A Cure For Obesity?

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Happy 2024! January is that time of year to look back and take stock of our accomplishments in the prior year. A time to look forward and plan our upcoming goals. The most popular New Year’s resolutions are health related. With obesity rates near 42% in the U.S. and reaching 25% in Colorado, according to the Centers for Disease Control, many of us may seek to improve our health through weight loss.  

There are good reasons to want to lose weight. Obesity reduces our quality and length of life. It increases the risk of chronic health issues such as hypertension, type 2 diabetes, heart disease, stroke, sleep apnea and joint pain. A Body Mass Index (BMI) of 25-29.9 is considered overweight and a BMI of 30 or above is considered obese. Although it is more difficult to lose weight than to gain it, there are options beyond the tried and true “move more and eat less.” 

Bariatric surgery can be a safe and effective weight loss intervention reserved for those with a BMI>35. While there is a plethora of pharmacologic agents that can effectively aid in weight loss, the newest ones on the market are GLP-1 RA (glucagon-like peptide 1 receptor agonist). 

Semaglutide (brand names Wegovy and Ozempic) and liraglutide (Victoza) have been approved by the Food and Drug Administration for use as weight loss medications since 2021. They were first used to treat type 2 diabetes and resulted in significant weight loss. Tirzepatide (Zepbound) just received FDA approval. Its dual therapy contains GLP-1 RA and GIP (glucose-dependent insulinotropic polypeptide) and shows greater efficacy than GLP-1’s alone. The FDA has approved their use for weight loss in people with a BMI of 30 or more and in people with a BMI of 27 or more with at least one weight-related health condition, such as high blood pressure or diabetes. 

GLP-1 RAs work by increasing your satiety from a meal. They delay stomach emptying and passage of food through the intestinal tract so you feel fuller and will eat less. They also offer protection from cardiovascular events and stroke.  

Common side effects are nausea, vomiting, constipation, and diarrhea, which can subside over time. They can also lead to acute kidney failure, pancreatitis, bowel obstruction and thyroid cancer. If not covered by your insurance, they can cost about $1,000 per month. You are likely to gain the weight you lost if you stop the medication.  

Whatever your weight loss goals, a healthy diet and exercise regimen are advisable regardless of any weight loss measure you pursue. Talk to your health care provider to determine the best path forward to a healthy new you in 2024. 

Jane Newman is an ICU nurse at Lutheran Medical Center.  

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