Dr. Robert F. Kushner from Northwestern University discusses new weight-loss drugs for obesity management. Topics include nutrient-stimulated hormone-based meds, less common medications, comparing terzepatide to semaglutide, and future weight loss drug advancements. The focus is on improving overall health outcomes with successful interventions.
New weight-loss drugs target multiple mechanisms for appetite suppression, revolutionizing obesity management.
Patients on weight loss drugs must manage gastrointestinal side effects through diet adjustments and gradual dose increases.
Deep dives
Newer Weight Loss Drugs Mimic Entero-Pancreatic Hormones
These newer weight loss drugs mimic entero-pancreatic hormones like GLP-1 and amylin to suppress appetite effectively. Originally developed for diabetes treatment, these medications have multiple targets beyond the brain for appetite reduction, representing a significant advancement in obesity management. Candidates for these drugs are individuals with obesity (BMI 30 or greater) or BMI 27+ with medical complications like hypertension. Selection between drugs like liraglutide, semaglutide, and terzepatide depends on accessibility and affordability, with semaglutide and terzepatide showing high effectiveness in achieving weight loss.
Adverse Effects and Management of Weight Loss Medications
Common gastrointestinal side effects of weight loss drugs include nausea, diarrhea, or constipation, which can be managed through slow dose escalation and dietary adjustments. Patients are advised to consume smaller, healthier meals, avoid fatty foods, and maintain adequate hydration to reduce side effects. Planning meals becomes crucial for patients experiencing significant appetite reduction. Abruptly stopping these medications can lead to weight regain, emphasizing the need for long-term strategies like lifestyle modifications and potential intermittent dosage use.
Future of Weight Loss Drugs and Health Benefits Beyond Obesity
The future of obesity care shows promise with evolving dual and triagonist medications that combine different hormones for enhanced effectiveness. Oral small molecules are being developed to provide alternatives to injectable peptide medications. These nutrient-stimulated hormone medications offer weight-independent benefits, such as improving cardiovascular health, sleep apnea, and fatty liver disease. The FDA's indication changes reflect the broad impact of these medications, emphasizing overall health improvements beyond weight loss alone.
New weight-loss drugs have transformed care for people with obesity. In this Clinical Reviews podcast, Robert F. Kushner, MD, MS, of Northwestern University Feinberg School of Medicine joins JAMA Deputy Editor Mary McGrae McDermott, MD, to discuss prescribing these drugs to improve health outcomes and minimize adverse effects in people with obesity. Related Content: