Novel Weight Loss Drugs—Weight, There’s More…
Nov. 15, 2024 5-Min Read
Illustration by Mira Norian for Verywell Health
Many people are interested in knowing more about the new drug sensation for treating overweight and obesity conditions afflicting 2/3 of the population, not just a few wealthy celebrities. Some are at least curious because there hasn’t been any good drug for weight loss in decades.
With my certified training in medicine (MD) and clinical pharmacy (PharmD) to serve my lifelong devotion to promoting sensible wellness as a cardiologist (FACC), I feel compelled to share my humble perspectives and insights with the public at this time.
Welcome Aboard
If you’ve booked a trip to a healthy, happy, hasslefree life with an optional stop at weight loss, you’re on the right plane. So, buckle up for this important in-flight announcement.
I sincerely hope the new, novel, red-hot anti-obesity medications (brand names like Ozempic, Wegovy, and Zepbound), will one day puncture our ballooning public health crisis of the past decades. I know, I know. Hope is not a plan.
Let’s give it some time to make sure these new drugs won’t turn out to be yet another canceled flight, like dozens of others in the past 75 years, leaving us in disappointment, quiet desperation, and even debt.
First on our pre-flight checklist is long-term side effects. The many failed drugs in the past got canceled for their flight patterns of nasty, unexpected, off-target ill effects, some of which showed up years later.
Case in point: Fen-Phen. Yes, it slimmed people down, but at the cost of significant heart valve deformities in up to 30% of them. It dropped from the sky in 1999, 24 years after approval by the FDA. My cardiology colleagues and I spent years cleaning up the wreckage.
Then there was Rimonabant—a high-flying European weight-loss drug sensation that crashed like a dark comedy. It was effective and popular until neuropsychiatric disorders reared their ugly heads, including depression and too many suicides. Sure, death is a complete weight-loss solution, but I strongly recommend against it. The FDA withheld its U.S. landing permit in 1998—a near-miss.
Dozens of similar weight-loss drugs also went down in flames over the past decades. Only 8 older relics still lingered on the shelves. Few people know about them because they’re rarely prescribed, for good reasons.
Fast forward to 2021, when the FDA started greenlighting a new batch of powerful novwl weight-loss drugs, such as Ozempic, Wegovy, Zepbound, and others. To date, they’re only for “shooters” who aren’t shy of a lifelong commitment to needles.
Fasten Your Seatbelts
Their generic names include liraglutide, semaglutide, and tirzepatide. As with all new drugs, there are still ongoing issues to be resolved. I’m hopeful, and neither optimistic nor pessimistic. Many doctors remain cautious and clear-eyed, having learned our lessons.
First off, we won’t know about their long-term side effects, if any, for a while—years to be safe. So far, the headlines have been modest, primarily nausea, vomiting, diarrhea, and constipation. Hey, at least this gastrointestinal symphony adds to the suppression of appetite, which is supposedly the primary way these drugs work.
Second is the price tag. Each costs roughly a year’s minimum-wage salary—even at the lowest federal scale. Insurance won’t foot the bill for weight loss, only for their original other medical indications. (They’re different. See below.)
And even if insurance would pay, covering all the country’s overweight citizens would require a trillion-dollar bailout per year. That means either everyone’s health premium would shoot up by 20% or everything else in healthcare would get slashed by 20%.
Third, these drugs weren’t even created for obesity. They are originally prescribed for diabetes and related ailments, like heart and other organ failure. So, to be fair to the very sick, weight in the waistline should wait in line.
A “saving grace” is these drugs’ high dropout rate. More than half do depart before death. In a large 2023 study, 66-81% of users gave up within 3-12 months. A 2024 analysis of two of the most popular new drugs finds 50-75% of users quit within 2 years. The drug makers don’t list the reasons. Irreconcilable differences, perhaps?
What happens after people stop? The weight boomerangs right back, and then some. But here’s the kicker: users lose muscle (25-39%) and regain fat. The body ends up flabbier and literally fatter, which is much harder to reverse.
Bonus Miles
There is mounting data suggesting that these novel anti-obesity drugs produce multi-system benefits, including reduction of various organ failures, diabetes, sleep apnea, arthritis, dementia, certain addictions, and all-cause mortality.
The jury is still out on whetehter these good effects are independent side-actions of the drugs or simply the direct benefits from shedding excess unhealthy weight. If weight loss alone will bring unhealthy overweight people back to better health, function, and longevity, shouldn’t we look harder for workable ways to lose weight without taking lifelong drugs.
Researchers are studying if this new approach might work. Kick-start weight loss with these novel drugs while at the same time build a healthy lifestyle to fortify it. After losing the desired amount of excess weight, wean off the drugs but continue with the by-then set-in lifestyle to keep the weight off for life.
If they prove that indeed works in the long run, you’ll get the best of both worlds. However, you must keep living the healthy lifestyle for life. Wait, that kind of a life sentence is no punishment. In fact, once it has become your habit, as in Healing Habits, it becomes automatic and effortless with no discipline or sacrifice required. It’ll be just like brushing your teeth. Such a deal!
Are We There Yet?
Despite decades of disappointment, many of us still hope “This time it’ll be different”. Because obesity is such an ever-expanding problem, we keep wishing for a “miracle cure” that is effective, affordable, non-toxic, free of side effects, and easy to take, almost like fluoride in our tap water.
Ah, but there is, indeed, already such a real solution that has been around for ages. Because it isn’t glamorous or profitable, it gets snuffed. It’s called living a healthy lifestyle. It isn’t hot on social media, but it works for life.
Its validation by research is so strong that every health authority, and even the drug makers, agree that a healthy lifestyle must be prescribed alongside anti-obesity medications. This mandate is just conveniently glossed over due to the inconvenience of implementation.
As a doctor for 50 years, I confess that writing (later clicking) a prescription is quick and easy, whereas recommending (let alone implementing) a lifestyle change…not so much. It took me 25 years to develop the Metacardio Method for building Healing Habits to make sure it’s clinically sound and validated.
Think of Healing Habits as water to a diet or oxygen to breathing—or to life, for that matter. Lifestyle is the bedrock. All effective weight treatments start and continue with, add and return to, depend and fall back on it.
Health science has proven this to be also true for many other medical conditions, including heart disease, diabetes, arthritis, many intestinal ailments, and cancer. Lifestyle is the Category-A recommendation in national Clinical Practice Guidelines for these diagnoses.
So, if you’re going for treatment or, better still, prevention of these awful ailments, let Healing Habits be your faithful co-pilot. This dependable companion will stay under your feet long after your flight.
Happy Landing with These Parting Gifts
You already know in your heart a healthy, happy, hasslefree lifestyle is essential for the life you want because you have common sense. Putting it into practice is the hard part—until now.
The Metacardio Method for Healing Habits is here for you. No matter what. No charge. No demand. No excuse.
Visit www.metacardio.org and welcome to download:
A free lifestyle-building enhancer for all – a Metacardio® mobile app on your iPhone for the 12 weeks of daily prompts with illustrative graphics, animations, audios, and videos.
A .pdf copy of a comprehensive guidebook, free for clinicians and health coaches:
Every offering is completely non-monetized because no one could pay me enough to have this much joy from working on cracking this growing ‘cardio-diabet-obesity’ pandemic tough nut all these decades of my gratifying career.