What to Consider Before Considering Weight Loss Medications

When it comes to weight loss, it seems everyone has an opinion on what works best. Right now, the opinions about weight loss medications are all over the place. Many find the new antiobesity medications an amazing tool for the treatment of obesity, while others claim it’s a “crutch.” 

Jennie Stanford, MD, an obesity medicine physician, says GLP-1 receptor agonists work by targeting specific hormones in the gut that increase fullness, promoting weight loss. “GLP-1 receptor agonists should be considered as part of a longer-term weight management strategy.” Dr. Stanford explains that while weight loss medications may help you lose 10 pounds quickly, “using them for short-term, small volume weight loss may backfire in terms of weight regain.” 

I read a recent Facebook post from someone considering GLPs to help with losing the 10 pounds they gained over the summer. They decided against using the medications, but not because they didn’t meet the criteria for the prescription, all they needed to do was “clean up” their diet.

And that’s where the stigma and shame about using weight loss medications come into play. We feel shame when we lack the willpower to eat better, so we have this internal debate about whether or not we should use weight loss medications. But this kind of thinking only compounds the issue, causing negative thoughts and feelings that trigger overeating, reducing your motivation. 

But the decision to take antiobesity medications is between you and your doctor. It’s a personal choice and one that should consider your physical and emotional needs. Let’s take a look at some of the things you might want to consider before considering antiobesity medications.

Managing Changes in Energy Levels

As Dr. So pointed out, fatigue is an unfortunate side effect of antiobesity medications. Folks using GLP-1 receptor agonists say that over time they can predict when the drug will hit and zap their energy. Though the timing of the energy drain differs, users of the medications say they may feel tired on the first day of the injection or the fatigue may strike a few days after. 

Planning your injection around your schedule may help to avoid low energy from disrupting your routine. After a while, people taking the GLP-1 receptor agonists find the side effect improves over time. If you are experiencing low energy or fatigue as a result of these medications, you have some options. One option may be changing medications, such as going from Ozempic to Monjauro, which can be discussed with your prescribing physician.

What Happens to Your Social Life

“So you might not want to go out to eat as much with your friends, and when you do, you probably won’t eat as much as you previously did,” according to Meghan Garcia-Webb, MD, a board-certified internal medicine, lifestyle medicine, and obesity medicine physician in Boston, Massachusetts. 

Dr. Garcia-Webb says you may not find food, or alcohol, as entertaining as you once did and you may want to find other ways of socializing that don’t revolve around food. 

Don’t worry, your social life isn’t over. You can still enjoy going out to eat, but you may have to think differently about how or what you order. Maybe sharing a meal with a friend or just ordering an appetizer may work for you. You can also enjoy making new memories by doing different activities with friends and family, like going on weekly hikes or joining a pickleball team. 

Should You Tell Friends and Family?

Whether you tell your friends and family is completely up to you. Your health information is personal and you don’t have to tell anyone about your weight, weight loss plans, or that you’re considering antiobesity medications. Licensed psychologist Rachel Goldman, PhD, recommends having some reflection questions to help answer some of the ones that may arise (or have some sample scripts ready to go):

• What purpose is it serving for you to share this?
• If you share this news, do you think that person would be someone who can support you on this journey?

“Since GLP-1 drugs came out, people initially were more secretive about it, but now I’m seeing people become more open and honest about being on weight-loss drugs since it’s become more common and more and more people in the media are admitting to using them,” reports Sue Decotiis, MD, an NYC-based weight-loss doctor. 

Questions and comments about your weight should be off-limits. “However, be prepared for people to comment when you lose weight, some people just can’t help themselves,” warns Dr. Garcia-Webb.

Only people knowledgeable about the medications should be asking questions, says Dr. Decotiis. Anyone taking antiobesity medications shouldn’t feel pressured to disclose their personal health information, she explains. 

Managing Opinions

Dr. Stanford reminds us that antiobesity medications are a tool for the treatment of obesity and overweight individuals with weight-related diseases like Type 2 diabetes and heart disease. These medications are reversing health problems and improving wellness and well-being. 

It’s important to always remember why YOU are taking these medications. Regardless of what others may say, you know you made the right choice for yourself. “It is amazing how some people feel entitled to comment on someone’s weight, but at the end of the day, it has nothing to do with you. Just stay focused on your own health journey and what’s right for you,” says Dr. Garcia-Webb.

The main concern with opinions, judgment, and shame is that it may derail treatment. “If people’s judgments are preventing a patient from properly taking the drug, drinking enough water, and eating the right nutrients, that can be a major problem,” says Dr. Decotiis. 

You can’t change how someone thinks or feels and some people may make remarks that are inappropriate. Dr. Decotiis reminds her patients that they came to see her for a reason, it’s not just about weight loss, but gaining control over their health. 

How Others Can Support

Having the support of a team of wellness experts who can help you make the necessary lifestyle changes is essential for reaching your health goals, whether you take antiobesity medications or not. 

When speaking to your doctor, Angel Luk, RD, a registered dietitian and co-founder of FoodMysteries.com, says it’s important to talk about the pillars of obesity management with your doctor: nutrition therapy, physical activity, behavior modification, and medical intervention.

All of these factors need to be part of your plan so you can succeed. You may also find it helpful to connect with support groups. Talking, learning, and sharing with those who are struggling with similar issues can help you feel less alone.

How to Wean Off Old Coping Behaviors

All of our experts agree that lifestyle is the most important part of your weight management program. Creating healthy habits is how you reach your goals and stay there.

Lifestyle modifications should be recommended before medication, says Dr. Sanford. One should assess their current food intake, physical activity, sleep, stress, and alcohol intake to come up with a plan with their healthcare provider.

Making small, manageable changes is a good place to start, says Luk, offering specific suggestions such as:

• Eating your first meal within two hours of waking
• Spacing your main meals every four hours
• Finding ways to add daily movement into your day in a sustainable manner (i.e. walking for at least 10 minutes after eating, aiming for 30 minutes a day)
• Building mindfulness habits around reasons for eating beyond hunger such as “eating for comfort, companionship, or as a reward”

Creating healthy, sustainable lifestyle habits and ways to cope is essential for anyone considering weight loss medications, even those who only want to lose small amounts of weight, remarks, Dr. Stanford.