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Medically Managed Weight Loss: Everything You Need to Know

The weight a person carries is something that goes beyond simple lifestyle and choices. It involves complex and complicated genetic, environmental, and physical factors. This is why there are entire industries that have been built on weight loss, diets, and exercise. It's why you can scroll forever watching fitness and diet influencers on Instagram and TikTok spewing their advice to everyone that will listen.

But all "body positivity" aside, those struggling to lose weight may want to consider the role medication plays in managing weight effectively and efficiently.

"Not everyone can eat less, exercise, and lose weight with willpower alone. Often times genes, hormones, environment, sleep, and mental health play a huge role."

Tim Pickett, PA-C, medical weight loss expert and founder of KindlyMD

Weight Loss is Beyond Diet and Exercise

While nutrition and physical activity are fundamental to weight management, they are not enough for everyone. Medications provide an additional tool that can help overcome the biological barriers to weight loss faced by many.

Appetite is regulated by hormones. The stomach, pancreas, intestines, and fat cells secrete chemicals that tell the brain to eat. Some of us are then drawn to certain foods more than others. I like cookies, cakes, and baked goods, while my wife enjoys salty chips and fruity candy. Hormones and other chemical signals are regulated by functions evolved over hundreds of thousands of years. These hormones provide the drive to feed the body with calories, which it then converts to energy. Energy equals survival.

The primary hormone sending hunger signals to the brain is called Ghrelin, and it is produced in the stomach. Remove most of the stomach (like what happens in a sleeve gastrectomy surgery) and you reduce the body's ability to produce Ghrelin. This makes sleeve gastrectomy surgery the most common bariatric surgery performed today, with a 25-35% overall weight loss success rate. If you have more than 100 pounds to lose, surgery may still be the best medical route to take.

Hunger, however, is not the only reason people gain weight over the years. Multiple factors lead to body weight. Genetics, environment, medical conditions, inflammation, sleep hygiene, injuries, emotional factors, finances, stress, hormones, medications, behavior, and many other factors also contribute to weight gain.

Despite what we've all been told, calories in and calories out isn't the answer either. This theory assumes we absorb 100% of all the calories we consume, and we certainly do not. Hormones play a role here, too — insulin specifically.

Why Fad Diets Don't Work

Consider the number of people in the world with hormone imbalances. Cortisol, the stress hormone, is linked to increased weight gain. Many have thyroid problems also, another hormonal concern that has huge implications for weight issues.

Furthermore, when the body loses weight, the brain kicks in to protect us from starvation. This launches a cascade of hunger hormone release and a reduction of the feeling of fullness. The metabolic process actually slows down. You read that correctly: your metabolism actually slows down when you lose weight. It makes sense from an evolutionary standpoint of survival, but for us modern humans, it has very little, if any, real benefit. In fact, it's a major hurdle to overcome in a weight loss journey.

The body seems to have it's own weight set point: the size it wants to be, regardless of your situation. I'm built like my dad, you're built like your mom. Interviews with obese patients often find that people try out 20 or more diet or exercise programs before finding a solution or giving up entirely. For some, trying new fad diets, joining gyms, paying trainers, and following health influencers online is a lifetime commitment.

Now, this isn't all to say you should avoid exercise or eat whatever you want. It's meant to show that weight loss is not one-size-fits-all with a set willpower-driven solution. While you may temporarily reduce your caloric intake, the odds are stacked against you to keep the weight off long term.

What Are GLP-1 Medications?

GLP-1 (Glucagon-Like Peptide-1) medications, also known as GLP-1 receptor agonists, are a class of a drugs commonly used in the treatment of type 2 diabetes. These medications have taken the world by storm after being approved for use by the FDA for weight loss. They mimic the effects of GLP-1, a natural hormone involved in the regulation of blood glucose levels. GLP-1 medications have many effects and functions on the body.

  • Enhancing Insulin Secretion: GLP-1 medications stimulate the pancreas to produce more insulin when blood glucose levels are high. Insulin is a hormone that helps cells absorb glucose from the bloodstream, lowering blood sugar levels.
  • Reducing Glucagon Secretion: GLP-1 medications also suppress the secretion of glucagon, another hormone produced by the pancreas. Glucagon typically works to raise blood glucose levels by promoting the release of stored glucose in the liver. By inhibiting glucagon, GLP-1 drugs help to prevent blood glucose from rising too high.
  • Slowing Gastric (stomach) Emptying: GLP-1 medications slow down the rate at while food leaves the stomach and enters the small intestine. This slowing helps to reduce how quickly glucose absorbs into the bloodstream, leading to a more gradual rise in blood sugar levels after meals. This helps people to feel full faster and longer while eating less.
  • Appetite Suppression: GLP-1 medications lead to a reduction in appetite and food intake, benefitting weight management.
  • Cardiovascular Benefits: Some GLP-1 medications have been shown to reduce the risk of heart attack, stroke, and cardiovascular death in people with type 2 diabetes who have developed cardiovascular disease.

Comparing GLP-1 Medications

There are many FDA-approved medications for patients looking to lose weight. Phentermine, Orlistat, Contrave, Saxenda, etc., though none are more popular right now than the GLP-1 medications Semaglutide (Ozempic & Wegovy) and Tirzepatide (Mounjaro & ZepBound). These medications are helping people lose weight at such a pace that it has taken the media by storm. As a result, you've likely seen articles claiming "the end of obesity" written by doctors and surgeons who are convinced we are at an inflection point in American healthcare, body positivity be damned.

Let's compare these popular medications and what they do.

  • Mounjaro / ZepBound (Tirzepatide): Recently FDA-approved for weight loss, this medication is known for it's dual-action on both GLP-1 and GIP receptors. KindlyMD providers prefer this drug for weight loss due to its superior performance in clinical trials when compared to Ozempic.
  • Ozempic (Semaglutide): Highly effective in reducing blood glucose levels and body weight, this medication is a favorite among many.
  • Wegovy (higher dose of Semaglutide): Specifically approved for weight loss, this medication demonstrates significant results in clinical trials.

Integrating Medications into a Weight Loss Strategy

Medications should be a part of a broader plan that includes dietary changes, physical activity, and psychological support. It's essential to tailor the approach to each patient, taking into consideration their medical history, lifestyle, and weight loss goals.

Lifestyle changes, including nutrition, physical activity, sleep, stress reduction, and mental healthcare are still the cornerstone of weight management. Any program that doesn't include follow-up education on functional progress, muscle building, nutrition, and mental healthcare are not effective long-term. Rather, the inclusion of these things makes a medical weight loss program including GLP-1 medications that much more successful, offering promise to millions looking to make a change.

A Holistic Approach to Weight Loss

At KindlyMD, our mission is to revolutionize holistic healthcare by integrating medically managed weight loss as a cornerstone of our Complete Care service. We are dedicated to empowering individuals on their health journey through a combination of cutting edge medications, such as Ozempic/Wegovy (Semaglutide) and Mounjaro/ZepBound (Tirzepatide), with personalized mental health support, body composition analysis, and nutrition and exercise counseling. Our approach is rooted in compassion, innovation, and the belief that optimal health encompasses both the mind and body, ensuring every patient achieves sustainable success.

Call 801-851-5554 today or email to set up a free consultation with a healthcare professional and discuss the right treatment plan for you.

By KindlyMD
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