My Disney Diet Diary Chapter 5 "Make a Plan - Medications"
Sometimes I have patients who are doing everything right – eating regular meals and exercising almost every day, yet these patients are unable to lose weight. That is a big red flag for me that they may have underlying metabolic or health issues. The first thing I need to do for these patients is to order a full set of blood work to rule out health issues and determine the best medicine to prescribe to help them get started.
Here’s my magic:
Women – metabolic panel, blood sugar, insulin level, thyroid screening, anemia screening, and a hormone panel (estrogen, testosterone, dhea-s)
Men - metabolic panel, blood sugar, insulin level, thyroid screening, anemia screening, and a hormone panel (testosterone free and total)
Children - metabolic panel, blood sugar, insulin level, thyroid screening, anemia screening. For teen girls add hormone panel (estrogen, testosterone, dhea-s)
Based on the findings from blood tests, I make recommendations for Medically Supervised Weight Loss. So what is my #1 GO TO Medicine??
Ozempic and Wegovy
If money grew on trees, I would give these treatments to every weight loss patient that walked through the door. These medicines were initially made for diabetics, but once patients starting losing substantial amounts of weight and we saw very little side effects, these medicines became the building block for the majority of my patients who desired long term weight loss. Unfortunately, these are branded medicines and can cost up to $500 or more if you are uninsured. However, there are many different medicines that can fit the budget for patients looking for medicine options.
I had one patient tell me that food used to be an issue for her and it affected her mood. In fact, she was so occupied with food that her daily planning and weight became the center of her life. Now that she is on Ozempic, she told me her appetite is no longer a concern and she has a tremendous burden lifted from her shoulders. She definitely showed amazing results for a relatively easy medicine to take and has achieved normal weight for height.
I use other medicines considering patient’s tolerance, cost, and underlying conditions as listed in my algorithm below:
1. Stimulants – work by increasing metabolism and causing a sensation of feeling full. These meds are safe and effective for short term weight loss. Examples: Phentermine/Adipex, Diethylpropion
2. Endocrine Meds – help patients who have an underlying endocrine source for their obesity. They work by giving patients the sensation of feeling full and helping the body to be more sensitive to its own insulin thus lowering blood sugar and weight. Examples: Ozempic, Trulicity, Metformin, Wegovy, Semaglutide
3. Mood Modulators – help by affecting neurotransmitter hormones like Serotonin, Dopamine, and Norepinephrine. These medicines help those who have underlying emotional issues, anxiety, and stress eaters. Examples: Contrave, Qsymia, Topamax, CBD oil
4. ADHD meds/Stimulants – are useful for long term management, to keep energy high, and to help with appetite. In particular, Vyvanse is used for Binge Eaters and is extremely helpful for patients who have had bariatric surgery and need help with maintenance.
Decisions, Decisions ...
The most important thing to remember is that you need make your decision on weight loss treatment in conjunction with your doctor’s advice. My patients know that unless we’re dealing with catastrophic life or death issues, I don’t tell them what to do. My role as their doctor is to give them their options and then allow them to make their own choices.
What are some of the medicines that you have tried for weight loss? Did you have any trouble with any of them or find a useful product? If not, are you ready to try something new? Then it’s time to reach out and make an appointment with your primary care provider.
Our last Disney Diet Diary will feature highlights from my trip! See Ya Real Soon!!
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