Aug. 15, 2023 – A new poll out this month showed that 45% of U.S. adults are interested in taking a prescription medication for weight loss. That’s good news, according to doctors who are on the front lines of the nation’s obesity epidemic, because it may mean that views about obesity as personal failure or the result of a lack of willpower are finally changing.
The new class of drugs, whose roster includes names like Wegovy and Ozempic, can help people lose up to 15% of their body weight.
“Certainly 45% of U.S. adults would meet the criteria for using anti-obesity medication, but I am a bit surprised that the number [in the poll] was that high,” said Judith Korner, MD, PhD, a professor of medicine and director at the Weight Control Center at Columbia University Irving Medical Center in New York City. “Historically, there really has been quite a bit of reluctance for most people in terms of wanting to take medication for weight loss.”
The new poll results could be a sign that more and more, the conditions of obesity and being overweight are being viewed as diseases. Reducing stigma is a critical step in creating a pathway for people to seek treatment.
The poll from the health policy think tank KFF showed that among people who had ever been told by a doctor that they were overweight or obese, 67% said they would be very or somewhat interested in trying a safe and effective prescription weight loss drug. Being overweight or obese is determined using a combination of a person’s weight and height that results in a score called body mass index, or BMI.
For those among the 45% of people interested in new weight loss treatment options, just making an appointment to meet with a medical professional about weight loss will likely first require overcoming unhelpful internal self-talk.
Last week, Jamy Ard, MD, met with a woman to discuss weight loss options. She told him she believed weight loss was a matter of willpower and that she should be able to tackle the challenge on her own. She ended up declining treatment.
“That’s internalizing the message that it’s somehow your fault,” said Ard, who co-directs the Weight Management Center at Atrium Health Wake Forest Baptist in Winston-Salem, NC. “Everything that we know is that it’s really not totally within your control, and there are a lot of external factors that impact what your body weight is at any given point in time. That’s a real barrier for people to overcome is, ‘I should be able to figure this out on my own.’”
‘You Don’t Have to Feel Like You Are Stuck’
Along with finding a helpful inner voice, people who are ready to seek care will need to set aside perhaps painful memories of how they’ve been treated based on their weight, particularly within the same health care settings that are supposed to help them.
The negative inner voice is called “internal stigma,” and it stems from the ideas that are planted there by society and the health care system itself through experiences called “external stigma,“ Korner explained.
Primary care providers are able to treat obesity and overweight, and that’s a great place to start, Ard said, but it’s also perfectly fine to seek care from a specialist or through telehealth options.
“There are people who know how to do it well, who make people feel cared for and heard,” said Ard, who is also a professor of epidemiology and prevention at Wake Forest University School of Medicine. “Find someone who can work with you – even if it is at a distance using remote options or telehealth. You don’t have to feel like you are stuck if your experiences locally have not been ideal.”
One way to find a provider experienced in treating obesity is to use the lookup tool on the website for the American Board of Obesity Medicine, of which Korner is chair of the board of directors.
A sign that it may be time to look for someone experienced in treating obesity is that when weight is discussed, people are simply told to adjust their diet and to exercise, Korner said.
“It’s sort of like telling a person with an ulcer, ‘You have a lot of stress in your life. Go home and don’t get so stressed and your ulcer will get better.’ That doesn’t work,” she said.
For people who live in rural areas and don’t have nearby access to specialists, Ard said more telehealth specialty options are coming online. Earlier this year, Weight Watchers acquired the telehealth platform Sequence as part of its goal to offer prescription weight loss options. The effort now has 37,000 clinical subscribers, along with 4.1 million traditional Weight Watchers subscribers, according to the transcript of the company’s second-quarter call with investors.
Before your first visit, it’s important to check what your insurance plan will cover.
“Then, I think the other thing that I would suggest people do is really think about what other changes – from a lifestyle standpoint – they want to take,” Ard said. “Use of a medication does not take away the need to still engage in a healthy lifestyle program, and that includes physical activity, healthy diet, and proper sleep.”
He noted that some people may be what is known as a “lifestyle responder” and not need medication. Others, particularly those who have severe obesity with major health risks, might need multiple treatments.
And finally, it’s also important to be open-minded while keeping in perspective that obesity is a disease. Just like taking a blood pressure medication, weight loss drugs might have to be taken long-term, and maybe even for life.
“It’s like any other medication. If you don’t take it, it won’t work,” Ard said. “We’re not giving a cure for obesity. We’re giving a treatment for obesity.”
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