Focus On... Are Weight Loss Drugs Right for You? with Rebecca Shafer, MD MSEd ABOM, Physician Lead, Center for Healthy Weight Management

Everyone says they could stand to lose a few pounds. But a new study reports that nearly three-quarters of adults in the US are overweight or obese. That’s up dramatically from 1990 when the number was half of US adults. Obesity increases the chance of serious health conditions like high blood pressure, heart disease, liver disease, kidney disease, heart attack, and stroke.

Ryan Health’s Center for Healthy Weight Management works with patients with overweight and obesity to address or head off serious health concerns. The Center is open to any Ryan Health patient at least 18 years old who has seen a Ryan Health provider in the past six months. You must have a BMI (Body Mass Index) of 25 or over. BMI between 25-29 is considered overweight, and BMI 30 or over is considered obese.

The Center is a primary care-based program. Patients use it as long as they want. The first six months are loosely structured, with enough interaction to provide guidance and support. The goal is for patients to achieve significant weight loss.

There are three prongs to the program: dietary counseling, physical activity counseling, and medication management. There are significant health benefits to injectable weight loss medications like Ozempic and Wegovy, and there are other medication options too.

Ryan Health can prescribe injectable weight loss medications through this program. However, patients must have either a BMI of 30 or higher or a BMI of 27 to 29 along with diabetes. Some private plans will consider other co-morbidities such as liver disease, high cholesterol or high blood pressure; Medicare and Medicaid only cover injectables if you have a diagnosis of diabetes.

Some patients are frustrated they can’t get injectable drugs like Ozempic and Wegovy without having diabetes. There are, however, other weight loss medications that we can prescribe. These are oral meds, rather than injectables. They are slightly less effective and take longer to achieve the desired result, but they do work. These include Phentermine, or combination medications like Phentermine/Topiramate and Bupropion/Naltrexone.

Whether you’re taking an injectable or an oral medication, they mostly have similar effects. They either lower your appetite or stimulate your metabolism to break down food. In order to see results, you must also have a strict dietary and physical activity plan. The drugs are not a magic bullet and won’t bring the desired result without appropriate dietary and physical activity changes.

A few things about injectables you need to know:

• There may be side effects, such as nausea or vomiting, when you start treatment.
• You must inject the meds yourself on a weekly basis. Providers will show you how, and there are YouTube videos for guidance, but this is something you will have to do on your own.
• It’s possible that once you start these meds, you may be on them forever, especially if you have diabetes. They are developed for chronic use.

The goal of any weight loss program is to make lifestyle changes—diet and exercise—that will keep the weight off and reduce the risk of serious health problems. If you are on these meds, you will feel fuller and hopefully eat less, which should result in weight loss. And given the rising rates of obesity in the US and the impact it has on all aspects of our lives, that’s a good thing.

To make an appointment for the Center for Healthy Weight Management, first see your Ryan Health provider. Make an appointment using the Online Scheduler or call 212-749-1820. The Center sees patients every Thursday at Ryan Health | West 97th Street.