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Weighing the Options: Diet, Exercise and Weight-Loss Medications
5 min. read
In the realm of weight loss, the conversation is evolving. With new medication options like GLP-1 receptor agonists gaining attention, it’s more important than ever to understand the role they play alongside traditional approaches like diet and exercise.
In a recent Baptist HealthTalk podcast, Weighing the Options: Diet, Exercise, and Medication, Neki Mohan, an award-winning journalist, sat down with Beatriz T. Jimenez-Cadilla, Pharm.D., a Clinical Ambulatory Pharmacy Specialist at Baptist Health, to discuss the latest advancements in weight-loss medications; who should consider them; and how they work. Here’s a breakdown of the key takeaways from their conversation, which is also posted on YouTube.
What Are GLP-1 Receptor Agonists?
GLP-1 receptor agonists are a class of medications that mimic a hormone called glucagon-like peptide-1 (GLP-1), which is naturally produced in the body after eating. These medications have been on the market since 2014 and have gained significant attention due to their weight-loss benefits. The main function of GLP-1 is to signal to the brain that you're full after eating, which helps reduce appetite and control portions. They also slow down digestion, keeping food in the stomach longer and promoting a feeling of fullness.
Dr. Jimenez-Cadilla explains that these medications have been particularly beneficial for individuals with obesity-related health complications. “Most recently, [GLP-1 receptor agonists] have been studied in a wide variety of populations that have obesity-related complications like osteoarthritis, obstructive sleep apnea, high blood pressure -- or a history of a heart attack or stroke,” she says. “There are exciting times ahead as more trials are set to be published, expanding access to these medications.”
Who Is a Good Candidate for Weight-Loss Medications?
Weight-loss medications, including GLP-1 receptor agonists, are not for everyone. Candidates typically have a body mass index (BMI) of 30 or more, though those with a BMI of 27 or higher who already have obesity-related complications, such as high cholesterol or pre-diabetes, may also qualify. However, these medications are generally considered for individuals who have struggled to lose weight through lifestyle changes alone, including diet and exercise.
Dr. Jimenez-Cadilla notes that patients who have already attempted weight loss through diet and exercise but have not seen success may be eligible for medication. “If you have tried to lose weight with lifestyle adjustments and you have failed to lose weight by just making changes, then you may be eligible for these agents,” she explains. “Also, people that have a BMI of 27 or more but have obesity-related complications already, like high blood pressure, high cholesterol, obstructive sleep apnea, or osteoarthritis, may also be eligible.”
How Do Weight-Loss Medications Work?
These medications work by mimicking the natural hormone GLP-1, which is released after eating. This hormone signals to the brain that you're full, helping to reduce your appetite and food intake. Additionally, GLP-1 receptor agonists slow down the process of digestion, meaning food stays in the stomach longer and you feel fuller for a longer period between meals. This helps to curb cravings, making it easier to stick to a balanced eating plan.
Dr. Jimenez-Cadilla explains how this process works in the body: “These medications mimic a hormone that we naturally produce ourselves in our body, which tells the brain you’ve eaten and to stop eating.” She adds that increasing the amount of this hormone through medication “helps you feel fuller quicker,” reducing portion sizes and curbing cravings.
Weight-loss medications can lead to significant reductions in appetite. For the best results, patients should aim to make at least modest changes to their lifestyle, such as adopting healthier eating habits or incorporating more exercise into their routine. “We always encourage patients to at least try something that they’re able to, something sustainable in their lifestyle, whether it’s diet or exercise,” Dr. Jimenez-Cadilla advises.
The Benefits Beyond Weight Loss
The benefits of weight-loss medications extend beyond just the number on the scale. As patients lose weight, they often experience an increase in motivation, leading to further improvements in mental health and well-being. Losing excess weight can reduce the strain on joints, alleviate symptoms of sleep apnea, and even improve conditions like high blood pressure and high cholesterol. In some cases, weight loss can even improve fertility in individuals who were previously struggling with infertility due to obesity.
Dr. Jimenez-Cadilla highlights the positive effects on mental health as well.
“As people start losing weight and see progress, they become more motivated,” she explains. “They want to do more for their health, incorporating more changes to their lifestyle to get the full benefits of the medication.” She also notes that “obesity itself causes infertility issues.”
And that weight loss can improve fertility, allowing individuals to conceive when they had previously struggled, she adds.
Are There Risks and Side Effects?
GLP-1 receptor agonists carry potential side effects. The most common issues reported include nausea, vomiting, and gastrointestinal discomfort. These side effects occur because the medication mimics a hormone that naturally causes fullness after eating, and in doing so, it can lead to a feeling of nausea or bloating.
More serious side effects, though rare, can include pancreatitis (inflammation of the pancreas) or stomach paralysis. This is why it’s crucial for patients to use these medications under the supervision of a healthcare provider, who can monitor their progress and make necessary adjustments to their treatment.
“If you experience any concerning symptoms, such as severe stomach pain or persistent vomiting, it’s important to reach out to your doctor immediately,” Dr. Jimenez-Cadilla explains. “These side effects are manageable, but they require careful monitoring and adjustment of the treatment plan.”
Why Medical Supervision Is Essential
Using weight-loss medications without medical supervision can be dangerous. The doses of these medications must be carefully managed, and it’s important to gradually increase the dosage based on tolerance. Starting at too high of a dose can increase the risk of serious side effects, such as pancreatitis or stomach paralysis.
A healthcare provider can also help ensure that the medication is paired with the right lifestyle changes and monitor progress over time. This kind of support is crucial for achieving optimal results while minimizing risks.
Dr. Jimenez-Cadilla stresses the importance of medical oversight: “These medications should be titrated to the maximum dose as tolerated, but not more often than every four weeks,” she explains. “Patients should be monitored for weight loss, side effects, and tolerance to the medication.”
While weight-loss medications like GLP-1 receptor agonists can be a helpful tool in the fight against obesity, they are most effective when used as part of a comprehensive approach that includes diet, exercise, and medical supervision. These medications can assist in reducing appetite, improving mental health, and even addressing some obesity-related health conditions. However, they should never be viewed as a substitute for the foundational principles of healthy living—diet and exercise.
“If you’re considering weight-loss medications, it’s essential to have an open conversation with your healthcare provider to determine whether they are right for you,” Dr. Jimenez-Cadilla said. “By working together, you can create a tailored plan that supports your health goals and sets you on a path to long-term success.”
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