An influx of anti-obesity drug research has flooded the obesity treatment market with anti-obesity medications (AOMs), which obviously raises questions about their efficacy and safety, side effects, and ability to access and use.
One such question was raised to me by one of my clients which prompted me to write this blog. As a Nutritional therapy practitioner, I am not allowed to prescribe any medication but of course, I can shed some light and my views on these medications.
So, what is the mechanism, and how do AOMs work? AOMs (anti-obesity medications) work by imitating a hormone, GLP1, that reduces appetite. A handful of AOMs are under research that mimics a few different hormones/receptors that induce feelings of fullness/satiety, slow down gastric or stomach emptying, and reduce the feelings of reward associated with eating. These drugs were initially approved by the FDA in the USA back in 2005 for the treatment of type 2 diabetes, with increased AOM clinical trials, they have now been approved to be used as obesity treatment as of 2021. With the ongoing research, there will be more drugs in the market that not only target hormones and receptors but also gut microbiome.
Side effects? A few of them have been reported ranging from nausea, vomiting, diarrhoea, and intestinal blockages to more serious ones including suicidal thoughts. The drugs could lead to loss of bone and muscle more than fat, but my concern is what if patients become dependent/ addicted? Will they put on weight even with short-term delay in availability and how affordable are these drugs? Reports suggest that the cost is approximately $1300/month, which is about a thousand pounds sterling. Earlier this year NICE (National Institute for Health and Care Excellence) which provides national guidance and advice to improve health and social care in the UK recommended the use of Semaglutide (AOM) for adults with a BMI of >35 and one weight-related health condition such as diabetes or high blood pressure, so if you are lucky, you might get one prescribed by your GP.
We know that there is a growing list of co-morbidities like diabetes, cardiovascular issues, malignant cancers, and mental health issues associated with obesity hence the need to address it is more urgent than ever. We are also aware that obesity is not just the result of ‘eating more, moving less,’ the list of causative factors ranges from environmental, behavioral, socioeconomic, and genetic predisposition to trauma and adverse childhood events. Hence AOMs may promise impressive weight loss benefits in clinical trials, but they may not be effective for everyone.
On one hand, they seem to demonstrate that Obesity is not the result of a lack of willpower but on the other hand, there are concerns that they may exacerbate eating disorders and fuel diet culture, societal pressure to look slim, and an unhealthy outlook to health as a whole.
Lastly, there is evidence from AOM clinical trials that, when prescribed alongside diet, physical activity, and behavioral support, people can lose upto 15% of their body weight after one year.
So, I will leave you to ponder how similar the results would be if you could spend much less on a nutrition coach, a personal trainer, and a behavioral therapist, whilst volunteering an hour or two at your nearest community center or garden and achieving your desired health state without any side effects!
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