Weight management options: New weight loss medications and their positive results are a “hot topic” in the news today; but let’s revisit other effective options and consider risks and benefits.
Incredibly high costs and adverse reactions are two factors to consider
Drugmakers say that drugs such as Ozempic, Wegovy and Mounjaro can help someone lose 15% to 20% of their body weight. Given the severely detrimental effect of obesity on general health, these drugs are a great addition to our weight management options. The other effective options include bariatric surgery, medical cannabis and NeuroResearch Protocol, as well as some special diets.
We will take a look at pros and cons of these methods.
First of all, losing weight requires eating fewer calories, whatever method you use to achieve it.
Weight loss is simple accounting:
- Human fat is about 3500 cal. per pound of fat tissue.
- A human needs about 11cal per pound of weight per day to maintain their weight. E.g. a 200lb person eats about 2200 calories of food per day. If they eat more, they gain weight. If they eat less, they lose weight.
- Physical exertion will not help most people lose weight. Running a mile burns about 100cal. Running 5 miles a day for 7 days burns about a pound of weight. This amount of exercise is not practical for most obese people. Exercise is very good for your health, it will make you live longer, but it will not help you lose weight.
- To lose weight you must starve your body, so it uses its fat deposits to maintain its functions, at 11 cal. per pound of your weight per day.
The level of hunger is controlled by multiple mechanisms in our body. There are several biochemical systems at play. For example, a hormone Leptin is produced when you use your fat tissue resources to maintain body function: its level goes up, you become hungry and start looking for food, so your body can stop using its stored resources. More Leptin is also produced when you don’t sleep well and are under stress. Improving sleep and reducing stress often helps people lose weight. This is probably the reason a significant number of our medical cannabis patients lost significant amounts of weight (record case 180 lb in 2 years): they calm down, sleep better and become less hungry.
Glucagon-like peptide (GLP-1) “can inhibit postprandial gastric emptying and reduce gastric acid secretion, inhibit gastric and duodenal peristalsis by inhibiting vagus nerve, and increase the pressure of pylorus, thus reducing appetite”. Therefore, drugs that mimic its effect. Like Ozempic, Wegovy, Mounjaro and others, can make people eat less and lose weight.
Neurotransmitters Serotonin and Dopamine suppress hunger by making one satisfied with less. They also improve mood in people who are depressed and have a variety of other beneficial effects. NeuroResearch Protocol is a method we use in our weight management program to deal with hunger and allow patients to diet comfortably.
Some diets, like Atkins and keto diets, limit carbohydrate load, which reduces insulin release and help reduce hunger in many people.
And then of course there is bariatric surgery, where a part of stomach is removed or stomach’s volume is somehow reduced otherwise with devices. This causes reduction of food volume in each meal. If people can limit the number of meals they consume, their caloric intake drops and they can lose weight.
Now to pros and cons:
Will power alone: this works in about 2% of people attempting to lose weight this way. If it works for you, I take my hat off.
Atkins and keto diets: I’ve seen this work in a number of people. It is definitely an option to consider and try. If it works for you, great! You are one of the lucky few. One thing to remember: you still need to consciously work at reducing calories, as with any other method.
Bariatric surgery: it works long term for some people, but many others compensate for small stomach volume by eating more meals and regain their weight. Remember, this approach does not address the biochemical hunger controls. Then these people are obese again, and the frequent side effects of the procedure remain: nausea, abdominal discomfort, vitamin deficiencies, etc. My feeling is this should not be done until all other methods have been tried.
GLP-1 agonist drugs: This is a new and exciting method. The literature is filled with good reports. But what are the possible side effects?
Many doctors, psychologists and eating disorder experts worry these new medications, originally developed to treat diabetes, could become a problem long-term.
Common side effects of these new drugs include: nausea, diarrhea, vomiting and constipation. The drugs also come with a warning that they may increase the risk of thyroid cancer, acute pancreatitis, gallbladder disease, low blood sugar, kidney injury, damage to the eye's retina and suicidal thinking or behavior.
