behavioral and nutrition interventions with or without pharmacotherapy or surgery.

Factors that can play into obesity

Genetics may play a role in becoming overweight or obese. Studies involving twins and adoption have revealed the heritability of body mass index (BMI) between 40% and 70%. Some genetic mutations have been discovered over the years and are starting to be treated in the pediatric population. Keep in mind, having genes that may predispose one to obesity does not translate to inevitably developing it.

Poor nutritional habits are another contributing factor. Examples are excess intakes of low nutrient dense foods—refined carbohydrates and high amounts of saturated fats. Abnormalities in different pathways of the body that involve hormones such as insulin resistance can cause the body to not process sugar properly.
Environmental aspects such as family, culture and where you live may impact the development of obesity.
Certain classes of medications can be associated with weight gain such as antidepressants, steroids, contraceptives and medications for treatment of diabetes, high blood pressure, migraines, seizures, bi-polar disorder, allergies, insomnia and more.
Sleeping less than seven hours or more than nine hours may also increase the risk for obesity.

Lack of regular physical activity also plays a role.

Types of weight loss injectables

Harvard Health reported many cardiologists are recognizing the best way to assist in treating other chronic diseases, such as cardiovascular disease, is to treat obesity. Some of the weight loss injectables are FDA-approved to treat diabetes. For example, Semaglutide is approved to treat people with diabetes and weight loss and is marketed as Ozempic and Wegovy respectively. These two medications act similarly to hormones naturally created in the gut and brain and trigger the pancreas to release insulin when blood sugars are elevated. They also slow gastric emptying and target brain receptors involved in reducing appetite. These drugs have been shown to assist people in losing up to 20% of their body weight compared to past anti-obesity medications only assisting in 5-8% weight loss.

Tirzepatide is also an FDA-approved medication to treat people with diabetes and is marketed as Mounjaro. It is expected to be approved for weight loss in 2023.

Another option approved to treat weight loss is Liraglutide, which is marketed as Saxenda and Victoza.

Weight loss injectables can cost as much as $1,000-1,500 per month for those whose insurance does not cover it. Currently Medicare does not cover these for obesity alone.

Who are these medications intended for?

People with diabetes who are overweight, especially those at high risk for heart disease
People without diabetes with a BMI of 30 or higher, or a BMI of 27 or higher with at least one weight-related health problem such as high blood pressure or high cholesterol

If a person meets these label indications, weight loss injectables may assist in successfully losing weight by increasing adherence to behavior change. Thus, lead to improving physical fitness whereas beforehand they could not easily participate. However, these medications do not change the science of weight regulation and are not a “quick fix” to losing weight. They are meant for long-term use. If treated like another fad diet or weight loss trend, they will most likely be just that. Once stopped, gradual weight re-gain has been observed.

Studies also do not support the use of weight loss injectables by those who are able to lose weight through behavior and lifestyle changes such as nutrition and exercise alone.

Behaviors associated with weight regain

Eating too many ultra processed foods (soft drinks, cakes, cookies, chips, fast food, etc.)
Eating big portions
Skipping meals
Dining out frequently
Frequently drinking high calorie beverages
Consuming too much alcohol
Eating for emotional reasons
Eating in front of a screen such as a mobile device or television

Working with a registered dietitian nutritionist who is specialized in obesity and weight management can assist with tolerance to these therapies by developing a nutrition plan and guiding behavior changes that will assist in long-term success. In some cases, weight loss is limited without lifestyle and behavior changes in conjunction with using these medications. Combining the two has been shown to maximize their potential. The most successful weight loss plans combine sustainable nutrition, exercise and behavioral therapy.

How to successfully lose and maintain a healthier weight

Everyone’s nutrition plan should be unique and designed to fit their lifestyle. Working with a dietitian can help you identify healthy habits realistic for you. For example:

Decreasing the number of sweets per week
Reducing or omitting fried food
Eating out less often
Replacing old habits with new ones such as walking outside versus reaching for a snack when needing to de-stress.

Throughout your weight loss plan, a registered dietitian nutritionist can also ensure you are meeting important nutrient goals such as daily protein intake which supports lean muscle mass and a healthy metabolism.

Cooper Weight Loss is a six-month, medically-experienced weight loss program. The program emphasizes nutrition, psychology, behavior change and fitness for a comprehensive, sustainable weight loss approach. To learn more, visit cooperweightloss.com. To schedule a one-on-one consultation with a Cooper Clinic registered dietitian nutritionist, visit cooperclinicnutrition.com or call 972.560.2655.

Article provided by Carli Davis, RDN, LD, CNSC, and Cooper Clinic Nutrition.