Weight Loss Drugs: Are They Right for You? (video/podcast)

“These drugs were formatted as both diabetes medications as well as weight-loss versions,” says Dr. Harris. “It’s usually based on BMI and other medical conditions.”

BMI stands for body mass index, which is calculated based on an individual’s height and weight. Someone with a BMI higher than 30, which is considered obese, would qualify for the drugs based on BMI alone. Someone whose BMI is 27 or above may qualify if they also have a weight-related medical condition, such as diabetes, high blood pressure, sleep apnea, or acid reflux.

“Most people with diabetes would qualify for the medication, and definitely people 50 to 100 pounds overweight may qualify. Some people who are struggling with 30 pounds of extra body weight may qualify,” says Dr. Harris. “Discussing realistic results is also important because people who are trying to lose 100 or 200 pounds may actually do better with something like weight-loss surgery.”

Unlike some weight-loss drugs, these medications are not stimulating, so they don’t usually interact with blood pressure medications; in fact, they can lower blood pressure. However, there are people who should not use them, including women who are pregnant, breastfeeding, or trying to get pregnant and people with a history of pancreatitis or medullary thyroid cancer.

Additionally, these drugs are not recommended for someone who wants to lose just 10 to 20 pounds. The FDA does not support weight-loss medication for people with a BMI below 27. Nor will insurance cover the drugs, which can be expensive, for people who don’t have a medical need for them.

Like most medications, these weight-loss drugs have pros and cons. When used consistently, they do cause considerable weight loss over time and can help stabilize blood sugar levels in people with diabetes. However, they require a lifetime commitment; studies have shown if the medication helps you lose weight and then you stop taking it, the weight almost always comes back.

“These are chronic medications, just like if you were to take a blood pressure medication for years,” says Dr. Harris. “So we do anticipate people will be on this medication or some other form of weight-loss medication, whether injectable or pill form, probably for decades if not the rest of their lives.”

Weight-loss drug side effects are another concern. Because the drugs slow the rate at which the stomach empties, food can remain in the stomach considerably longer. This can lead to stomach-related side effects like nausea, vomiting, bloating, or constipation, because the gut is moving much more slowly than normal. These side effects tend to get better over time, but should you increase the dose, they can return.

Dr. Harris notes that it is important to use these weight-loss medications as a tool to help you change your diet and exercise for long-term health and weight maintenance.

“A lot of people are finding they’re able to lose weight successfully with medication without being as active. And unfortunately, that can result in a greater proportion of muscle loss than fat loss,” she says. “We don’t want people just to lose weight. We want them to be healthy; we want them to be strong.”

She encourages patients to prioritize a diet of high-quality food, high protein and vegetables, along with weight-bearing exercise, to maintain their muscle mass during the weight phase.

If you’ve tried diet and exercise to lose weight without success and you meet the BMI guidelines described earlier, consider making an appointment with your doctor to talk about whether these drugs might be a good option for you.

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