Some of the popular weight loss drugs on the market have been around for about 10 years.
But, thanks to social media, a lot of them became popular about a year ago, making it hard for some of the drugs to come by.
The sudden popularity has some people skeptical.
However, as more research is released, the data shows positive long-term results such as lowering the risk of heart disease, helping people get off medication and lowering the risk of kidney stones.
According to Endocrinology Physician Assistant, Dipal Divecha, the weight loss drugs are most effective in this order:
Injectables:
- Zepbound (same ingredient as mounjaro)
- Wegovy (same ingredient as ozempic)
- Saxenda
Oral medication:
- Contrave
- Qysimia
- Phentermine
- Alli
Who should take them?
To qualify for the drugs, patients typically need to have a BMI of 30 and above or a BMI of 27 and above with at least one comorbidity (like hypertension, diabetes, sleep apnea.)
They’re a tool, not a magical fix.
Advanced Diabetes and Endocrinology use body composition scales, which measure weight loss by focusing on maintaining muscle mass and losing dangerous visceral fat that surrounds your organs.
Pairing the medication with strength training exercises and a healthy diet would lead to the best results.
“You have to help the medication to help you. The majority of the patients say, ‘I don’t want to stay on the medication for too long. I want to get over the hump and then I want to get off the medication.’ Is it possible? It’s absolutely possible. But again, you have to help the medication to make that happen,” Divecha said. “The whole point of being on this medication is to train your brain on how to eat right.”
Divecha said using the medication and conditioning your body to make wise decisions takes about a year.
Will insurance cover these drugs?
Not always.
“Right now, for all these medications, we are having difficulty getting that approved even with people who meet clear indications,” Divecha said.
Patients who can afford to pay out of pocket may shell out thousands of dollars for the injections.
For people who want insurance to cover the cost, they need doctors to put in the legwork, filing paperwork, calling for authorization and proving that their patients are serious about changing their lives.
“We have to prove that you have done your part at the personal level,” Divecha said, “We have to make sure the patient has tried good diet habits and dietary changes six months prior to trying these medications for insurance. Insurance wants to know that your patient is physically active, doing their part, getting up, and moving around.”
Why won’t insurance cover it?
Many of these drugs are still in short supply. Several of them are medical treatments for people with type 2 diabetes. Limiting who can access the drug is in part because of cost and partially because people who need the medication to manage diabetes are having difficulty filling their prescriptions.
Divecha said oral weight loss drugs are easier to find and can be a lot more cost-effective if patients are interested in the weight loss pills.
Warning
Some people turn to compounding pharmacies to find these medications. While you still need a prescription at a compounding pharmacy, Divecha warns against them.
“We do not recommend compounding agents because we don’t know the safety of that and the dosing of those medications. So, they work, no doubt about it, but they haven’t gone through FDA clearance. We don’t know the long-term side effects. We don’t know what’s exactly in that mixture,” she said.
What are the side effects?
While many argue there’s not a lot of data on weight loss drugs, the data that is coming out continues to show benefits. The Texas Heart Institute said weight loss drugs are revolutionary and will help to prevent heart disease in some patients.
“Every time they do a study in both of those classes of drugs, it’s amazing improvement. So, in fact, this last weekend, I was surfing my phone, looking at the medical literature as it’s popping up, and there was a new article about the SGLT2 inhibitors and how they prevent kidney stones,” said Dr. Sephanie Coulter, Texas Heart Institute. “Our team, we are big fans of adopting new scientific developments, especially because we’re watching the literature and then we’re treating our patients and we’re watching them to see, because we’re often a little cynical about new therapies, but these therapies are revolutionary.”