The study showed that some long-standing advice is valid: prescription weight loss medications work best if used in conjunction with lifestyle changes and not instead.
Saxenda (liraglutide) is a prescription drug approved in the United States to stimulate and maintain weight loss when added to calorie reduction and exercise.
But it has not been rigorously checked whether the drug plus exercise is better than the drug alone (or just exercise).
The new trial, published May 6 in New England Journal of Medicine, did exactly that. And it was found that for a year the combination gained, which helped people lose more pounds and specifically body fat.
Experts who did not participate in the trial said it stresses the importance of “complete” tactics to keep extra weight switched off.
“The standard of care with all obesity treatments (medications and surgery) is to use them as a complement to ongoing behavioral changes,” said Dr. Scott Kahan, a spokesman for the Obesity Society. .
Changes in sustainable diet and regular exercise are critical, said Kahan, who also heads the National Center for Weight and Wellness in Washington, DC
Weight loss medications are helpful, Kahan said, but they are not “magic cures.” However, some doctors, he noted, may prescribe them without sufficient support to patients in the face of the currency’s lifestyle.
There are several medications approved in the United States to aid in weight loss. They include Xenical (orlistat), Qsymia (phentermine-topiramate) and Contrave (naltrexone-bupropion).
Liraglutide is sold under two brands: Saxenda, the drug for losing weight, and Victoza, for type 2 diabetes. Saxenda contains a higher dose of liraglutide and works by mimicking the action of an appetite hormone called LPG- 1, according to the manufacturer of the drug, Novo Nordisk.
The drug is taken by injection every day.
For the new trial, funded by Novo Nordisk, researchers recruited 195 obesity adults who spent eight weeks on a low-calorie diet. After that, they were randomly assigned to one of four groups: medication plus exercise; medicines only; exercise only; or a placebo group who was given an inactive “medication” and told to stay with their usual activity level.
Exercise groups, on the other hand, had a fairly vigorous routine. They were encouraged to attend group classes twice a week and exercise only twice a week, with running, cycling and brisk walking main activities.
All four groups received advice on long-term dietary changes.
After one year, the medication / exercise group had lost 16% of their initial weight, on average. This was compared with 11% in the exercise group and 13% in the medication group.
The combined approach was also the most effective at changing body composition: those patients lost about twice as much body fat and cut more of their waistline, compared to those of any strategy.
They also preserved their muscle mass, according to researchers led by Signe Torekov of the University of Copenhagen in Denmark.
“The most important point here is that the study confirms that yes, combining medication with exercise is more effective,” said Dr. Reshmi Srinath, who heads the Mount Sinai Weight and Metabolism Management Program. in New York City.
He had some caveats: the patients in the trial were quite young — on average at forty — and healthy. Such vigorous exercise may not be suitable for older adults or people with certain health conditions, such as painful arthritis.
“With these patients, it is usually recommended to walk or incorporate some weight training at home,” Srinath said.
But, he added, the conclusion remains: “Medications should be used as a complement to lifestyle changes.”
This applies not only to Saxenda, but to prescription weight loss medications in general, Kahan and Srinath said.
When it comes to choosing a medication, Srinath said, it is a case-by-case decision, given the side effects and health conditions a patient may have. In this study, the most common side effects among Saxenda users were nausea, diarrhea, and dizziness.
Personal preferences also come into play in the medication decision, Srinath noted. “Some patients are hesitant to take a daily injection,” he said.
The important thing, Kahan said, is that people who have “tried over and over again” to lose weight know that there are treatments that can help you.
“People often don’t realize it because we’re in this wild west full of fake products to lose weight,” he said. “But there are good legitimate options that have been scientifically studied.”
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more advantages weight management.
SOURCES: Scott Kahan, MD, MPH, director, National Center for Weight and Wellness, Washington, DC, and spokesman, The Obesity Society, Silver Spring, Md .; Reshmi Srinath, MD, assistant professor of endocrinology, diabetes, and bone disease, and director of the Weight and Metabolism Management Program, Icahn School of Medicine in Mount Sinai, New York; New England Journal of Medicine, May 6, 2021