Why Experts Are Now Recommending Weight Loss Medications in Addition to Lifestyle Changes

• The American Gastroenterological Association has released new guidelines recommending prescription medication along with lifestyle changes to treat obesity.
• Officials at the association say diet and exercise alone may not be enough to achieve long-term weight loss.
• Experts say childhood obesity, chronic inflammation, and food addiction are some of the factors that inhibit the long-term success of lifestyle changes.

Medication could be an important item that’s missing from your weight loss plan.

Four recently approved medications for treating obesity are now being recommended by the American Gastroenterological Association in addition to lifestyle changes.

Officials at the association say the medications, when used alongside other lifestyle changes including diet and exercise, are showing results more effective than lifestyle changes alone.

How much more effective?

A study done in conjunction with the recommendations reported these weight loss reductions by body weight percentage when compared to a control group.

• Semaglutide (Wegovy🙂 10%
• Phentermine-topiramate ER (Qsymia): 8%
• Liraglutide (Saxenda): 4%
• Naltrexone-Bupropion ER (Contrave): 3%

Dr. Eduardo Grunvald, a study author and the medical director of the weight management program at UCSan Diego Health, explained in a press release that these medications work by treating a biological disease, not lifestyle issues.

Obesity rates in the United States have increased over the past 20 years from 30% to nearly 42%, leading to health complications, according to the study authors.

“Using medications as an option to assist with weight loss can improve weight-related complications like joint pain, diabetes, fatty liver, and hypertension,” Grunvald said.

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Limitations of lifestyle changes

Dr. Amy Lee, the chief medical officer at Lindora Weight Loss and Wellness Clinics in Southern California, told Healthline there are many factors that affect the way people lose weight.

“From my experience, diet and exercise alone may not be enough,” she said.

Lee explains there are several other factors that can play a role in making weight loss difficult.

Here are some of the most common factors she says she’s come across in her work.

Childhood obesity

Lee says if someone grew up overweight since their childhood, their metabolic foundation has already set them up for a more difficult weight loss journey in their adulthood.

Chronic inflammation

Inflammation is an underlying condition of health that could be related to one being overweight or it could be associated with an unrelated medical condition that keeps the body in a state of inflammation, Lee says.

“Conditions such as diabetes, chronic pain, arthritis, insomnia (just to name a few) can be very inflammatory, which can change the way the body stores fuel and fat,” she explains.

Hormonal changes related to age

Lee said that hormone disruptions that occur as our bodies age can directly impact our metabolism.

The changes could be “as straightforward” as sex hormone decreases related to female menopause or male andropause.

“But other hormones that could be disrupted include thyroid hormones which play a role in metabolism as well,” Lee said.

Impact of the increase in technology

“As more and more people depend on technology, the complication could be one becoming more sedentary which results in less activity and increase in complacency, boredom, and effects of mental health,” Lee said.

“People can become more tired and unmotivated in general to stay on a weight loss program or even to go out to do things,” she added.

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The role of food addiction

Joan Ifland, Ph.D., FACN, the chief executive officer of Food Addiction Reset LLC, tells Healthline the “primary reason people cannot lose weight is that we live in an obesogenic culture.”

Ifland says that in modern culture, processed foods are everywhere and we are surrounded by addiction stimulation, says Dr. Ifland.

“Processed foods act on the brain like drugs of abuse leading to loss of control over impulses,” she says. “In the absence of impulse control, people eat them helplessly. Diet and exercise don’t correct this.”

In addition, Ifland says weight loss programs might actually make the addiction worse by restricting calories, which wakes up the fear-of-famine food-seeking impulses in the brain.

What to consider about medication for treating obesity

You’re not alone if lifestyle changes just aren’t working for long-term weight loss.

Lee says that “medications are not for all people, but if it does help, then one should embrace it.”

Here are some of her recommendations when considering medication to treat obesity.

Ask questions

Knowing what you’re taking is critical to your wellness journey.

“Patients should understand which classes of medications are available and be well-informed on potential side effects and contraindications,” says Lee.

“These are all prescription medications, so one must sit down with their medical provider to go over the details of each option,” she notes.

For example, says Lee, “some of the medications are purely stimulants and others could help with altering the way we metabolize food.”

Remain realistic

Ifland adds that no single medication can cure a processed food addiction that could be contributing to obesity.

Ifland adds there are other things to also consider:

• As soon as the medication is discontinued, the weight comes back.
• Side effects may be serious so medications cannot be continued indefinitely.
• Insurance companies may not pay for weight-loss medications indefinitely.
• The actual weight loss might be small in comparison to the discomfort of the side effects of the medication.

