I’m an obesity medicine doctor and have long taken weight-loss drugs like Ozempic. They’re no fad

08/01/2024 04:09
I’m an obesity medicine doctor and have long taken weight-loss drugs like Ozempic. They’re no fad

Most diseases can’t be treated solely with lifestyle intervention, and obesity is no exception.

For as long as I can remember, obesity has affected me and my family. From my father to my brother and even five generations before that, the disease was in our DNA—starting in childhood for some and later in life for others.

Obesity met me in med school, and not just on the pages of my textbooks. My routine was flipped upside down, and I was all of a sudden struggling with my weight and overall health. Pulling all-nighters and on many days getting my sustenance from the hospital vending machine, I went from being somebody who never gave much thought to what food I was putting into my body to someone who quickly noticed my serving sizes were getting larger and larger. Dealing with the stress of residency, and shortly thereafter the stresses of pregnancy, like many people I found myself eating the standard American diet and gaining weight. The reality was, I was predisposed to this disease—I’d just made it that far without experiencing it first-hand. Once I experienced it, it felt nearly impossible to manage.

I knew I wasn’t alone, but that didn’t make it any easier. And surprisingly, despite being on the path to becoming a doctor myself, I found it difficult to get the care I needed. Globally, one in eight people are living with obesity, yet despite it affecting such a large portion of the population, it’s historically been associated with shame and judgment—with only one’s lifestyle choices to blame. It wasn’t until 2013 when the American Medical Association (AMA) recognized obesity as a disease that required treatment and prevention. Ironically, I was board certified in obesity medicine one year prior, already on a mission to close the gaping holes in care for people like myself.

At 200 pounds, I was embarrassed to admit I needed more than just a change in eating habits. Like many of my patients, I was exercising (Peloton and lifting weights twice a week with my trainer) and eating a healthy unprocessed diet but would only see 5 pounds of weight loss and then stall. At the time I was working on studies supporting the use of GLP-1s—drugs including Ozempic, Saxenda, and Wegovy that help control blood sugar by boosting insulin, curbing appetite, and slowing digestion—and prescribing and seeing results through my patients. Yet, I still thought I was supposed to lose the weight on my own. I had developed high blood pressure and mild sleep apnea, and I was headed down a medical comorbidity path I did not want to follow.

I wasn’t practicing what I was preaching until 2014, when Saxenda was approved by the FDA for weight management. In just 12 months of being on the medication, I’d lost 20% of my weight, what medical nerds like me would call a “high responder.” I continued the medication for another three years, despite my health plan not covering it—a conversation for a different time—because it was working, and the weight wasn’t coming back.

Work moved me to Boston, leaving me without a primary care physician and a prescription to GLP-1s. Already at a healthy weight, I decided to give it a try on my own. I was living the lifestyle I’d been recommending for years, and for the first six months, it worked. Eventually, like the randomized controlled trials show, I slowly gained back 20 pounds and realized working out and eating well wasn’t enough for my body—and I needed to accept that.

Nearly a decade later, having taken a variety of GLP-1s from Saxenda to Ozempic to Wegovy, which I take now, I’ve learned a few things that should have been taught in med school.

Most diseases can’t be treated solely with lifestyle intervention, and obesity is no exception. Medication usage isn’t one size fits all. Some people may find success in temporary usage while others, like me, may need to take it long term. Obesity is a domino for other health conditions—from sleep apnea to cardiovascular issues to poor mental health. For me, perhaps the biggest lesson I’ve learned through my experience is that there isn’t enough obesity care without the bias, shame, and blame.

I cofounded knownwell, a metabolic health company focusing on comprehensive obesity and primary care, to give people like myself a place to feel seen and heard. Even I, an obesity medicine specialist, needed a village—top doctors, dietitians, trainers, and more—to get me to where I am on my health journey today. I hope to be part of that village for others.

Although it feels like GLP-1s like Ozempic and Wegovy are brand new because everybody is talking about them, the reality is, they’ve been a science-backed solution for people living with obesity for over a decade. This isn’t just a fad, and it’s not an easy fix—it’s a step in the right direction toward bridging the gap in chronic care for the disease of obesity.

People may judge those of us who choose to manage our obesity with comprehensive care by adding medication and surgery instead of relying solely on “diet culture,” but having taken medication myself for nearly 10 years, I can tell you, I’ve never been healthier. I’d much rather stick with weekly injections alongside a balanced diet and exercise plan, which supports a longer, healthier life, than risk gaining weight back and facing the complications that go with it. 

There is no “easy way” to lose weight. Weight loss isn’t a normal function of the human body, and many of us are genetically predisposed to abnormal weight gain in our current environment. Yes, the environment we live in needs to change, too, but right now, we have to live the best we can with the tools we have at our disposal—one tool being drugs like Ozempic.

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