Lifestyle changes and medications are crucial

A new study finds that changes in lifestyle and weight loss medications can help reduce weight by 10 percent. Losing weight in a sustained and healthy way is usually very difficult.Experts say this new data can help people who want to lose weight work with their doctors safely.

New research finds that lifestyle changes combined with weight-loss medications enabled overweight and obese people to maintain nearly 11 percent weight loss for up to five years.

Weight loss greater than 10 percent offers significant health benefits, according to the researchers.

“If weight loss can be maintained, metabolic abnormalities can be reversed with significant benefits in patients with type 2 diabetes, cardiovascular disease, and many other diseases in which obesity is the primary cause,” said study lead author Michael A. Weintraub, MD, lead author and a member of the Division of Endocrinology, Diabetes and Metabolism at Weill Cornell Medicine, told Healthline.

Weintraub and team will present their findings June 12 at ENDO 2022, the Endocrine Society’s annual meeting in Atlanta, Georgia.

“Our real-world study,” Weintraub said. “It shows that anti-obesity drugs coupled with lifestyle changes can achieve significant weight loss of 10 percent of body weight and that loss is sustained long-term.”

The study analyzed data from 428 patients at an academic weight management center.

“This research can help guide clinicians toward designing affordable, personalized treatment regimens to help patients lose weight long-term,” he said.

All patients received advice on how to follow a low-glycemic index diet and exercise by the obesity medicine specialist during their office visits and were offered additional advice with a registered dietitian.

The medical intervention included FDA-approved and off-label weight-loss medications including metformin, phentermine, and topiramate.

At their final visit, patients were using an average of two weight-management medications.

Followed for about 5 years, the participants maintained an average weight loss of 10.7 percent.

“In our study, we were surprised by the magnitude of weight loss achieved and maintained,” Weintraub said. “By adding anti-obesity medications, patients lost and maintained an average of 10 percent of their body weight, which in this cohort was 23 pounds.”

He added that a third of the patients were able to maintain a weight loss of 15 percent or more in the long term.

“If weight loss can be maintained, metabolic abnormalities can be reversed with significant benefits in patients with type 2 diabetes, cardiovascular disease, and many other diseases where obesity is the primary cause,” Weintraub said.

Brian Quebbemann, MD, FACS, a bariatric surgeon and founder of The NEW Program in Orange County, Calif., said that for many people who are overweight or obese, a 10 percent weight loss doesn’t mean they’ll end up at a moderate weight.

“Yes, a 10 percent weight loss does provide some health benefits,” Quebbemann said.

He compared it to a person with a blood pressure of 200 over 140 who is better off given medication that lowers their blood pressure to 180 over 120. At that level, they would still be considered to have high blood pressure.

“Yes, they are better, but they are still a long way from healthy blood pressure,” Quebbemann said.

Suchitra Rao, MD, a bariatric physician at O’Connor Hospital in San Jose, California, said that when used properly, weight-loss medications can help people safely reach their weight-loss goals.

“However, obesity is a chronic, complex and relapsing disease,” he noted. “It may be necessary to continue them long-term to maintain weight loss and prevent weight regain.”

Rao added that beneficial lifestyle interventions to promote and maintain weight loss include behavior modifications to adapt our lifestyle to eating a healthy diet, learning to stay active regardless of age, managing stress and getting enough sleep. .

According to Minisha Sood, MD, an endocrinologist at Lenox Hill Hospital in New York, while all drugs have potential side effects, the real issue is whether a drug’s benefits outweigh its risks.

“In the case of obesity, the benefits often outweigh the risks,” he said. “Metformin, topiramate and phentermine have been used successfully and safely for many years.”

Sood noted that these medications have manageable side effects and can be easily discontinued if someone experiences intolerable side effects.

However, when the drug is stopped, weight may increase.

Jonathan Purtell, a registered dietitian at Lenox Hill Hospital in New York, said relying solely on lifestyle changes to lose weight doesn’t work for many people.

“The two most common would be hypothyroidism and polycystic ovary syndrome, which would require not only lifestyle changes but also prescription medications,” she said.

When asked if weight-loss drugs are the best option for people who can’t seem to lose weight through diet and exercise alone, he said they could be a useful tool.

New research finds that a combination of weight-loss medications and lifestyle changes can result in significant long-term weight loss.

Experts say that once the medications are stopped, the weight can come back.

They also encourage people trying to lose weight to carefully evaluate their lifestyle to make healthy changes that will promote weight loss.