Ozempic-like drugs aren’t making the progress for which doctors had hoped
By Deborah Jeanne Sergeant
Shortly after the FDA approved medications like Ozempic, Wegovy and Zepbound, obesity rates began to decrease as these weight loss medications helped patients drop pounds.
The medication works by helping patients feel satisfied sooner so they eat less.
However, obesity rates are still on the rise, according to physician Kaci Schiavone, bariatric surgeon at Highland Hospital.
“The medical community is realizing that these medications are great for some people, but people with high BMIs aren’t losing as much as they need,” Schiavone said. “It’s not enough weight loss to lead to improved weight outcomes. Surgery for the average patient led to an increased amount of weight loss, 50%-75% of excess weight loss compared with 10% on average of total body weight loss with the medication.”
For people with a BMI of 40 or more, the medication isn’t as effective. Those who have a lower BMI and who can tolerate the medication’s possible effects of gastrointestinal upset, diarrhea, vomiting, constipation and pain, do well.
Schiavone said that the long-term cost for the medication “far exceeds the cost of the surgery.”
Most people take Wegovy or Zepbound for life to maintain weight loss, costing up to $1,000 monthly out-of-pocket, but bariatric surgery’s effects can last indefinitely.
“Obesity is a chronic medical condition that we as a country will need to work on together,” Schiavone said. “There are issues with access to healthy food, spaces where you can safely perform physical activity.
“It’s education and being proactive and opening access to care once it’s identified that it’s a medical condition a patient is suffering from. Part of improving access to care is eliminating bias and stigma for people with obesity. It impairs treatment and limits access to care.”
Physician Dilendra Weerasinghe, who practices at Rochester Regional Health, said that few people with obesity seek treatment.
“Only 2% of those eligible to have metabolic bariatric surgery do so and 95% of people don’t seek any treatment for obesity,” Weerasinghe said.
He blames stigma about the condition and lack of awareness that patients can seek medical treatment. If society can break that stigma, he believes that more people will seek treatment and education on nutrition and physical activity.
“There’s a lot of push from industrial lobbies to basically say, a calorie is a calorie,” Weerasinghe said. “A mango has 10 tsp. of sugar, but a can of Diet Coke has zero calories, so it’s a healthy choice, they think, but you gain weight from the Diet Coke as it destroys the gut microbiome. If you stimulate the sweet center, it’s no different if it has no calories.”
He wants more people to realize that sticking with natural, whole foods is essential to healthy living, including maintaining a healthy weight.
“We have to understand that we were designed or created to have real food,” he said. “The first step is eating real food and moving away from highly processed foods. If there are more than five ingredients or any sound like they’re from a science experiment, that shouldn’t be your food. Eat real and eat a sensible diet. If you are obese and especially with concurrent medical conditions, don’t be afraid to seek treatment.”
Obesity contributes to increased risk of Type 2 diabetes, heart disease, high blood pressure, joint problems, sleep apnea and certain cancers.