Readers explain why diet and exercise alone won’t work for all obese patients

Dear Readers: In a recent column, I criticized the sudden popularity of using diabetes medications for weight loss. I was responding to reports that an increasing number of people are using them for occasional weight loss to shed a few pounds. But too many readers felt that I was unaware of the latest scientific studies in this area for clinically obese people. I am grateful for the many letters I have received on this subject and I want to share some of them with you:

Dear Annie: I feel compelled to respond to your recent conversation with someone writing about his friend who successfully lost weight using GLP-1 receptor drugs like Ozempic and Wegovy.

Yes, healthy eating and exercise are an important part of any lifestyle, but there are those of us who, due to a mixture of genetics and other factors, end up with 50 or even 100 pounds overweight. We are not like you; our weight challenges are not simply a failure to exert proper willpower.

I lost 50 pounds on my own through Healthy Choices before turning to these new wonder drugs after two years of not being able to lose any more on my own. Once on medication for a few months, the most confusing emotion came over me: anger. That’s what it’s like to be in a normal body. A body where blood sugar levels are swinging causing voracious hunger does not ruin our lives or ravage our bodies. Those of us who have been obese all our lives are just beginning to feel what it’s like to be in a body like yours, and we’re more than a little angry that it’s taken so long. . We are angry that we have been told that our problems are based on willpower or simply a failure to balance incoming energy with outgoing energy.

These drugs were discovered initially in the treatment of type 2 diabetes – and there is a stigma for obese non-diabetics who access the drugs – but type 2 diabetes is where most of us are heading with untreated obesity. I don’t feel guilty at all for intervening in my obesity now instead of waiting for type 2 diabetes to take me.

We already face huge barriers to accessing these medicines. For example, most insurance plans still get away with excluding obesity treatment coverage, so we have to pay between $350 and $1,350 per month, depending on the drug. But of course, if we get so sick that we become type 2 diabetics, the drugs are paradoxically covered without any problem.

I ask you to encourage your readers not to be judgmental about using these miracle drugs – at least until they’ve carried about 100 extra pounds every day of their lives. — Light up the Lean

Dear Enlighten: You are making the case so clearly that you could be a spokesperson for clinically obese people who benefit from these drugs. I very much appreciate your important comments.

Dear Annie: I am a registered nurse who administers this class of drugs to patients who suffer from obesity-related diseases and who have difficulty losing weight through traditional diet and exercise alone. There are a whole host of factors for some people that make weight loss through traditional methods almost impossible. There are factors such as thyroid disease, PCOS, autoimmune diseases, certain medications, insulin resistance, genetics, etc. that make weight loss so difficult. — Ignorance is never bliss

Dear Annie: I urge everyone to watch Nova’s special, “The Truth About Fat,” which delves into the science and new insights behind the world’s obesity explosion. Science now knows that the obesity gene is present in more than 30% of the population. — Scientific questions

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