Wait! There’s a Different Type of Weight-Loss Drug?

If your doctor says your high body mass index (BMI) and blood sugar levels are risks to your health, you’ll probably think of two options beyond a dieting-exercise combo: Bariatric surgery or the newly popular weight-loss drugs in the GLP-1 agonists  family, including the most recent shining star, tirzepatide.

There’s a third way to go. Other medications that can help you lose weight, regulate your blood sugar, or both. Unlike the GLP-1 agonists prescriptions, these drugs are meant to be taken for a limited period of time, not for the rest of your life. They have downsides, as most medications do. Notably, you’ll lose fewer pounds than with the GLP-1 agonists, most of which are injected, while these other choices can be taken by mouth.

It’s worth asking about them for the short-term, though, if you have Type 2 diabetes or prediabetes and are clinically overweight or obese.

The Other Weight-loss Drugs

Several pharmaceuticals on the market address blood sugar and/or weight, and some have been around for many years. Popular ones include:

• Phentermine
• Phentermine with topiramate
• Bupropion with naltrexone
• Metformin
• Metformin with dapagliflozin

With the GLP-1 agonists, you can probably lose 15 percent to 25 percent of your bodyweight, but you’ll have to maintain your prescription for life. With these other drugs, you’ll shed no more than 5 percent to 10 percent of your bodyweight, meaning these drugs are less efficient for weight-loss purposes.

Still, these pharmaceuticals might be good choices if your BMI is less than 30. If it’s higher, they might be good for the immediate future, especially if you’re not open to bariatric surgery and/or GLP-1 agonists just yet. They’re not as likely to be your wisest route if your blood sugar is so challenging that you’ll likely need insulin soon and you’re BMI is quite high.

A Short-term Solution

You can take most of these drugs for six months, maybe a year or two, but any longer than that is not common and hasn’t been studied intensively by scientists. That means if you start a regime with one of these medications, you might get your blood sugar to a healthy level and also thin down a bit. However, just a few months later you’ll need to stop taking the drug and try a new weight-loss strategy — a Plan B or Plan C.

Like all prescriptions, each of these has its pros and cons. Phentermine, for example, is an amphetamine. It’s legal, but it can raise your blood pressure and ultimately increase your heart rate. Taking it might not be worth the risk. Maybe you can use it as a stopgap for a couple of years, alone or with topiramate.

Similarly, you might take metformin to control your diabetes or prediabetes, on its own or with dapagliflozin. They might be a good choice for keeping your blood sugar in check, but they won’t affect your weight enough that they’re worth it for that purpose – especially since they are not inexpensive. Sometimes insurance will cover the cost of tablets for a period of time and then decline to cover them going forward.

Obesity is a medical condition. It is not due to laziness. If you drop even 5 percent to 10 percent of your weight, that will begin the process of changing your metabolism. That can lead to preventing cancer, Alzheimer’s, heart conditions, liver issues and diabetes, among other issues. That’s why taking some kind of targeted action will help you in so many ways.

It can be tempting to take a medication that controls your blood sugar and helps you lose 10 percent of your weight in a year or two. Once you stop, however, you’ll regain the weight. All the benefits will be lost – including your decreased chances of those same medical challenges.

The Whole Picture

When you’re overweight and a Type 2 diabetic, there’s only one way to control your BMI and blood sugar forever, alone or together with medications and weight-loss surgery — live a healthier lifestyle:

• Eat low-fat wholesome foods, including whole grains, fruits and vegetables.
• Avoid hyper-processed foods.
• Limit the quantities of what you eat and drink, including soft drinks and alcoholic beverages.
• Exercise every day, whether that means walks, bicycle rides, weight-lifting, racquet sports, dance apps, swimming or whatever other activity you will stick with regularly.

One or more of these alternative medications can help you jump-start the weight loss. Changing your diet for good, together with physical activity, is the best route to maintaining a lower BMI and moderating blood sugar levels. Plus, you’ll feel more energetic. Do not blame the prescriptions if you gain the weight back once you stop taking your weight-loss drugs. Own up to your lack of compliance to lifestyle changes.

It is not a crime to be on lifelong weight therapy using an assortment of short-term medication prescriptions. However, if you can afford it or if insurance will pay for it, consider the GLP-1 agonists medications or bariatric surgery — with the low-fat foods and frequent physical movement.

Within your financial ability, do what is best for yourself long-term. Consider a solution that will work for the rest of your life.