Weight loss drugs create problems and opportunities

Some doctors, psychologists, and eating disorder experts worry the new weight loss medications, originally developed to treat diabetes, could become a problem long-term. Most people are likely to regain lost weight if they don’t keep taking the drugs for life, and the psychological toll of that rebound could be damaging, psychologists predict. Even weight loss companies like Jenny Craig wonder if the drugs could be bad or good for business.

Those who lose weight on the once-weekly shots still need to exercise and eat well to see a health benefit. Substantial weight loss is generally associated with health improvement, but that has yet to be shown with these medications.

It’s unclear whether the newer generation of weight loss drugs suppressing appetite will provide different long-term results than other weight loss approaches. In the longest study, lasting 68 weeks — about 16 months — weight loss plateaued and started to climb again by the end, suggesting people’s bodies had acclimated to the drugs.

The media has been giving these weight loss drugs free DTC via stories that aren’t always accurate in communicating risks and the need to change behaviors. HCPs are worried that patients view these drugs as a shortcut to losing weight. One doctor told me, “the drugs alone may curb appetite, but patients still need behavior modifications to lose weight.

Ways to change patient behaviors:

Here are five ways you can assist your patients in changing behavior:

  • Build trust in the relationship. A strong relationship is essential to helping patients change behavior. Here are some questions to ask in order to assess whether trust is present:
    • Does the patient truly feel that you are acting in their best interest? 
    • Do they feel you are taking the time necessary to truly understand theirpersonal issues and needs before applying a solution? 
    • Do you understand their health goals and the results they wish to achieve? 
  • Address the knowledge/motivation gap. Don’t assume patients know how to do what you’re asking or believe it’s the best approach for them. Typically patients who don’t follow through either can’t or won’t because they don’t see the value of changing. If patients don’t have the will to make a change, they won’t be successful. Here are some questions to address their knowledge and motivation:
    • Do they understand the “why” behind what you are asking them to do? 
    • Do they get the connection between what you are asking them to do and how it will achieve their personal health goals/results?
    • Do they know how to do what you are asking?
    • Do they believe this is the best choice for them?
    • Are they willing to do it? 
  • Help them build their winning team. It’s tough to change behaviors, especially if patients have engaged in certain behaviors their entire life. A good social support network is important to increase odds of success once they leave your facility. Here’s how to know if they have a winning team behind them:
    • Do they have someone at home to encourage them?
    • Do they need a health coach to help them navigate the changes?
    • Do they know of other resources in the community that can help?
    • Are they comfortable reaching out to others for help? 
  • Take barriers out of their environment. Many times patients know what to do but may not be able to do it because of restrictions in their environment. Here are some questions to ask:
    • Does their home environment support or hinder the change?
    • Do they have access to the resources or equipment they need to make the change?
    • Can they afford to make the changes necessary?
  • Show them positive changes over time. Make it visual! A health scorecard that shows the behavior changes and impact on health outcomes goes a long way to sustain the new behaviors. Assist them in developing a reward program focused on positive behaviors and achieving their health goals/outcomes. Once the desired health outcome is achieved, help them develop a plan for maintaining and sustaining the positive behaviors that helped them get there.

It’s hard, but it has to be part of any weight loss reduction strategy.

There is good news, however. Drug companies are already working on weight loss pills with fewer side effects and can help patients avoid overeating. The bad news is that drug companies are spending a LOT of money to tell physicians that high BMIs are unhealthy, even though that may not be true.

Weight loss companies need to integrate changes in customer behaviors and inform them that these drugs may not be the answer to keeping weight off.