It’s the morning and you are a little groggy going through your morning routine, looking down at the weight scale like you do every morning. Too much. Too heavy. Not matching your goal. Same as it ever was.
But, you tell yourself, you didn’t eat hardly anything yesterday. No breakfast, a salad at lunch, a bowl of soup for dinner. And, oh dear, you actually gained weight. Now what?
Welcome to the weight game. You play it every day, always convinced that you’re doing a better job today than you did yesterday. You tried a new scheduling approach. Didn’t work. You tried a different menu. Didn’t work. You staggered your snacking times. Something should have worked. C’mon. But haha: The scale says “nope.”
You close your eyes and give yourself a talking to like you always do when the scale gives you bad news. “I will lose weight tomorrow. I promise. Whatever it takes.” And then, nada.
You’re not alone. Nearly 40 percent of all American adults are obese. Another seven to 10 percent are morbidly obese. More than 18 percent of American children are obese. The number of obese adult Missourians and Kansans comes in just below the national average at around 36 percent. Obesity rates have risen in every state since 2011.
What can be done besides, well, eating better and exercising? You can enroll in a Weight Watchers program or a Nutrisystem program or a dozen other such programs that prey on the depth of your willpower.
Hmm. Sounds like work. But hold on—there may be a magic cure to obesity.
There are weight-loss drugs making big news—most notably Ozempic—created to treat diabetes, with product literature emphasizing the drug is not for weight loss (even as it shows a chart that demonstrates its weight-loss features). There are other weight-loss and diabetes drugs, such as Saxenda and Zepbound, as well as three other FDA-approved weight-loss medications.
With most of these drugs, one easy self-administered injection a week and off comes the weight. They mimic a naturally occurring hormone that makes you feel full. You can lose five percent of your body weight in the first three months, some marketing campaigns claim, and up to 15 percent in a year (that’s a weight loss of 30 pounds for a 200 pound person).
Sales for these drugs are going through the roof. Ozempic is up 28 percent from last year, reporting a net profit of nearly $4 billion, according to an article in Forbes. Wegovy’s sales doubled from 2023.
Amy Beck, a wellness psychologist who has worked with patients with obesity for over 20 years, says obesity is a chronic health problem that requires behavioral adjustments as part of its cure. People should include working with a psychologist as part of their weight-loss journey, she says
“Behavioral interventions help support better long-term management of these chronic conditions,” Beck says, “whether it’s problem solving about how to actually implement the recommendations that your doctor or your dietitian are giving you or whether it’s dealing with mental health issues that are barriers, such as depression or anxiety.”
Beck says the behavioral component to obesity that she sees frequently is attention deficit hyperactivity disorder. “I believe there’s a 30 percent overlap for folks who have obesity and ADHD, and I see it in my clinic all the time,” she says. “It starts off from just a neurochemical or neurobiological wiring issue, such as not having enough dopamine.” The fastest way to get dopamine to the brain is through food, and people with ADHD struggle to plan when to eat. “It’s like, ‘Oh yeah, I forgot that I’m going to be hungry at lunch today. I didn’t bring food with me, so I guess I’ll go to the nearest restaurant and find something to eat because I didn’t plan to be hungry today.’”
Obesity has a significant genetic component, particularly once a person gets to the level of severe obesity, Beck says. “It’s not the standard issue of lifestyle only,” she says. “Diet and exercise is always part of the treatment, but it’s not going to be the whole thing. There’s been a lot of stigma and bias and shame in the medical community toward people with obesity. There is evidence of weight-based stigma and discrimination in children as young as the age of three.”
Dr. Rick Tague, founder of the Center for Nutrition in Leawood, Kansas, says he thinks the pandemic caused people to gain weight. “There’s the ‘pandemic 20’ or the ‘pandemic 40’ (weight gain), because suddenly, people were trapped at home,” he says. “They couldn’t go to the gym, and they were stressed and stress-eating and gained weight. And so it kind of moved people into a higher weight category and they’re now more aware of their weight. I don’t think it was the virus or the epidemic itself but the consequences of the pandemic that made people feel the pain of [being] overweight, [and it] motivated them to seek some help.”
Dr. Caleb Tague, Rick’s son, works part time in the center’s obesity medicine clinic. “If people are not ready to hear what they need to do, like cut back on certain things they eat, and they’re not ready to make those changes, then that’s not going to happen,” he says. “It’s more complicated than that. It’s not as simple as just ‘eat better and exercise more.’ Turns out, it’s much more nuanced and complicated, and there are lots of factors involved.”
Are drugs the answer?
Are so-called miracle drugs like Ozempic really the answer? Ozempic’s website lists side effects such as thyroid tumor development, inflammation of the pancreas, nausea, vomiting and diarrhea. “These shots are simply another tool for people who need them to be healthier, but they are not magic,” Beck says. “If you eat whatever you want with no regard to nutrition, you’re probably going to feel like trash with gastrointestinal side effects.”
American society is always looking for the easy fix for anything, and these shots are not that, she says. “They are a way for some bodies to work better internally, but there is still quite a lot of effort needed to make healthy lifestyle choices, such as eating nutritious food more often than not and exercising regularly.”
But it’s more than just dealing with the legitimate drugs. “I’ve had patients tell me what’s out there where you can just buy stuff online without a prescription,” Caleb says. “I don’t know where they’re getting it from. They have no idea what they’re getting. No one’s monitoring it. No one’s paying attention. It’s really scary to think about.”
Beck says that it’s important for people to understand the true value of setting habits and routines. “You want to make the healthy choice, the easy choice, so you’re not having to fight yourself in every meal and situation and diminishing your willpower.”
What happens is that people start off the day well, but by 8 pm, they end up just sitting on the couch with a bag of chips. “It was too hard to follow your plan,” she says, “and so you have to try and find habits to make the behavioral parts easier.”
Caleb says that one thing he always likes to tell patients is that we like to think we’re in control of what we eat. “But we’re really not,” he says. “We are completely driven by hormones and those chemicals coming from our hypothalamus. They’re that powerful. It’s these medicines that are helping subdue that. And that’s why it’s been such a remarkable thing for people to see the results that they’re getting. It’s because those hormones are so powerful.”
More studies are underway on the new crop of weight-loss drugs. Researchers found out that semaglutide, the active ingredient in both Ozempic and Wegovy, significantly reduces the risk of kidney disease and death from cardiovascular events in patients.
Wonder weight-loss drugs? Magic beat-the-obesity bullets? Could it be? Time will tell as more people try them and more drug companies jump on the bandwagon trying to capture market share of these fast-selling injectables. But this is a dynamic situation—supplies of Ozempic are now limited due to the surging demand as more family doctors prescribe it for weight control. And the injection pens are also in short supply due to demand.
What weight control doctors want to know from patients seeking treatment
• What is their medical history?
• What’s their experience with trying to diet in the past?
• What sort of appetite issues do they have?
• Do they have food addictions?
• Do they have stress-eating disorder?
• Do they have issues like depression or substance abuse or some related past history that might influence their eating behaviors now?
• Are there personal stresses at home that need to be dealt with?
Source: Dr. Rick Tague, founder, Center for Nutrition, Leawood, KS
