How and when to treat obesity with medication?

Last June, the media announced the existence of a drug capable of causing a loss of more than 20% of weight in obese patients. Called tirzepatidesparked public interest in this type of compound.

But the use of overweight drugs is not new. Although the basis of all treatment is a low-calorie diet associated with physical exercise, there have also been molecules for decades that help reduce excess pounds.

Three Proven Effective Compounds

Currently, there are three drugs available in Spain that have proven their effectiveness:

  • Orlistat: It is an orally administered molecule that reduces the intestinal absorption of fats from food. You can reduce up to 4% of the starting weight.

  • Naltrexone: He is opioid antagonistused in the treatment of alcoholism and to prevent relapse of opiate use, is associated with bupropion, an antidepressant used against smoking. The joint action of the two reduces the appetite and makes it possible to obtain losses of 5% of body weight on average.

  • Liraglutide: Daily subcutaneous administration, mimics the effect of GLP-1 (Glucagon-Like Peptide-1). This intestinal peptide, synthesized in response to the presence of food in the digestive tract, stimulates the secretion of insulin by the pancreas after meals. Another peptide participates in the process, GIP (Glucose-dependent Insulinotropic-Polipeptide). GLP-1 and GIP also generate feelings of fullness by acting on a region of the brain called the hypothalamus. Prescribed patients lose up to 7% weight.

soon in pharmacy

In addition, in the coming months, we can expect the incorporation of other drugs from this last group, called incretin-incretin mimetics. An example is semaglutidewhich is administered subcutaneously weekly and has shown weight reductions of up to 14%.

As for tirzepatide, the molecule that has recently caught the eye, has a double effect: it acts simultaneously on the cerebral receptors for the incretins GLP-1 and GIP, regulating the sensation of appetite. It is also expected to be available in Spain in the medium term, along with other molecules currently in development.

Side effects

It should be considered that drugs to treat obesity are not insignificant. While orlistat can cause flatulence and faecal incontinence, naltrexone/bupropion sometimes causes nausea, constipation, headache, and insomnia, and should not be given to people with certain psychiatric conditions .

The incretins (liraglutide, semaglutide and tirzepatide) have variable efficacy: in some people they produce notable effects and in others they are totally ineffective. In addition, they cause nausea and vomiting and are contraindicated in people with diseases of the pancreas.

Only exercise can preserve muscle and lose weight primarily at the expense of fat.
Shutterstock / Flotsam

When should they be used?

Although they can be of great help, drugs remain an adjunct in the treatment of obesity. Physical activity is particularly relevant, as medications and diet also decrease body water and muscle mass. Only exercise can preserve muscle and lose weight primarily at the expense of fat.

It should be emphasized that the treatment of obesity must be carried out under medical supervision. Among other factors, it will take into account the body mass index (BMI), which is calculated by dividing a person’s weight (in kilograms) by their height (in meters) squared. Drug use it may be indicated when the BMI is equal to or greater than 30 kg/m², or if it is greater than or equal to 27 kg/m² and the person suffers from diabetes, hypertension or hypercholesterolemia.

Currently, we do not have any drugs that have shown losses greater than 20% of body weight. In cases where it is necessary to obtain superior descents, gastrointestinal surgery is a treatment option. It is indicated when the BMI is equal to or greater than 40 kg/m² or in the event of a BMI equal to or greater than 35 kg/m² if the patient is diabetic, hypertensive or hypercholesterolemic.

When asked if there is a treatment to lose weight without changing your lifestyle, the answer is no. Drugs and surgery can be a good complement to diet and exercise in some cases of obesity, but they alone do not solve this pathology.

Leave a Comment