Historically, weight loss medications have gotten really bad reputation. Many people remember Fen-Phen and it turned out to cause valvular problems so it was taken off the market. Only Fenfluramine was removed because Phentermine actually has been around for a very long time and is a very effective appetite suppressant. However because of the bad reputation the medication received so many years ago, doctors have been reluctant to use the medication to help people lose weight.
It’s really an unfortunate thing that has happened in the weight loss world in general. People really stop using the medication and many doctors didn’t treat obesity, even then, as a chronic medical condition. Obesity was related to laziness or lack of willpower.
Roughly two years ago, a weight loss medication was approved for the first time in 20 years. This marked a change in the tide to address overweight and obesity as a chronic medical condition. That medication is now in year three of trials with patients using it continuously.
No different then you might take blood pressure medicine for life or asthma medication for life, the people that are staying on the medication are doing better at maintaining their weight loss than when they are taken off the medication. That new medication actually opened the door for many more. In this last year, there have now been four medications that have been approved for weight loss and others coming down the pipeline.
Weight loss medications really are no different then treating any other medical conditions with medications. As physicians we do that all the time. If somebody’s cholesterol is elevated, we give them a cholesterol pill. If they have high blood pressure, we give them high blood pressure pill.
While I don’t believe that there is one magic pill to treat obesity and weight loss, the medications can be very, very useful in helping someone address a particular aspect that seems to be complicating their weight loss journey. For some people it’s hunger. For some people it’s cravings. For some people it’s the enjoyment of food, binge eating or nighttime eating. The medications that are out can be used for specific reasons.
Our approach has been dietary first and behavioral but we don’t hesitate to use those medications when they need to be used. Again, just like treating any other medical condition and the reason we do that is it isn’t just about losing weight, we have to address all of the factors that go into someone’s weight. There is the psychological aspect. There is the emotional aspect. There is the behavioral aspect. All of these things go into causing someone to gain weight and have trouble losing weight. We have to make sure we use all the tools we have to treat this very complex medical condition.