Ozempic, Wegovy, Mounjaro. These names have entered our common parlance within the last year via news articles, television stories, and celebrity exposes. Everyone from Hollywood to your neighbor seems to be on medication for weight loss or trying to find a way to access one via their medical provider, from primary care physicians to dermatologists. The widespread demand for these medications has resulted in a shortage for those who could benefit most from pharmacological assistance to manage medical conditions such as diagnosed obesity and diabetes.
These newer anti-obesity medications (AOMs) are extremely effective, with an average weight loss of 15 to over 20 percent, depending on the medication. Ozempic, Wegovy, and Mounjaro all fall under the category of GLP-1 receptor agonists. GLP-1 receptors promote fullness by delaying gastric emptying, which contributes to feeling satiated more quickly, thereby resulting in less food intake and subsequent weight loss. This class of medications has been found to be safe and efficacious in longitudinal studies, with manageable side effects for most, and can truly be a game changer in the field of weight management. Unfortunately, most mainstream media coverage has focused on anti-obesity medications as a stand-alone treatment and does not adequately discuss the very real possibility of weight regain if medication is ceased and behavioral changes are not made.
Obesity is a multifactorial condition and should be addressed as such. A focus on or sole prescription of AOMs neglects the critical roles of medical management, nutrition, physical activity, and behavioral change, as supported by the Obesity Medicine Association, a leading organization in obesity care.
A multi-pronged approach to obesity treatment involves careful and intentional planning to assess an individual’s motivation and readiness for change, pre-existing medical and psychological conditions, dietary habits, and activity level. Factors such as job hours, family dynamics, life stressors, socioeconomic status, and food access are also crucial to understand. The evaluation for and prescription of AOMs by an obesity medicine specialist can contribute to significant weight loss, but a holistic approach is required for the possibility of long-term success without lifelong AOM therapy.
As a licensed clinical psychologist with a multidisciplinary medical weight management program, I address behavioral and psychological aspects of weight management care. I help my clients connect with their motivations for working on weight loss, set behavioral goals to make gradual, sustainable changes with dietary intake and activity, build social supports, and eat mindfully to fully experience the pleasures of food with portion control. I can also attest that there is much more to lasting weight loss than experiencing physical fullness. Many of us turn to food, even if not physically hungry, because it looks or smells appealing, for stress management, to lift a saddened mood, amplify a positive experience, connect with memories, and as a form of procrastination, recreation, or vehicle for socialization. The psychological work behind weight helps build insight into triggers for non-physiological eating, promotes the development of alternate means of emotional coping if food has previously been relied upon, can foster a greater sense of self-efficacy and control, a recognition of the physiological and psychological importance of leading a healthier lifestyle and nonscale related victories, and hopefully a resultant sense of pride as individuals strive for their weight and health goals.
Nutrition, activity, behavioral change, and medication are complementary roles in weight management. A reliance on just one aspect, such as medication alone, fails to see the complexity that is weight. Let us celebrate that through pharmacological advances; we now have more options to help aid individuals with obesity and stave off the obesity epidemic, but let us not minimize the importance of care that considers the whole picture and, in fact, the whole person.
Roopal Lalaji is a clinical psychologist.
