Medical Management

There are several medications, some of them new, which are available to treat obesity. The relatively new ones include the injectables, among which are Saxenda, Wegovy, Ozempic, Zepbound, and Mounjaro. The generic names for the most popular of the brand-names medications are semaglutide (sem-uh-GLUE-tide) and tirzepatide (ter-ZEP-uh-tide). For obese patients who are able to tolerate therapeutic doses of these meds, the average weight-loss is around 11-12% (semaglutide) or 20% (terzepatide) after about a year of therapy. Injectables have some nice features. For one thing, they are usually well tolerated. Most of the adverse effects of the injectables are gastrointestinal (diarrhea, constipation, nausea, etc.) and are not severe. Also, with the exception of Saxenda, the shots only need be taken once per week. Not bad!

There are some downsides. For one thing, the injectables are inconsistently covered by insurance. They are expensive, and the out-of-pocket cost can be many hundreds of dollars per month. Another problem with them is that the weight loss only lasts as long as the medication does. When people stop taking the injectables, regain the lost weight is the usual outcome.

Besides the injectables, there are various oral medications, including Contrave, Xenical, phentermine, diethylpropion, and others.

For a full explanation of the medical options, make an appointment with Dr. Fitzer.