The Whole Story on Anti-Obesity Medications

We’ve all seen the advertisements touting miraculous, effortless weight loss with a pill or an injection. Wouldn’t it be great if it really worked that way?

Unfortunately, those ads don’t tell the whole story. Anti-obesity medication (AOM) can play an important and useful role in an overall weight management plan. However, an AOM is not a silver bullet. All the studies you see on TV or in magazines have been done with patients who make multidisciplinary lifestyle changes and follow them regularly. The medication alone doesn’t do it.

Let’s take a look at how an AOM can support a healthy weight management strategy.

What is the role of an AOM?

An AOM is one tool that can help people in the fight against the disease process of obesity. It can be used at any point, in conjunction with many weight loss options. Sometimes it helps in particular situations, such as with someone who is hungry all the time, or someone whose weight yo-yos up and down.

A typical person can shed 5-10% of their body weight through a combination of nutritional choices and exercise. It can be difficult to keep weight off long-term, however, due to our genetics, our environment, and the way our bodies have evolved to fight off periods of starvation. Adding an AOM may help move that average up to 5%- 20%, depending on the choice of medication. It’s important to note that people with more weight to lose may need additional tools like bariatric surgery.

What are the limitations?

At the time this article was posted, the FDA has authorized six different anti-obesity medications and they work in different ways. Some help regulate appetite, while others help you feel full, or help curb cravings. However, the AOM does not replace the other components of a healthy weight management program.

An AOM is also not a guarantee of weight loss. Some people simply don’t respond to them.

You also must qualify. In general terms, you must have a BMI of 27 or more with comorbidities, or 30+ without to qualify for AOM use.

What is the cost?

The monthly cost can range from roughly $30 for short-term generic medication, up to $1,000-$1,500 per month for an FDA-approved injectable drug. Unfortunately, insurance coverage is not automatic. Some insurers do not cover it at all. Others that cover it may take you off the medication if you don’t meet ongoing progress criteria. Most require that you meet your deductible first. It’s important to verify your coverage with your insurance carrier before you plan to begin using an AOM. It’s also important to know that, due to federal policy, Medicare prohibits coverage of this medication.

What about buying an AOM online?

Online sources are substantially less expensive, and that looks attractive. However, beware of purchasing an AOM from an online compounding pharmacy. The FDA warns against this because these pharmacies are not well regulated. People have been known to become very sick as a result of taking an AOM they ordered online.

What is the timeline?

Some medications are meant for short-term use (up to 12 weeks). The newest injectable medications are gradually increased (“titrated”) over a period of six weeks to five months to achieve the maximum impact. They are not appropriate for short-term weight loss. It’s important to note that discontinuing a long-term AOM often leads to weight regain. That’s why these medications are typically continued even after the weight has been lost.

What is the commitment?

Patients regain their lost weight when they stop using the injectable AOMs. Keep in mind that if you start taking an injectable AOM, you may be on it for the long term.

What about availability?

It can be difficult to find AOM in pharmacies, especially the initial dosage. Patients can wait months to fill their initial prescription, and spend hours calling around to find their next dosage. And while it may be tempting to jump to a higher dose right away, that can come with nasty side effects such as nausea, vomiting, or constipation. You’ll need some patience if you plan to take an AOM, and you’ll need to follow the plan outlined by your provider.

How can I get an AOM?

You will need a prescription for an AOM, as well as professional medical supervision. Certain patients cannot safely take an AOM, while others must be cautious about which type of AOM fits their health situation. It is important to collaborate with your provider to ensure that you stay safe and avoid complications.

So what’s the bottom line?

The reality is that lifestyle changes are the pillar of any successful weight management strategy. In many cases, people also need tools to help. Medications are incredible tools that can contribute to your success.

At Trinity Health, we help our patients learn strategies and behavior tools to support long-term weight loss These strategies, plus knowledge of nutrition and a realistic exercise plan, create the best opportunity for achieving your healthy weight.

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