Ever since fen-phen was taken off the market for its fatal side effects, Americans have been clamoring for another medication that would make the pounds melt away. In 2021, it seemed as though those prayers had been answered as Wegovy, a medication approved for use in weight management, came on the scene. Wegovy (and its cousin Ozempic) is a semaglutide that has been on the market as a diabetes medication since 2017. The side effects of reduced hunger (and sometimes stomach upset) led to significant weight loss in many patients, and so physicians began to prescribe it even in the absence of a diabetes diagnosis. The allure was so powerful that there was a shortage of the medication at the end of 2022 because everyone was jumping on the bandwagon.
So is this the end of the obesity epidemic? The answer may be more complicated than you think.
For one, Wegovy and Ozempic work primarily by reducing physical hunger. For some individuals, the kind of stomach-growling, lightheaded, belly-gnawing feeling of physical hunger seems to never go away. For these folks, turning down physical hunger could be the key to reducing portion sizes and limiting caloric intake. For others, food plays a role that far exceeds that of satisfying physical hunger. Food is entertainment, food is comfort, food is reward, food is childhood, food is family, food is a numbing agent. For those who use food for any of these reasons, reducing physical hunger will only do part of the job. Anyone who has eaten an entire box of cookies, or even ordered dessert at the end of a satisfying meal, knows that we often eat for myriad other reasons.
Further, the hunger-blunting effects of these medications seem to go away as soon as the medication is discontinued. At a cost of more than $24K/year (when insurance does not cover the bill), maintaining one’s weight loss for even a few years becomes a pricy endeavor. If the medication is not continued faithfully, hunger rebounds with a vengeance, and all is lost (or gained, as it may be).
Given these factors, it seems that Wegovy and Ozempic might be a great part of the solution for individuals who are struggling with obesity, but they very well may be just one tool in a weight loser’s toolbox. With physical hunger in check, individuals who have historically had difficulty adhering to weight management programs might have a whole new perspective. This is the prime time to fill one’s body with highly nutritious foods in appropriate sizes to start to “relearn” what it means to healthfully feed oneself. Additionally, when cravings hit, it may be easier for these folks to understand why they are feeling an urge to numb or distract, because food is looking attractive to fill a nonphysical need.
Participants at Structure House, while on Wegovy or with hopes to eventually discontinue it, learn patterns of eating that support their body, mind, and soul. With the support of registered dietitians, participants have the opportunity to learn thoughtful meal planning and preparation that will support them in making nutritious choices that will optimize their medication outcomes. Personal trainers and exercise physiologists are available to help participants reestablish their relationship with physical activity and fitness, since movement will become more accessible and comfortable as the weight comes off. Finally, therapists and life coaches can assist participants — through workshops and individual sessions — in identifying the triggers that have led to emotional and compulsive eating so that, even without medication blunting physical hunger, participants will have new tools and strategies to address all the other reasons we go to food.
Structure House has always had the “whatever works” approach because we know that weight management is never a one-size-fits-all endeavor. Whether you are currently taking weight loss medication or are interested in weaning off it, our residential program is the perfect setting to set you up for lasting success.
