My Thoughts on Weight Loss Drugs
The Internet is enthusiastic about the new class of weight loss drugs, GLP-1 agonists, such as semaglutide. I have my doubts and I will explain why with an analogy.
A patient tells his doctor that his schedule only allows him to sleep four hours a night. But he can't stay alert on that schedule, so he asks the doctor for a pescription that will allow him to stay alert. Does the doctor prescribe aphetamines? No, he says, change your schedule to get more sleep. It's not healthy to continue working like you do.
Another patient sees her doctor and says I am gaining weight because I am always hugry. Should the doctor say I have a drug or ask, "What are you eating that leaves you hungry and can you change you diet to cut out the junk food?" The current opinion is, "I will give you a drug and you can eat what you want, only less of it."
But hunger is part of your body's feedback system. If you are still hungry after eating, it's not your hunger drive that is disordered, it's your eating habits. And overriding your feeling of hunger makes no more sense than overriding your need to sleep. Sooner or later suppressing your body's feedback system is going to lead to trouble.
But people want the easy way out and doctors see an opportunity for new business, so I am shouting against the wind. I am writing this in hopes a few will listen.