सारांश
- Obesity is now recognized as a complex, chronic disease with various complications, necessitating a multidisciplinary approach involving physicians and dietitians. Weight loss medications, such as GLP-1 agonists and GIPs (Monjaro, Wegovy, Ozempic), are increasingly popular, aiming to mitigate complications like type 2 diabetes, asthma, and fatty liver disease.
- GLP-1 agonists work by decreasing gluconeogenesis in the liver, inhibiting glucagon, decreasing gastric emptying, and reducing food intake and cravings in the brain. Simaglutide and tzipetide have shown significant weight loss results in clinical trials, with tzipetide demonstrating an average weight loss of 22% in individuals without diabetes.
- When prescribing these medications, guidelines suggest it for individuals with a BMI over 30 or over 27 with co-morbidities. Common questions arise about stopping the medication, where tapering down the dose or using it intermittently are options. Additionally, concerns exist regarding muscle mass loss during treatment, necessitating resistance and aerobic training, as well as increased protein intake.
- After stopping the medication, patients often experience increased appetite and decreased satiety, potentially leading to weight regain. It's crucial to address this physiological response and avoid shaming patients. The average length of therapy in the real world is only 90 days, highlighting the importance of long-term lifestyle programs to maintain weight loss.
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