Eating Earlier Can Reduce Hunger, Cravings, and Weight Gain

• New research indicates that eating earlier in the day may be better for your health.
• People who ate their meals later in the day experienced greater hunger and cravings.
• They also had changes that might favor fat storage.
• Nutritionists say if you are getting hungry in the evening, it’s a good idea to plan your meals earlier.
• Eating foods that are rich in protein and fiber can help you feel full for longer, too.

ResearchersTrusted Source at Brigham and Women’s Hospital say that when it comes to weight control, eating earlier in the day may be better for you.

They found that people who ate later in the day were hungrier throughout the day and had lower levels of serum leptin, the hormone that helps regulate body fat.

They also burned fewer calories and had lower core body temperature.

According to the researchers, late eating changes gene expression in adipose tissue in favor of increased fat storage.

When these alterations occur, it could predispose people to become obese.

According to the U.S. Centers for Disease Control and PreventionTrusted Source (CDC), obesity is quite common in the U.S. with 41.9% of adults being classified as being obese as of 2017.

Statistics further indicate that it is a rapidly rising concern with the prevalence of obesity increasing from 30.5% to 41.9% between 1999 and 2020.

The CDC additionally notes that obesity is linked to preventable causes of premature death like cancer, type 2 diabetes, stroke, and heart disease, as well as higher medical costs.

How meal timing affects the body

The study authors write that interventions aimed at obesity often target behaviors, such as reducing the intake of calories or increasing exercise, usually with only temporary success.

However, since previous studies have found an association between eating later in the day and obesity risk, they wanted to examine what influence meal timing might have on weight.

Specifically, they wanted to see whether eating later in the day caused people to become hungrier or burn fewer calories, as well as whether there were any changes in the functioning of adipose tissue which might explain these effects.

They were careful to keep other factors constant, however, such as nutrient intake, physical activity, sleep, and exposure to light.

The team of scientists had 16 people who were either overweight or living with obesity eat the same set of meals. Each study participant was randomly assigned to eat either an early or late protocol. Those on the early protocol ate breakfast in the morning, followed by lunch and dinner.

Those on the late protocol were on a delayed schedule, not having their first meal of the day until about four hours later. Both groups then switched places and did the other protocol.

The researchers found that when people ate later in the day, they were twice as likely to report being hungry. They were also more likely to desire certain foods like starchy foods or meat.

Additionally, they had several other changes conducive to weight gain, including reduced leptin, fewer calories burned, and lower body temperature.

Julie Palmer, a registered dietitian at The Ohio State University Wexner Medical Center, said that what we can take away from this study is that we feel hungrier when we wait to eat later in the day.

“[W]hen higher-calorie foods are more available to us later in the day … we’re more likely to overeat them,” said Palmer.

Palmer further noted that when we feel more satisfied and less hungry, this can help us eat less later on, which would support greater weight loss.

“If we know that we are more likely to feel hungry in the evening, we can make mindful choices like low-calorie, high-nutrition foods in the evenings such as vegetables, whole grains, and beans. The fiber will help us feel full and satisfied.”

Tips for healthy meal timing

Shereen Jegtvig, a nutritionist and author who teaches at the University of Bridgeport in Connecticut, said part of healthy meal timing is figuring out what works best for you.

“One person may do best with eating five small equally spaced meals throughout the day and another person may have an easier time controlling their intake if they use an intermittent fasting type of eating plan.”

If you are the type of person who likes to eat most of their food earlier in the day, then you probably won’t experience any problems.

“But people who prefer to eat later or get hungrier at night might want to plan their p.m. meals a little earlier in the day,” said Jegtvig.

A healthy balanced dinner including protein, fiber, vegetables, and fruits is important, she explained, with a focus on protein and fiber to keep you feeling full longer.

“Sip on water or other low/non-calorie beverages in the evening and nix the late-night snacks,” she advised.

Palmer suggested that you should concentrate on fueling your body during your most active hours.

“If you can’t take time for a meal, choose lots of small ‘mini-meals’ throughout the day,” she said. “Try to eat a mini-meal every three to four hours.”

A mini-meal, according to Palmer, is a combination of carbohydrates and protein, for example, peanut butter and whole grain crackers or low-fat string cheese and a piece of fresh fruit.

“Bring lots of these snacks with you as you work so you do not feel so hungry in the evening,” she added.

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