These side effects can be significant. And if they don’t keep taking these drugs “for life” most people are likely to regain any weight that was lost. Some psychologists have surmised that the physical and psychological toll of that rebound could be damaging.
What are the costs?
Even though demand for anti-obesity medications is expected to grow exponentially as a shortage ease and several new drugs come on the market, the drugs can still cost $1,000 a month or more per person. Because the drugs need to be taken on a “life-long basis” how many people can truly afford this? Some insurance companies are beginning to cover them for weight management since obesity can be more expensive in the long run, but this is still work in progress.
Pharmaceutical companies also are lobbying heavily to get insurers, including government-funded Medicare, to cover the cost of weight loss medications.
Health insurance typically will not cover the costs of these medications. It is estimated that 40 million of the 110 million Americans living with obesity have insurance coverage that would/may include weight loss medications.
Neuro Research Protocol (NRP) – based weight management program we offer at Life Medical helps people achieve a sustained weight loss of around 1-2 lbs. a week; heavier patients can lose even more than that. If a patient is serious about their weight management, this program along with these supplements offers help to lose weight and keep it off for $170 - $330 a month, which is a fraction of the costs of the new weight loss drugs and it has a more favorable side effect profile (basically no side effects after the initial 1-2 week adjustment period).
Of course, the supplements are not “curative”, just like all the other methods are not. If you have a tendency towards obesity, the supplements work well to reduce your hunger and enable you to lose weight. Many people do find that they need to continue taking them as a life-long habit to be able to keep their weight off.
Here are a few examples of patients who have used the program:
- I personally have been on these supplements for 25 years now to keep my weight at a level suitable for appearances on the beach and to keep myself from “foraging for food”. Even after all these years I find that if I forget a dose, I start “looking for food”.
- A 45-year-old woman in my practice lost 43 lbs. going from 223 to 180. She told me that the weight loss was fairly easy which was great to hear. However, she quit the program because her clothes didn’t fit anymore, and she did not want to buy a whole new wardrobe. Go figure!
- A 40-year-old woman was on the program last year and lost 20 lbs. (245 to 225lb), then stopped taking the supplements. Her loss stopped but she was able to maintain it. She decided to come and resume the program with a goal weight of 160 lbs. One week after she resumed the program, she was still slightly hungry but lost 7 lbs. As she continues in the program, she can expect 1-2 lbs. per week of weight loss which will be fat loss. We usually see the full effect of each supplement dose within a week, and most people respond to level 1, 2 or 3.
- A 60-year-old man lost 35 lbs. in five months going from 215 lbs. to 180 lbs. in 5 months. He is satisfied with his progress and is continuing to stay on the program.
- A 57-year-old woman came to see me and started with the supplements CLICK HERE to see the graph of her progress below. She went from 240 lbs. to 147 lbs. in about a year. When we stopped the active phase of the program, I suggested that she continue on the supplements. She did not and never came back for a follow-up. I saw her in public a couple years later, and she was significantly heavier than when she started.
Psychology is a factor in weight loss. I tell my patients that many of us have certain psychological issues which make us eat. It is not uncommon to become overweight as a form of protection from others. For instance, one 325 lb. female patient told me she does not want to lose weight because then men will start looking at her. She experienced a trauma in her life, which caused this reaction.
If a patient actually wants to improve their weight, any underlying emotional state that could impede the progress needs to be addressed in more ways than just taking the supplements. I often recommend medical cannabis as a way to help ease any underlying emotions that may get in the way. Homeopathy is also a treatment that can help deal with deep trauma in a more curative way. Occasionally as part of my program I suggest that a psychologist may need to be involved. I’ve also seen some remarkable results in people getting serious with yoga.
In conclusion weight loss is complicated. It is different for every person. My Weight Loss Management program is successful because I take the time to listen to the patient and come up with the best suggestions for their circumstances. I am always here to answer any questions patients might have.