Diet, exercise, medication? What’s the key to losing weight?
Commercials for diet and weight loss drugs seem to be everywhere. Every time you change the channel, there’s an ad for something that could be the magic key to losing weight. But how do you know what’s right for you?
Some of the most talked about medications are Zepbound and Wegovy. They belong to a class of medications called GLP-1 antagonists, and were initially used for patients living with Type 2 diabetes.
“Semaglutide works by binding to the GLP-1 receptors in the body,” explained Dr. Jennifer Clair, a primary care physician at LMH Health Primary Care – 6th and Maine. “One role of the medication is to reduce blood sugar. In higher doses, it interacts with the receptors in the body which tell it that you’re full and can result in a decrease in appetite.”
Who are they right for?
Dr. Jennifer Clair
In March 2024, the Food and Drug Administration (FDA) approved Wegovy for weight loss in adults with obesity or who are overweight and have at least one weight-related comorbid condition, such as cardiovascular disease.
“For someone who has a BMI over 30, GLP-1 medications may be the preferred weight loss option in combination with diet and exercise,” Dr. Clair said. “They may also be an option for someone who has a BMI over 27 and high cholesterol, sleep apnea or a weight-related comorbidity.”
She emphasized that when you think about GLP-1 medications, it’s important to remember they’ve only been used for weight loss for a few years. The long-term effects on weight aren’t fully known. They have been used longer for treatment of Type 2 diabetes, and have a good safety record in treatment.
Compounding – is it safe?
Though the number of people who are eligible to use drugs like Wegovy rise, it doesn’t mean that the price of these GLP-1 medications has decreased. The average cost per year for someone unable to use insurance is thousands of dollars. People desperate to find them at a lower cost are increasingly turning to compounding pharmacies to obtain the drugs. Dr. Clair said that’s not a wise plan.
“The problem is that it’s really not clear what the compounding pharmacies are making these drugs out of,” she said. “Both the FDA and the Kansas Board of Pharmacy have come out with very clear statements that these aren’t safe and aren’t tested. I understand how frustrating it is to know that something is out there that could help and you can’t afford it, but I don’t believe using a compounding pharmacy is the answer.”
Eating healthy
Keto. Paleo. Atkins. Mediterranean. Whole 30. The list of diets seems endless. Even when using a GLP-1 medication for weight loss, it’s important to incorporate healthy eating into your lifestyle, but Dr. Clair said that there simply isn’t one “best” diet.
“Data gathered from people who have lost weight using a variety of diets didn’t show that one diet is superior to the others,” she explained. “The Mediterranean diet, for example, is very heart healthy but isn’t necessarily low calorie because it concentrates on the type of food, not the amount. You have to look at the calorie intake with any diet you follow.”
It’s also important that your diet is sustainable in the long run. Those that set unrealistic expectations may work initially but fail over time. Remember the cabbage soup diet and the grapefruit diet? You may lose a few pounds, but how long can you really go on eating cabbage soup?
“If there’s one thing you should change in your diet, it is limiting sugar. It isn’t an easy thing to do, but it’s clear if you really look at it that we get a lot more sugar than we need. That does a lot of harm,” Dr. Clair said.
With food prices on the rise, it can be difficult to eat healthy on a budget. Dr. Clair explained that there are ways to keep those costs down, especially when it comes to vegetables and fruit.
“One thing that gets overlooked is using frozen vegetables and fruit in your diet. You get good nutritional value from them and there can be a cost savings,” she said. “If you’re able to, grow some of your own vegetables. Look for places that sell the misfits – the fruits and vegetables that are the wrong color, size or are funky looking. Those are all ways to make eating healthy more affordable.”
Get moving!
Exercise is a key component in a healthy lifestyle. According to guidelines from the Centers for Disease Control and Prevention (CDC), adults need 150 minutes of moderate-intensity physical activity a week.
“Combining exercise with some type of diet modification is going to give you better success with weight loss,” Dr. Clair said. “If you’re losing weight without exercise, you can lose muscle mass. It’s important that physical activity be part of your lifestyle.”
150 minutes of activity sounds like a lot. It’s much more sustainable when you break it down into smaller chunks. Aim to get 30 minutes of exercise per day at least five days each week. If you think about it as three 10-minute blocks each day, it becomes even more manageable.
It’s also important to check in with your doctor before embarking on a new exercise or weight loss plan on your own, especially if you have a chronic health problem.
“Your primary care provider can help you get started on the path to a healthier lifestyle,” Dr. Clair said. “Whether it’s helping you determine what type of diet to follow, talking to you about exercise or prescribing medications, I’m here to help. I want to see you succeed.”
