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Voices & Opinion

POV: Here’s What’s Wrong with How People Are Using New Anti-Obesity Drugs

Too often, patients aren’t being provided the necessary nutritional and lifestyle counseling when they’re put on these medications

Over 40 percent of adults living in the United States are categorized as having obesity, which is considered a disease by the American Medical Association (AMA). Obesity, with excessive body fat centrally located around the waist, also increases the risk of getting other diseases, such as heart disease, certain cancers, stroke, and type 2 diabetes—four of the eight leading causes of death among Americans.

Research has confirmed that newly available glucagon-like peptide-1 receptor agonists (GLP-1 RA), also known as anti-obesity medications, help individuals lose weight by reducing a person’s appetite and increasing their satiety, or that feeling of fullness. Thus, they eat less. These medications—which include Ozempic, Wegovy, Zepbound, Mounjaro, and Trulicity, among others—have been shown to help a person lose 15 to 20 percent of their excess body weight, on average. This means a person who is 250 pounds could experience a weight loss of about 50 pounds, as well as likely improve their blood pressure and glucose levels, among other positive health outcomes. 

Unfortunately, consuming these medications may not be as benign as some individuals assume: users can experience side effects such as nausea, constipation, and diarrhea. In fact, as many as 50 percent of those who start these drugs stop taking them within a year and gain the lost weight back. These side effects, and the high monthly out-of-pocket costs, are likely feeding into their decision to stop taking the medication. This frustrates not only the individual, but also the insurance companies and employers who are paying for this short-term weight loss without any long-term health benefits.

My problem is with how these medications are currently being administered. There is often a lack of nutritional and lifestyle guidance being uniformly provided to these folks when they are put on these medications. 

Professional nutrition counseling would not only help them manage the unwanted side effects, but also improve their diet quality. Let’s face it: a person consuming a daily diet littered with sweets, treats, and savory chips chased with sweetened beverages will lose weight when taking these medications, because they have a reduced appetite and are eating less of this unhealthy diet. But it still is an unhealthy diet that increases the risk of other chronic diseases. There are also nutritional and dietary concerns when consuming these medications. There is a risk of vitamin and mineral deficiencies and inadequate protein intake, which can cause the loss of lean body mass, dehydration, and the potential for disordered eating. 

Partaking in nutritional counseling would provide individuals with a better chance at keeping the weight off should they want to stop taking the medication due to these adverse side effects, financial issues, or reaching their weight-loss goal. Those taking these medications should be meeting regularly with a registered dietitian nutritionist (RDN), who is the healthcare provider qualified to provide this personalized, science-based nutritional and lifestyle advice. 

RDNs are trained to assess a person’s medical history and current habits and provide a personalized, healthy eating pattern for long-term success. By not utilizing their expertise, we are not optimizing the benefits of these new weight-loss drugs. This is a wasted opportunity that could easily be corrected if all those who are on this medication are also given a referral to meet with an RDN. Many insurance companies may even cover the services of a RDN based on a person’s medical history, which can make this service extremely affordable. You may be a “co-pay” away from gaining this expert counseling. RDNs at the Sargent Choice Nutrition Center can provide nutrition counseling, but individuals can also find an RDN in their area here.

Joan Salge Blake (Sargent’84, Wheelock’16) is a clinical professor of nutrition at Boston University’s Sargent College of Health & Rehabilitation Sciences, the author of Nutrition & You, and the host of the nutrition and health podcast Spot On! She can be reached at salge@bu.edu.

“POV” is an opinion page that provides timely commentaries from students, faculty, and staff on a variety of issues: on-campus, local, state, national, or international. Anyone interested in submitting a piece, which should be about 700 words long, should contact today@bu.edu. BU Today reserves the right to reject or edit submissions. The views expressed are solely those of the author and are not intended to represent the views of Boston University.