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Downside of One-Size-Fits-All: Rethinking Weight-Loss Medications Strategy

A comprehensive approach to obesity management goes beyond prescribing medications for a quick fix.

The quest for effective weight-loss strategies that lower the risk of obesity-related disease has spanned decades, with health-care organizations tirelessly seeking solutions to better address the obesity epidemic. While weight-loss medications have been available for years, none have been as effective as the latest generation of GLP-1s, which have dominated headlines and social media, capturing the attention of medical professionals, payers, and especially consumers. This skyrocketing demand for GLP-1s has been the driving force for the launch of many weight-loss programs promising consumers easy access to prescriptions. For me, the line between provider and drug-manufacturer is getting blurry, with many programs offering only a few medications.

The question remains, can these providers make decisions based on what is best for the patient when treatment options are limited? As a medical professional, I challenge the idea of this one-size-fits-all approach where GLP-1s are the right treatment for everyone. When it comes to providing impartial patient care and improving health outcomes, we must consider all available tools, including behavioral support and different classes of medication besides GLP-1s.

A comprehensive approach to obesity management goes beyond prescribing medications for a quick fix. It uses expert clinicians to assess individual needs and to prescribe the right medication, when appropriate, combined with a proven approach to behavioral support for sustainable lifestyle change. For a better approach to a more pragmatic obesity-management strategy, here are my top five recommendations:

5-step comprehensive obesity care plan

  • Address the person not just the scale Treating the person and not the disease makes for a better obesity-management plan. Period. The entire context of a person’s well-being, including their physical and mental health, must be taken into consideration. The relationship between weight and mental health is connected. Stress, anxiety, and depression are often associated with obesity and must also be addressed to treat the whole person. Additionally, everyone has a unique combination of needs, preferences, and characteristics. Because there is not a one-size-fits-all path to better health, personalized care that addresses the human, not the diseases is a cornerstone to long-term well-being.
  • Tailored-medication management is a must Right person, right medication, right time. GLP-1s are not for everyone—whether it’s due to cost, side effects, eligibility, or where they are in their weight-loss journey. If indicated, it is best to leverage the full-range of medications, not just GLP-1s, to address each person’s unique weight-loss needs. Providers should meticulously assess eligibility criteria. This ensures prescriptions align with an individual’s overall health, considering co-morbidities, contraindications, and more cost-effective alternatives. This approach optimizes health outcomes, and controls costs by avoiding unnecessary medications.
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  • 1:1 treatment from experts is pivotal A critical element of obesity management is quality of care. Obesity is extremely complex with so many contributing factors such as lifestyle, diet, physical activity, mental health, genetics, medications, and more. One-on-one, individualized attention from a seamless network of providers, including dietitians, nurse practitioners, health coaches, and doctors certified by the American Board of Obesity Medicine, is necessary to minimize complications and ensure individuals receive the right treatment at the right time based on what they need in the moment.
  • Prioritize a proven behavioral-support program  Incorporating a proven behavioral-support program into an obesity-management plan empowers people to make informed choices, cultivate healthier habits, and improve their overall physical and mental health. The American Medical Association adds that while weight-loss medications help a person lose weight without exercise and diet, long-term health benefits come from incorporating lifestyle changes at the same time. The combination of weight-loss medication and lifestyle changes leads to greater weight loss than either one on its own.
  • Reporting and monitoring are key Additionally, monitoring and reporting are crucial not only for ensuring the safety of an individual, but also for understanding what strategies are working best and for evaluating the sustained impact of weight-loss interventions over time. Tracking also increases engagement with behavioral-support programs, clinical and medication adherence, and improvements in various aspects of health such as musculoskeletal pain, stress, and sleep. In this new paradigm of managing obesity, integrating a diverse range of weight-loss medications, coupled with personalized behavioral support, holds the potential to significantly impact the management of obesity and its associated health concerns and costs.

When done the right way, weight-loss medications can be a powerful tool in obesity management. Strategic initiatives, such as the above, will allow you to better navigate this ever-evolving landscape. Obesity treatment that includes responsible use of these medications reduces chronic conditions, increases quality of life, and offers your people a straighter path to happier, healthier, and longer lives.

Photo: Peter Dazeley, Getty Images

Dr. Tim Church MD, MPH, PhD, and Chief Medical Officer of Wondr Health is one of the country’s leading clinical thought leaders in exercise and obesity research. As the author of over 300 published clinical articles, Dr. Church has received many awards for his research in preventive health. At Wondr Health, Dr. Church leads the development of program curriculum, which is inspired by his medical expertise. Specializing in business-to-business strategies, Dr. Church is an advocate for the employer and has a proven track record of empowering organizations through disease prevention to decrease healthcare costs and inspire employees to be their best selves. Wondr Health works with 1,100+ employers, and 80+ partners and health plans, and has improved the health of 10 million people over the past 15 years.

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