As a former Registered Dietitian and current oncologist, it’s time to weigh in on the use of popular weight loss medications. My 10 years designing diets and counseling patients (diabetics, cardiac, hypertensive etc) taught me that diets are fleeting, genetics plays an enormous role, habits are a big part, family dynamics, psychological issues and even access to nutritious food, all factor in. It is not an issue of willpower.It is not a moral failing.

We tried everything: jaws were wired shut (!), parts of stomachs removed, stapled, or filled with a balloon, and every weight loss mechanism and over the counter med was tried. Finally finding a substance that could change the hormonal milieu and result in real, dramatic life changing weight control is having a tremendous positive impact. It is almost impossible for someone to exercise away 100 lbs. We are not talking about the 10, 20 or 30 vanity pounds, we are talking about changing a life to reduce diabetes, heart disease, hypertension and even cancer.

13 cancers are directly related to obesity: breast, colon, rectal, uterus, gallbladder, stomach, kidney, liver, ovary, pancreas, thyroid, meningioma and multiple myeloma! These represent 40% of cancers diagnosed in US each year (source CDC) . It is a hyper inflammatory state effecting everything. ENDO 2025 (annual meeting of the Endocrine Society) looked at 33,000 cases of cancer deaths related to obesity and found death had tripled in the US in the last 20 years. CDC reported that 40% of adults are living with obesity.

I encourage many patients like Rosalia this week. She is 5’1″ and 210 lbs and has been treated for breast cancer, now on anti estrogen therapy. This has caused her even further weight gain. I addressed this with her. “Rosalia, you should speak with your primary care physician and discuss the weight loss injections. You are already borderline diabetic and we need to reduce your risk of further cancer”. She perks up, “Doc, everyone tells me to lose weight, but I cannot exercise this away. I would love to be more healthy and be able to play with my three children”.

My recommendation is that you start the discussion with your primary care physician. If needed, see a bariatric specialist. Yes there are risks but obesity itself is a major risk too. Continue to exercise because muscle mass is lost, increase protein, take a multivitamin, and added D3, increase hydration. If your insurance does not cover, the manufacturers are now making lower cost meds available. We can no longer expect insurance to cover every aspect of our medical care.

The recommendation for these medications is for obese people, especially those with diabetes, who are looking to improve their overall well being and decrease the risk of major health impact. Have a discussion with your physician. Tools are finally available as never before. You should be strong, you should be fit, and you should be healthy. You should also be heard and be responsible for your wellbeing. Best wishes.