Coby’s Guide to Weight Loss Medications and Treatment

Struggling with weight loss is a common issue, and if you're facing this challenge, you're certainly not alone. According to data from the Centers for Disease Control and Prevention (CDC), nearly 74% of American adults were considered overweight, with almost 42% classified as obese in 2020. If you're contemplating medical weight loss programs to support your journey, this guide will walk you through the options available.

Understanding the Challenges of Weight Loss

While many people recognize the importance of maintaining a healthy weight for good health and overall well-being, achieving and sustaining weight loss can be incredibly challenging. Our bodies interpret a reduction in calorie intake and/or an increase in physical activity (and any resulting weight loss) as a survival threat, leading to a reduction in metabolic rate and an increase in appetite to conserve energy and ensure survival. This natural response can make long-term weight loss difficult.

Scientific studies support this understanding. For example, research published in Obesity Obesity Society’s flagship journal, demonstrated that metabolic rates can decrease by hundreds of calories per day after a period of calorie restriction, a phenomenon known as "metabolic adaptation." Additionally, as individuals lose weight, levels of the hunger hormone ghrelin tend to rise, making it even harder to keep the weight off.

One effective strategy to combat these challenges is through medical weight loss programs.

Exploring Different Types of Medical Weight Loss Programs

Medical weight loss programs are supervised by qualified healthcare providers, such as doctors specializing in obesity management and/or mental health professionals focusing on the emotional aspects of overeating. The best programs offer a comprehensive approach, addressing the root causes of weight gain with a variety of tools to enhance your chances of long-term success. Here are the key types of medical weight loss programs:

Behavior Modification and Obesity Counseling

Behavior modification therapy targets the underlying causes of overeating, such as boredom, depression, fatigue, or unhealthy coping mechanisms. Techniques used in these therapies include:

• Mindful Eating: This approach involves developing an awareness of food consumption, focusing on the sensory experience of eating without judgment. It helps prevent "mindless" eating.
• Intensive Behavioral Therapy for Obesity: intensive behavioral therapy for obesity focuses on identifying and replacing negative habits that contribute to obesity with healthier alternatives, like meal prepping or food journaling.
• Support Groups: Groups like Overeaters Anonymous offer resources and a supportive community to help you make lasting changes in your eating habits.
• Obesity Counseling/Cognitive Behavioral Therapy: Therapists can help address emotional factors, such as loneliness, that drive unhealthy eating behaviors.

Medical Weight Loss Medications

Weight loss medications work by addressing various factors that contribute to weight gain, primarily through:

• Appetite Suppression
• Craving Suppression
• Reducing Calorie Absorption

Appetite Suppression Medications

Medications that suppress appetite help manage the hunger associated with dieting. Some of the most effective medications belong to the class of drugs known as glucagon-like peptide-1 (GLP-1) receptor agonists (like semaglutide and liraglutide) and dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists, such as semaglutide, liraglutide and tirzepatide. These drugs mimic GLP-1 and GIP, which are satiety hormone produced by the gut, leading to significant weight loss. Examples include injectable medications like Ozempic®, Wegovy®, Mounjaro® and Zepbound®, with Wegovy® and Zepbound® being FDA-approved for weight management. Ozempic® and Mounjaro® are approved for type 2 diabetes treatment.

Semaglutide and tirzepatide are known for their effectiveness, helping people lose up to 20% of their bodyweight in a year when combined with diet and exercise. These drugs may also have side effects, primarily nausea. These side effects tend to subside over time as the body adapts to the medication. Side effects may also be managed with dietary adjustments or additional medications (such as the anti-nausea medication Zofran).

Craving Suppression Medications

Medications that suppress food cravings target the addictive response to food, reducing cravings rather than just physical hunger. These are particularly useful for those whose overeating is not primarily driven by hunger, such as emotional eating. Commonly used drugs include bupropion(Wellbutrin/Zyban) and Contrave, a combination of bupropion and the anti-addiction medication naltrexone.

