STATEN ISLAND, N.Y. — Staten Island has the second-highest obesity rate in New York City, so it’s no surprise that interest in groundbreaking new obesity drugs like Ozempic and Wegobee is surging in the borough, local doctors say.
According to the American Medical Association, the drug, classified as an incretin mimetic, can help patients lose 3 to 12 percent more weight than they would if they made lifestyle changes alone. That may not seem like much, but losing that weight and keeping it off can have big health benefits, according to the Mayo Clinic.
Wegovy sales are expected to more than double in the first quarter of 2024, and manufacturers are racing to increase production of the drug before 2024. Meeting surging demandThe Wall Street Journal reported.
The drug mimics the action of the incretin hormone GLP-1, which is released from the intestine after a meal.
But as with any new treatment, questions and concerns inevitably arise, and even people who doctors deem perfect candidates for these drugs have a ton of details to consider first.
Cost, of course, is a big issue. Many insurance companies don’t cover the drugs, which can cost $1,000 to $1,200 a month, doctors say. Others limit lifetime payments to about a year’s worth of treatment, says Alex Barkan, M.D., vice chair of surgery and chief of bariatric surgery at Richmond University Medical Center.
Side effects also need to be considered: Depending on the dosage, patients report digestive issues such as abdominal pain and nausea. They also often report “flatlining,” a loss of interest in pleasurable activities other than eating, Barkan said.
Diabetes control
Some are taken orally, while others are injected weekly by patients, but they were originally developed to fight diabetes and have certainly been revolutionary in terms of diabetes control, says Dr. Ciara Ortiz Pujols, a physician at the Staten Island University Hospital Comprehensive Weight Loss Center.
They’ve been around for a long time, she said, but It was only after Ozempic changed its chemical structure, making it more penetrative into the brain, that the “exponential explosion” was seen.
All of the drugs currently in development to treat obesity are in extensive testing, Ortiz-Pujols said, explaining that weight-loss drugs have a dark history, and that obesity wasn’t even considered a disease by the American Medical Association until 2013. “It was seen as someone else’s fault,” she said. Research into the inflammatory nature of obesity has led to a much broader field of research.
The drugs are being studied as treatments for heart disease, liver damage, kidney damage, dementia and even addiction, she said.
But the weight loss will likely be ineffective without other lifestyle changes, doctors said.
“These medications need to be used in conjunction with a holistic approach,” Ortiz-Pujols said, noting that the body’s natural tendency is to always try to get back to its highest weight. “The body is always actively working against you.”
Diet and Exercise
That’s why diet and exercise are such powerful tools to help you achieve your weight loss goals, she says.
“Obesity is a chronic disease,” Ortiz Pujols says. “It can be stopped, but it will come back if you don’t change your lifestyle.”
Barkan agreed, noting that the benefits are often temporary and require long-term lifestyle changes to last.
“When you stop taking the medication, the weight comes back,” he says, “and the effects — weight loss, loss of desire for many other things — are prolonged, but eventually go away.”
Loss of appetite
One important health risk to consider, doctors say, is the overwhelming loss of appetite that some users experience.
“These drugs are so powerful they suppress the appetite, so people forget to eat or go whole days without eating,” Ortiz Pujols said. “They’ll face problems like malnutrition and muscle wasting.”
The perfect candidate
So who is best suited for weight loss prescription drugs?
According to Barkan, the target patients are those who have been unable to lose weight through diet and exercise and have a body mass index (BMI) of 27 or higher. Most of the patients also suffer from serious medical conditions such as high blood pressure, diabetes, sleep apnea and joint problems.
The Mayo Clinic says that people who are trying to become pregnant, pregnant or breastfeeding should not take prescription weight-loss drugs.
