There has been much talk this past week about the FDA approval of Contrave and Liraglutide as new anti-obesity drugs. Anti-obesity drugs were quite hyped some 10-15 years ago, but have since declined in use and interest. Instead bariatric surgery increasingly came to the limelight and got more and more attention, although this could possibly be waning now as there is increased awareness of quite serious adverse events such as alcoholism, suicide and weight regain. Hence, these new drugs can potentially be a way of injecting some new energy into obesity treatment.
The last time around drugs were “happening”, almost a decade ago now, they were not very successful either clinically or commercially, something the manufacturers blamed on stigma and shame. While this may hold some truth, it is also quite likely that more and more overweight people realized that their problems could not be “cured” by an external intervention in the form of a drug or quite radical gastrointestinal surgery, and were therefore understandably not very keen to try either of those methods. However, since treatment should always be tailored to the patient, and since everyone is unique, it is nevertheless obviously a good thing for the clinician to have a large tool box to go to as opposed to a small one.
But my take on any new and trending method (diet, exercise, drug or surgery) that does not get to the roots of the weight gain, is that they do not help much in finding a lasting solution, a cure if you like. Whilst some valuable lessons can be learnt from trying something new, it also means a delay in the road to finding a real cure, i.e. losing the weight more or less permanently. Moreover, they can also pile on the frustration and misery (not to mention adverse events and cost) for individuals that are already vulnerable. More or less the only way to find this lasting solution, as I see it, is to find out whatever caused the weight gain to start with, and try to reverse that.
My own research suggest that the majority of weight gain stems from psychological and emotional distress, usually established at a very young age as a result of the family/social environment. These factors then interact with the current junk food environment and stressed out lifestyles to cause overweight or obesity. Usually people are very unaware of how much negative thoughts and emotions they are carrying around all day, and how much this affects their body weight.
Unless we go back and help people understand this, and why they gained the weight to begin with, we are unlikely to make much progress, particularly when it comes to weight loss maintenance. That is, you might lose a few pounds when you take one of these new pills/diets/whatever, but you will very likely regain them all when you stop taking that same pill/diet/whatever. That is why I don’t see pills as even close to being a solution to obesity, and that is why I am not at all excited by these new weight loss drugs.
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