Weight loss medication management refers to the comprehensive oversight and supervision of medications used for weight loss purposes. It involves the prescribing, monitoring, and adjustment of weight loss medications by healthcare professionals to optimize their effectiveness and minimize potential risks.
If you qualify, a licensed clinician evaluates your health history and goals to determine the safest, most effective medication plan for you.
The qualification for weight loss medication treatment depends on various factors and is determined on an individual basis by healthcare professionals. However, there are some general guidelines and considerations to determine eligibility. Here are a few factors that healthcare professionals may take into account when evaluating if someone qualifies for weight loss medication treatment
BMI is a commonly used measurement that compares a person's weight to their height. Generally, individuals with a BMI of 30 or higher are considered obese and may be candidates for weight loss medication treatment. In some cases, individuals with a BMI of 27 or higher with obesity-related health conditions, such as type 2 diabetes or high blood pressure, may also qualify.
Certain obesity-related health conditions, such as type 2 diabetes, high blood pressure, or sleep apnea, may make someone a candidate for weight loss medication treatment. These medications can help improve these conditions along with promoting weight loss.
Healthcare professionals will evaluate an individual's overall health status, including medical history, current medications, and any potential contraindications or risks associated with weight loss medications. They will ensure that weight loss medications are safe and appropriate for the individual's specific circumstances
Semaglutide is a glucagon-like peptide -1(GLP-1) receptor agonist that was first introduced under the brand name Ozempic to lower blood sugar in patients with Type-2 diabetes, but in the year 2021, it received FDA approval for the treatment of obesity under brand name Wegovy. It is administered as a subcutaneous injection and approved for use in adults and children aged 12 years or more with obesity (BMI ≥30 for adults, BMI ≥ 95th percentile for age and sex for children), or some adults with excess weight (BMI ≥27) (overweight) who also have weight-related medical problems. The dose must be increased gradually over 16 to 20 weeks to arrive at the 2.4 mg dosage. This progression can help to alleviate side effects, which include gastrointestinal symptoms, headache, dizziness, and fatigue.
As per the recent results of the SELECT trial by Novo Nordisk, 2.4 mg of Semaglutide once weekly was associated with 20% reduction in major adverse cardiovascular events in among a cohort with established cardiovascular disease with overweight or obesity, with no prior history of diabetes. Semaglutide is contraindicated in patients with personal or family history of medullary thyroid carcinoma or in patients with multiple endocrine neoplasia type 2. Warnings and precautions include acute pancreatitis, gall bladder disease, acute kidney injury (especially in patients with severe gastrointestinal reactions), diabetic retinopathy, heart rate increase, suicidal behavior, and ideation. Oral Semaglutide, in tablet form, is available for the treatment of diabetes.
Liraglutide is also a GLP-1 receptor agonist. It is a daily injectable medication that acts on hormones from the gut that send signals to the brain to make the patient feel full quicker and decrease hunger signals. Doses start at 0.6 mg subcutaneous injection daily and go higher up with weekly dose escalation with 1.2 mg in the second week, 1.8 mg in Week 3, then 2.4 mg in Week 4, and finally a maximum dose of 3 mg daily, usually achieved by Week 5. Some patients may lose 5–10% of body weight, especially with the liraglutide higher dose.
Side effects of taking liraglutide include nausea, diarrhea, constipation, vomiting, headache, decreased appetite, dyspepsia, fatigue, dizziness, abdominal pain, increased lipase, and renal insufficiency, increased heart rate. It is contraindicated in patients with personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 and other precautions and warnings are similar to Semaglutide.
Topiramate can be combined with phentermine to decrease appetite and cravings. Having the combination of two drugs increases efficacy. Adults with migraines and obesity are good candidates for this weight-loss medication. It is also approved for chronic weight management in pediatric patients aged 12 years and older with a BMI in the 95th percentile or greater standardized for age and gender.
Some patients may lose an average of 5–10% of body weight. If more than 5% is not achieved after 12 weeks of the maximum dose, the medication should be gradually discontinued. Daily doses with four strengths are available, starting at 3.75 mg/23 mg and going up to a maximum dose of 15 mg/92 mg.
Side effects of taking phentermine-topiramate include abnormal sensations, dizziness, altered taste, insomnia, constipation, and dry mouth. Contraindications include uncontrolled hypertension and coronary artery disease, hyperthyroidism, glaucoma, and sensitivity to stimulants. Exposure to topiramate during the first trimester of pregnancy increases the risk of oral cleft. An effective contraception in women of reproductive age group is essential.
Naltrexone-bupropion combines an opioid receptor antagonist with an antidepressant to affect the pleasure-reward areas of the brain and thereby decrease cravings and appetite. Some patients may lose 5–10% of body weight. Start with a daily dose of one 8/90 mg tablet and gradually increase to four tablets a day. The most common side effects include nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, and diarrhea. This medication should not be prescribed to a patient who has a seizure disorder or who takes opioids for chronic pain.
Setmelanotide is a melanocortin-4 receptor agonist indicated for chronic weight management in adult and pediatric patients 6 years of age and older with obesity due to one of several specific rare genetic disorders. The condition must be confirmed by genetic testing demonstrating variants in POMC, PCSK1, or LEPR genes that are interpreted as pathogenic, likely pathogenic, or of a variant of uncertain significance (VUS).
The process begins by scheduling a consultation with one of our healthcare professionals. Prior to the appointment, we will gather essential information about your medical history, including any pre-existing conditions, medications, allergies, and previous weight loss
After evaluating your health and concerns the healthcare provider will determine if weight loss medication is appropriate, they may prescribe a medication that is approved for weight loss.
Once the medication is prescribed, weight loss medication management involves regular check-ins and monitoring to assess progress, evaluate any side effects or complications, and adjust the treatment plan if necessary.
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