Medication alone will not end obesity

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It seems that whichever way you turn, someone is talking about injectable obesity medications. And if your patients believe what they read and hear, they might conclude that if they could only take these meds, everything else they eat will not matter.

These treatments have clearly made a big impact on the lives of those with obesity and other chronic health conditions. But as impactful as these obesity medications are, we must keep in mind that, on their own, they are not the cure-all they’re touted to be.

Livleen Gill, MBA, RDN, LDN, FAND
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Obesity is a complex disease with no single cause or risk factor. This complexity is why those with this condition require medical nutrition therapy (MNT) as part of a comprehensive medical management plan. While obesity medication can mitigate physical health concerns associated with overweight and obesity, it should not be used as a stand-alone solution. To successfully address obesity, an individual’s overall health status and their nutrition choices — especially mental and emotional wellness—must be assessed. Obesity care is most successful with an approach that is simultaneously individualized and multifaceted; primary care physicians are ideally suited to lead a cross-disciplinary team of trained specialists in the various areas of weight loss and management, tailored to the person’s unique health needs and goals.

If your patients are requesting obesity medication, they will likely have many questions: Which medication is best for me? Will one type be more effective than another? Do I have any existing health conditions that could be affected by the medication? What about my family’s health history? What side effects might I experience?

A team of health care professionals that includes a registered dietitian nutritionist (RDN), a medical care and obesity medication provider, and possibly other specialists as needed can help you get answers to these questions — quickly, efficiently and accurately. Together, these experts can craft an effective, personalized obesity treatment plan to help you meet your health goals.

For increased efficacy and successful long-term outcomes, people taking obesity medication need regular counseling to incorporate lifestyle interventions. This should include MNT delivered by RDNs: a personalized, nutrition-based treatment plan to manage their health conditions and enhance their well-being.

People generally — and correctly — associate RDNs with food and nutrition counseling, but our areas of expertise extend far beyond diet alone. Before an obesity medication prescription begins and during treatment, RDNs can screen for gastrointestinal disorders and other preexisting health conditions, as well as other medications that can cause weight fluctuations. They can identify signs of eating disorders and potentially harmful eating patterns. In addition to monitoring for body composition changes and health complications, RDNs pay attention to energy levels and mood shifts and advise accordingly. To help clients manage and mitigate side effects with healthy, sustainable eating patterns, RDNs are trained to consider all these changes while advising on proper macronutrient intake and factoring in medication-induced changes in appetite.

Another crucial but often underdiscussed component of medication-based obesity treatment is medication transitions — to a different dosage or drug — or getting off the medication entirely. Recent research shows that about 50 percent of obesity medication users stop taking it within one year. If a person switches medications or stops taking their medication for any reason, such as serious side effects, high costs, supply shortages or general life changes, the support team’s focus must shift from prioritizing weight loss to preventing weight regain. This necessitates lifestyle interventions, such as healthful, balanced eating and regular physical activity.

With MNT as part of a long-term medical management plan, RDNs are essential for sustaining the effectiveness of obesity medications. RDNs ensure that you have the nutrition knowledge you need to achieve and maintain your physical, mental and emotional balance. In your journey to a healthier life, we can be both your health care partner and your coach.

Livleen Gill, MBA, RDN, LDN, FAND, is president of the Academy of Nutrition and Dietetics. Representing more than 112,000 credentialed nutrition and dietetics practitioners, the Academy of Nutrition and Dietetics is the world’s largest organization of food and nutrition professionals.