Pharmacological Options for Weight Management

Maintaining a healthy weight begins with adopting sustainable, long-term lifestyle habits, including a balanced diet, regular physical activity, and behavioural changes that support healthier choices. For many people, healthcare professionals may also recommend working with a dietitian, obesity specialist, or a multidisciplinary care team to develop a personalised weight-management plan based on individual health needs and goals.¹

Fig 1: Treatment Options for Effective Weight Management

However, these lifestyle changes alone may not always be sufficient to achieve or maintain meaningful long-term weight loss. Research indicates that weight regain is common after structured weight-loss interventions end, with one-third to two-thirds of the weight lost potentially regained within the first year, and more than 95% potentially regained within five years.³

This does not mean that lifestyle changes are ineffective or should be abandoned. Rather, it highlights that obesity is a chronic condition that may require ongoing support and, for some people, additional treatment alongside lifestyle measures to achieve and maintain meaningful long-term weight management.

The Role of Medicines in Weight Management

Weight-loss medications are designed to be used alongside a healthy diet, regular physical activity, and behavioral changes, not as a replacement for these lifestyle measures. When prescribed appropriately, they generally offer a favorable balance of benefits and risks.⁴ These medications are available in different forms, including injections and oral pills. ⁵

How does Weight-Loss Medication works?

Fig 2: Pathways to Weight Loss through medications

Losing weight can cause changes in hormones that control hunger and appetite, which may make it easier for the body to regain the weight that was lost. Weight loss can also lower the amount of energy the body uses and slow down metabolism, making it harder to maintain weight loss over time. **Weight-loss medicines can help overcome some of these changes, supporting weight loss and helping people maintain it for longer.**⁶

The U.S. Food and Drug Administration (FDA) has approved several medicines for long-term weight management. These medicines are used along with a reduced-calorie diet and regular physical activity for Asian adults with a body mass index (BMI) of 27 kg/m² or higher, or 25 kg/m² or higher if they have at least one health condition related to excess weight, such as type 2 diabetes, high blood pressure, or abnormal cholesterol levels.⁷˒⁸

Fig 3: Medicines Approved for Weight Management

Benefits and Risks of Weight-Loss Medications

Weight-loss medications can help people lose weight and may improve overall health. Weight reduction can lower the risk of obesity-related health conditions, including heart disease. Other potential benefits may include⁵:

• Lower blood pressure, cholesterol, and blood sugar levels
• Easier movement and reduced joint or muscle discomfort
• Improved confidence and well-being

However, weight-loss medications also have some potential risks and limitations⁵:

• Long-term safety: Some weight-loss medications are relatively new, so their safety and effects with many years of use may not yet be fully understood.
• Nutrient absorption problems: Medicines that reduce fat absorption may decrease the absorption of vitamins A, D, E, and K. Your healthcare professional may recommend a multivitamin when appropriate.
• Weight regain: Some people may regain weight after stopping the medication, particularly if healthy eating and physical activity are not maintained.
• Drug interactions: Always inform your healthcare professional about all medicines and supplements you are taking, especially before starting a new medication.
• Pregnancy and breastfeeding: Weight-loss medications should generally be avoided during pregnancy, when trying to become pregnant, and while breastfeeding. Discuss your individual situation with your healthcare professional.
• Cost: Some weight-loss medications can be expensive, particularly when insurance coverage is limited or unavailable.

Weight-loss medications do not work the same way for everyone, and their effectiveness may decrease over time in some individuals. For this reason, weight-loss medications should only be used under the guidance and regular supervision of a healthcare professional.

What If Medicines Are Not Enough?

For some people, lifestyle changes and medicines may not provide an adequate response or may not be suitable. In such cases, a healthcare professional may consider other treatment options, including endoscopic procedures or metabolic and bariatric surgery, depending on the individual’s health, BMI and obesity-related conditions.

Endoscopic procedures such as endoscopic sleeve gastroplasty (ESG) and intragastric balloon can help limit food intake and increase fullness without surgery. These options are less invasive than surgery but can still have side effects and complications.

For appropriately selected people with obesity, metabolic and bariatric surgery can provide significant and sustained weight loss. Procedures such as gastric sleeve and gastric bypass can also improve blood sugar and cholesterol levels in some people.

The right option depends on your individual health needs and should be discussed with a qualified healthcare professional.

Final Takeaway

Weight management is a long-term process, and there is no single treatment that works for everyone. Healthy eating, regular physical activity, and behavioural changes remain the foundation of care. For people who need additional support, weight-management medicines can help achieve and maintain meaningful weight loss when used alongside these lifestyle measures.

References

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