Over a number of decades I have heard this lament from a number of patients: “It’s Not Working!”. The “IT” being referred to is a medication that is being used to help with weight loss efforts. Over the 40 years I have practiced medicine, many “weight loss drugs” have hit the market with the latest “fad” medications being the GLP-1 meds: Ozempic (semaglutide), Zepbound (tirzepatide) and some new ones about ready to hit the scene.
When people attempting to lose weight are taking these medications and they are not shedding weight at a pace acceptable to them, the thought process usually brings them to “It’s not working”. The first concept to think about is what the medication is intended to do. In the case of an oral amphetamine drug such as phentermine, this is supposed to reduce appetite and increase metabolism. Concerning the GLPs, these act my slowing the transit time of food from the stomach into the small intestines after a meal. By doing so, chemical signals are sent out to make people feel less hungry.
Here is the VERY important concept: Any medication used to help with weight control should be viewed as an adjunct and NOT some magic pill/injection that produces weight loss without a person changing their dietary patterns. When the thought process rises up that “IT is not working” the “IT” is usually the individual and not the medication. Certainly, if a person is using a GLP and does not feel one smidgeon of an appetite decrease; “IT” is in fact, the medication. However, this is usually not the case.
We all must be the ones to “WORK” when it comes to weight control. Yes, medications can help but they cannot “work” alone. Consider it a partnership with any medication prescribed to you. You must “work” together.
And one of my favorite theme songs from a movie: Carly Simon’s tune from the 1988 flick “Working Girl”.
