New Year’s resolutions to lose weight may get a rethink after a review of weight-loss data by a University of Ottawa physician has revealed that medication may be more effective than traditional lifestyle habit changes.
Dr. Yoni Freedhoff, an Associate Professor in the Faculty of Medicine, found intensive dieting plans that included a medical jab kept off up to 25 % of body weight compared to nearly 5% from dieting and exercise. Here, Dr. Freedhoff delves into his findings.
Question: What led you to look closer into this topic/area of research?
Yoni Freedhoff: The persistent narrative that obesity can be effectively treated with diet and exercise alone doesn't align with the evidence. I wanted to address the significant gap between public perception and what the data show about the efficacy of lifestyle interventions versus modern obesity medications.
Q: What exactly did you look at to come to the conclusions you did?
YF: We compared long-term data from the Look AHEAD trial (which represents one of the best-documented lifestyle interventions) to outcomes from trials on obesity medications. Look AHEAD participants achieved an average 4.7% weight loss over four years compared to newer medications consistently delivering more than double that: semaglutide showed 10.2% and tirzepatide reached 25.3% weight loss, with significantly greater durability.
Q: What kind of impact could this have on fighting obesity for our populations and healthcare systems?
YF: Medications should be seen as a first-line treatment, not a last resort that could dramatically reduce obesity-related health conditions like heart disease, type 2 diabetes, and fatty liver disease. This would alleviate significant burdens on healthcare systems, improve quality of life, and extend lifespans.
Q: What do you say to those people who may be hesitant to turn to drugs to counter obesity?
YF: I understand this hesitation; it stems from years of stigma and misunderstanding about obesity. But we already accept medication for other chronic conditions like hypertension or diabetes. Obesity is no different—it’s a complex, chronic disease that benefits from effective treatments, including medication.
Q: Is there not a concern that using such drugs like Ozempic to combat obesity could impact their availability for fighting other diseases?
YF: It might be a valid concern if there weren’t dozens of effective medications to treat type 2 diabetes compared to – basically – three useful obesity medications. The long-term solution lies in scaling up access and ensuring the needs of all patients are met, regardless of their condition.
Q: Are those medications designed solely for people with severe obesity or also for those looking for that little extra push to reach their desired weight?
YF: These medications are best suited for those who meet the medical criteria for obesity treatment, which includes people for whom lifestyle changes alone have not been effective. They are not cosmetic solutions but evidence-based treatments for a chronic disease. However, clinicians can help individuals assess their needs and options based on health, not aesthetics.
These findings were published in Medscape.
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