The concept of eating right and exercising has been around for thousands of years; even the ancient Greeks connected these habits to better health. It’s easier said than done, though, and the quest to lose weight has become a multi-billion-dollar industry. The idea of a “magic weight -loss pill” was once the stuff of dreams, and some attempts have come and gone in past decades – you might remember fen-phen – but, recently, new groups of weight-loss medications have burst onto the scene. But are they indeed the magic solution we’ve been looking for? Or does the solution for safe weight loss really go back to the basics of a healthy diet and a better than adequate dose of exercise?
Clinical psychologist Dr. Patrick O’Neil and registered dietitian Bailey Edge, both at the Medical University of South Carolina Health Weight Management Center, agreed that while the new weight-loss medications can certainly be beneficial for some patients, the importance of a nutritious diet and regular exercise continues to hold true – with or without medication.
The weight management programs which Dr. O’Neil and Edge specialize in are based on tried-and-true healthy eating and exercise regimens, but they emphasized that weight-loss medications have a positive role to play in certain cases and that the Center also provides nutritional and behavioral support to patients who are taking the medications.
“The FDA approvals for obesity medications always specify they should be used in combination with a reduced-calorie diet and increased physical activity,” Dr. O’Neil said. “It shouldn’t be a question of medication versus lifestyle change; they should be used together.”
Like most medications, weight-loss drugs come with both pros and cons. Positive results such as effective weight loss and improvement of overall health must be weighed against cons such as prohibitive cost and potential side effects – nausea, vomiting, diarrhea and constipation. That’s why the medications should be considered as serious interventions for a chronic condition such as obesity and not simply as a quick way to drop a few pounds.
Edge explained that today’s popular weight-loss medications lessen cravings and the desire to eat, which only enhances the importance of healthy eating. “People eat much less on these drugs, and we don’t want them to develop nutrient deficiencies or lose too much lean body mass (muscle). They should focus on protein, fiber and fruits and vegetables to encourage preservation of lean body mass and minimize gastrointestinal side effects,” she said. “If you lose a substantial amount of weight, inevitably some of it will come from lean tissue, but losing fat mass should be the focus. Eating the right balance of healthy foods can improve that.”
Dr. O’Neil emphasized that, unless your doctor recommends otherwise, weight-loss medications are typically for people who have not had adequate success with traditional diet, exercise and behavior change. By getting your lifestyle and habits under control, you have a better chance of keeping the weight off.
“People can be so eager to lose weight that they don’t pay attention to how to keep it off. It’s actually two separate challenges; no matter how you lose it, it still comes down to eating better and exercising regularly. The body has a number of tricks up its sleeve to try to get you back to your earlier weight if you don’t adopt healthful, long-term nutrition and exercise patterns,” Dr. O’Neil said.
He explained that although there are a multitude of physiological factors that influence body weight, weight loss and weight-loss maintenance ultimately come down to a matter of calories consumed versus calories burned. Whether a weight-loss medication blocks the desire for eating excess calories or someone choosing the diet and exercise route makes a lifestyle change to limit calories, this “energy balance” is the key to initial and long-term success.
There are several different weight-loss medications available today, including semaglutide and tirzepatide. If you’re interested in learning more, speak with your doctor to determine whether treating obesity with medication is right for you, and develop a plan to incorporate healthy eating and an active lifestyle into your routine.
If you prefer the lifestyle change route, Dr. O’Neil, Edge and others offer a range of programs at the MUSC Health Weight Management Center, through which they guide you to eat better, set up an exercise program and teach self-monitoring and behavior strategies to help you avoid falling back into old habits, thus having better success at losing the weight and keeping it off.
“Whether your doctor recommends you start weight-loss medication or you choose to lose the weight via diet and exercise, it’s important to incorporate the building blocks of a healthy diet and active lifestyle,” Dr. O’Neil said. “Developing these healthy habits and sticking with them throughout your life can help you keep the weight off for good.”
Learn more about the MUSC Health Weight Management Center’s weight loss programs at muschealth.org/weight, or call 843-792-2273.
By Anne Toole
