Darlene Purvis, a nurse practitioner with Memorial Health System, answers questions about existing and up-and-coming options for those struggling with obesity.
Q: What are some promising new medications or non-surgical options for weight management?
A: Medications are available for weight loss both over the counter and by prescription. Patients should receive guidance from a healthcare provider before using them:
- Food-and-Drug-Administration-approved medications, including semaglutide (Wegovy/Ozempic), tirzepatide (Zepboun/Mounjaro) and liraglutide (Saxenda), decrease your appetite so fewer calories are consumed. Liraglutide is a daily injection and more likely to be covered by insurance.
- Over-the-counter options like orlistat (Xenical) reduce fat absorption.
- Other classifications of over-the-counter medications for weight loss, including appetite suppressants (phentermine), amphetamine, phentermine, topiramate (Qsymia), and naltrexone-bupropion (Contrave), are available in tablets.
- Emerging treatments include retatrutide, currently in clinical trials, and monoclonal antibodies are being studied as an infusion to increase muscle mass and decrease fat.
Q: Are there non-drug therapies that show promise?
A: Yes, fitness and behavioral apps like MyFitnessPal can aid in tracking food and exercise. Continuous glucose monitors are available through your provider and are a great way to monitor your sugar level to avoid insulin spikes, which can cause further weight gain.
Q: How do providers determine the best treatment for a patient?
A: Providers will evaluate your body mass index and monitor factors like hypertension, atherosclerosis, stents, fatty liver, cholesterol level, insulin level and fasting glucose. They also will check thyroid function and cortisol levels. The results will allow them to recommend s plan. A nutritionist will offer even more advice and recommendations for healthy food choices.
Q: How can patients improve insurance coverage chances for newer treatments?
A: First, call your insurance and ask if the medications are covered. Weight-loss medications always need prior authorization. Some pharmaceutical companies offer patient assistance.
Q: What should patients know about the safety and success rates of treatments?
A: Discuss the risks, benefits and options of each medication and surgery with your provider. Lifestyle changes like healthier food, more exercise, adequate sleep per night, drinking 60 ounces of water per day and managing stress levels are the best ways to start and maintain weight loss.
The combination of weight-loss medicine and lifestyle changes leads to greater weight loss than lifestyle changes alone. When administered correctly to eligible patients, taking these medications can mean a loss of total body weight of 3% to 12% more than lifestyle changes alone, according to the Mayo Clinic.
