Cedars-Sinai Magazine
Weight-Loss Medications: Work With a Doctor
Aug 12, 2024 Cassie Tomlin
Injectable weight-loss medications are extremely effective in helping millions of people lose weight and treat health problems such as cardiovascular disease and Type 2 diabetes. But these medications are not right for every patient, and like any medicine, they can cause side effects that are best managed by a healthcare team.
If you’re concerned about your weight, talk with a doctor. Obesity is a complex, chronic condition, but specialized providers can help with healthy, sustainable weight loss and weight management.
“It’s important to tell your doctor the impact your weight has on your life, whether it’s related to your ability to walk in the park with your kids or your sleep quality,” said Ryan Bober, MD, an internal medicine physician in West Los Angeles who also sees patients online at the Cedars-Sinai Connect Weight Management Program. “You and your doctor can make a plan to improve your long-term health—not just focus on the scale.”
"There is no cookie-cutter approach for treating obesity."
A Comprehensive Approach
Obesity is associated with over 200 weight-related conditions, and weight loss is associated with health improvements to blood pressure, sleep apnea, energy levels, focus and more.
At an appointment to address your weight, a healthcare provider will ask questions to determine the factors that may be contributing to weight changes, Bober said. These considerations, as well as your history and overall health, will guide your doctor in determining the best approach to weight management for you, which could involve a dietitian, psychiatrist, endocrinologist, gastroenterologist, bariatric surgeon, therapists and other specialists.
If you have a body mass index of 30 or greater, or 27 to 29.9 with one weight-related condition, you may qualify for weight-management medications, such as the GLP-1 receptor agonists semaglutide (Wegovy), tirzepatide (Zepbound) or liraglutide.
The only safe and effective way to take these medications is under the guidance of an experienced practitioner who will focus on your whole health, Bober said. If you are prescribed a GLP-1 medication, your physicians will consider the other medications you’re taking and advise you when to change doses and how to manage side effects, which may lead to loss of muscle mass. Muscle mass is directly correlated with long-term health and lifespan, and a healthcare team will guide you in maintaining muscle with protein intake and exercise.
"I would be very concerned about a patient getting the medication in the short term from a clinic that doesn't know their health history," said Amanda Velazquez, MD, director of Obesity Medicine at Cedars-Sinai’s Center for Weight Management and Metabolic Health. "We don’t yet understand the impact of starting and stopping these medications, and you could be doing harm to your metabolic system."
Amanda Velazquez, MD
A Personalized Plan
A healthy lifestyle—including structured exercise and a nutritious meal plan—is the foundation of any program to address weight.
Research demonstrates that currently available GLP-1 agonists can help patients lose up to an average of 20% of their body weight in about one year, but only when paired with healthy lifestyle modifications.
"The results we’re seeing in health improvements and weight loss and maintenance are not just achieved by taking the medication," said Velazquez. "Because each person’s recommended diet and activity will be different, we strongly recommend that patients work with a multidisciplinary team to personalize a treatment plan."
Ryan N. Bober, MD
Lifelong Improvement
Weight management is a lifelong effort, and the right approach is different for everyone.
"There is no cookie-cutter approach for treating obesity," Velazquez said.
GLP-1 agonists are not the only treatments shown to have a significant impact on weight management. Patients also should learn about other options, such as older anti-obesity medications, bariatric surgery and newer endoscopic bariatric procedures.
Weight loss—whether achieved by taking GLP-1 medications or through other methods—can make meaningful improvements to your life if it’s done in a sustainable way, Bober said.
"People can participate in things they couldn’t before, and many patients tell me their relationships are better and they’re more confident in their daily lives," Bober said. "With a dedicated team, you can achieve lasting improvements to your life by addressing your concerns about your weight and improving your underlying metabolic health."