Updated: Dec 5, 2021
Obesity is a chronic disease characterized by dysregulation of energy within an individual. There are several types of obesity, with many different underlying causes and changes in different individuals, with an almost unlimited combination of factors when you take all the different variables into account. It is not as simples as “calories in, calories out”, or “low-carb”, or “excess insulin”, although each of these things is not wrong, either. Science is finally devoting resources to understand the causes and to offer therapeutic treatments beyond simple calorie reduction or bariatric surgery, although those things are important tools, also. The largest recent advancement is in the anti obesity medications in the class called glucagon like peptide receptor agonists, or GLP-1RA. I recommend this treatment option to some individuals in addition to diet, exercise, behavior modification and addressing any modifiable underlying causes of excess adiposity. I tell them that it will make them feel more gratified from less food and that gratification will last longer, so calorie intake will go down with less hunger and cravings, and may result in the loss or maintenance of up to 27% of their body weight, all while reducing the risk of Type 2 Diabetes and cardiovascular disease and without any stimulation or increase in heart rate or blood pressure. Sounds great, right? But it is still a medication, and many people still want to avoid medications if possible, which I agree with, in general. But, sometimes the benefits are medium to long term and can not be seen until you look over months and even years, whereas cost, potential side effects, the nuisance of administration and the mentality of chronic illness that can come with a prescription medication can come immediately. So, what is the medication actually doing inside your body, and why might you benefit from a medication if you are doing everything “right” with their diet and exercise? This is the subject of today’s blog.