Medications to Reduce Calorie Absorption

Medications like Xenical and Alli, which contain orlistat, block fat absorption in the body. While this can be effective for weight loss, these medications can cause gastrointestinal side effects and may lead to deficiencies in fat-soluble vitamins.

‍The Role of Diet in Weight Loss

Diet is crucial in any weight loss effort, as some form of caloric restriction is necessary to achieve weight loss. However, the ease of adhering to a diet varies depending on the plan and the individual. Working with a healthcare provider or registered dietitian can help tailor a diet plan that aligns with your weight loss goals and lifestyle.

Popular diet approaches include:

• Ketogenic and Low-Carbohydrate Diets:  Involve a very low carbohydrate intake, typically less than 50 grams of carbs per day.
• Intermittent Fasting:  Restricting meals to specific time windows, such as noon to 8 p.m.
• Combining dieting and intermittent fasting.
• Calorie Cycling: Involves alternating between lower and higher calorie days to prevent metabolic slowdown.

Meal Replacements

Certain weight loss programs utilize meal replacement shakes or bars to simplify meal planning and calorie control. While convenient, this approach may not be sustainable for everyone. The most effective meal replacement programs are often part of a clinician-supervised plan.

Professional Weight Loss Support

‍Qualified healthcare providers are best suited to guide your weight management journey. This could include a medical professional focusing on weight management or a mental health provider addressing emotional eating. Your healthcare team might also include registered nurses or dietitians who support your efforts.

In addition to behavior modification and medication, healthcare providers can offer personalized programs, bariatric surgery options, or medical devices to aid weight loss.

Personalized Programs

Medically supervised programs blend health coaching, supplements, weight loss medications, and tailored meal and exercise plans. These programs are customized to your specific needs and health status, ensuring a more targeted and effective approach.

Bariatric Surgery

For those with extreme obesity or multiple weight-related health concerns, bariatric surgery may be an option. Procedures like gastric bypass or sleeve gastrectomy reduce the stomach's capacity, promoting a feeling of fullness with smaller food portions. However, these surgeries come with risks and are typically considered a last resort.

Medical Devices

Devices like laparoscopic adjustable gastric banding (LAGB) limit stomach capacity to aid in weight loss. Alternatively, Plenity, a cellulose-based device, expands in the stomach to create a sense of fullness and reduce food intake.

What to Expect from a Weight Loss Program

Weight loss is a gradual process that requires commitment and lifestyle changes. A successful program offers support, accountability, and ongoing resources. You will work with your provider to set goals, track progress, and adjust the plan as needed.

The typical process includes:

• An initial consultation and detailed health assessment. Get started through Coby and submit your assessment today.
• As necessary, bloodwork other exams to establish your current health status.
• Development of a personalized treatment plan.
• Regular follow-up appointments to monitor progress and adjust the plan.
• Transition to a long-term maintenance plan once goals are achieved.

‍Choosing the Right Program

When selecting a medical weight loss program, it's important to consider factors such as the program's reputation, the qualifications of the providers, and whether the program is backed by a healthcare institution. It's also essential to choose a program that aligns with your personal goals and lifestyle.

Affordability is another key consideration. Be sure to understand the costs involved, including potential insurance coverage and out-of-pocket expenses. Coby provides transparent pricing for leading weight loss medications such as semaglutide and tirzepatide.

How Effective Are Weight Management Programs?

The effectiveness of weight management programs varies. The CDC recommends aiming for a gradual weight loss of 1 to 2 pounds per week for sustainable results. Here's what you can generally expect:

• Behavior Modification: Can lead to significant weight loss, with many individuals maintaining their results long-term.
• Weight Loss Medications: When combined with lifestyle changes, medications often result in greater weight loss than lifestyle changes alone.
• Diet Alone: Low-carb diets are particularly effective for short-term weight loss.
• Bariatric Surgery: Offers the most substantial weight loss, though it carries higher risks.

Kickstart Your Weight Loss Journey with Coby

If you're ready to explore medical weight loss programs, get started with Coby today. Submit your assessment for a free telemedicine consultation to find the right weight loss medications to set you on the path to achieving your weight loss goals.