Hello to all our readers!

This month, we're serving a riveting and contentious discussion for your consideration. We take a dive into the uncharted territory (at least for us) of the new-fangled weight-loss drugs and their implications.

The above is a quote from journalist Kuba Shand-Baptiste from a piece she wrote largely critical of modern weight-loss drugs. I think it perfectly encapsulates what some see as problematic about the goal of curing obesity. That is, it is facile to see ‘small’ as good and ‘big’ as bad. It neglects the fact that food, and the practices around it, is deeply intertwined with culture and tradition.

Our obsession with weight-loss is as old as time – well at least as old as Weight Watchers, which was founded over 60 years ago. Since then, we have been bombarded with fad diets, space-age-looking exercise equipment,‘miracle cures’, and more. The use of cure here is not accidental, as obesity and overweight has increasingly been pathologised over time as a ‘disease’ in need of ‘curing’. This is where our cutting-edge weight loss treatments make their entrance into the scene.

You’d have to have been hiding under a rock if you haven’t encountered media coverage on modern weight loss drugs. Known by various names – Ozempic, Wegovy, Mounjaro – these drugs all have something in common: they are all GLP-1 agonists.

We wanted to focus this month on covering what these drugs mean for people living with obesity and overweight. We have the wonderfully erudite Ekaterina Chashnikova crafting this month’s article GLP-1 Drugs: Disrupting the Status Quo in Weight Loss Medicine.

Ekaterina is a pharmacist and finds medcomms to be her natural habitat. Ekaterina loves to explore nuances and can get to the bottom of any medical topic. As a medical writer, she sees it as her mission to share knowledge and best practices with healthcare professionals and patients, and that’s exactly what she’s done in her article.

GLP-1 agonists are becoming increasingly mainstream, for better or worse. We want to prepare you for the storm by outlining how these drugs work, the evidence for their efficacy, and the ethical implications of their off-label use to treat obesity when their primary purpose (most of the time) is to treat diabetes.

So, without further ado, here’s a snapshot of this month’s content

• GLP-1 Drugs: Disrupting the Status Quo in Weight Loss Medicine
• The Old-fashioned ‘Miracle’: Bariatric Surgery
• From the vault – Obesity and Metabolic Syndrome: Top Four Preventative Measures
• About Us

With warmest wishes!

Ruth

GLP-1 Drugs: Disrupting the Status Quo in Weight Loss Medicine

n this article, Ekaterina introduces us to the new world of modern weight-loss drugs.

She discusses what exactly these drugs are, what they do, and what are some of the implications of their use, both practical and ethical.

Ekaterina touches on the global shortages of these drugs, directly resulting from off-label prescription for non-diabetics for weight-loss. As with any discussion on access to medicines, this is an ethical football, as it floats the idea of who is more ‘deserving’ of these drugs in the face of scarcity.

Read more here

The Old-fashioned ‘Miracle’: Bariatric Surgery

The emergence of discourse around these ’quick-fix’ therapies is reminiscent of older arguments regarding bariatric surgery.

In a 2022 paper (Himmelstein et al), the authors discuss the unending stigma surrounding obesity combined with the stigma of treating it with surgery. They note that, “Individuals who undergo bariatric surgery are subject not only to weight stigma, but also to stigma related to the procedure itself.” They are essentially subjected to a double dose of stigma.

There is a twisted notion (likely popularised by wellness gurus) that you have to earn your weight-loss via dieting, exercise, and brute willpower. If you undergo bariatric surgery, you are considered by some to be taking the easy way out; a shortcut. Similar discourse is festering around GLP-1s.

This is a ridiculous notion as it blatantly glosses over the myriad factors that contribute to obesity: genetics, environment, poverty, mental health, and more. While we often evoke words like ‘fighting’ or ‘survivor’ when it comes to cancer (and rightly so), we certainly don’t blame people who don’t survive for not fighting hard enough.

Perhaps we need to let go of the blame game, especially if we’re fortunate enough to not be predisposed to obesity, and embrace ‘quick fixes’ to reduce stigma and improve overall health.

From the vault – Obesity and Metabolic Syndrome: Top Four Preventative Measures

In light of these new drugs, we think it’s worth revisiting a piece written by the ever-wise Sarah Glover on staving off metabolic syndrome.

Sarah outlines metabolic syndrome and its association with obesity, specifically abdominal fat, and insulin resistance.

She outlines necessary preventative measures. These include regular exercise, quitting smoking, stress management, and dietary adjustments to support weight loss and heart health.

Even moderate exercise can be beneficial. Smoking cessation, though challenging, is crucial, and managing stress can also be helpful. Dietary alterations, such as more fibre, healthier fats, varied fruits and vegetables, and less meat, can contribute to overall health. For personalised advice on metabolic syndrome and obesity, professional consultation is recommended.

If this were written now, it's likely that GLP-1s would fit somewhere within this list.

Read more here

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