Weight Loss: Myths, Medications and Making Informed Choices

By Dr. Vahid Yeganeh, MD | Owner, Healthy Conditions in Buckhead

If you have ever tried to lose weight, you’re not alone; it turns out that about half of Americans report trying to lose weight each year. It’s easy to feel overwhelmed. A vast industry has sprouted around weight loss over the years. Weight loss medication is front and center in our media outlets recently, while more ‘health influencers’ are popping up on social media every day, with dramatized claims. Let’s face it, all it takes is one podcast episode to turn the people around you into experts, offering unsolicited advice on how you should lose weight. Getting constantly bombarded with conflicting information is not only confusing; it can be dangerous.

Energy Balance and Weight Loss in the Context of Overall Health
As an obesity specialist, I can attest that weight loss is a complex, individualized journey. While the energy balance theory—consuming fewer calories than we burn to lose weight—remains relevant, applying it can be challenging. Methods that create a caloric deficit for one person might not fit well for another and in some cases can even trigger unhealthy behaviors. There is no 'one size fits all' solution. Ideally, we are making a sustainable, long-term lifestyle change that supports better health. For those with a long history of fad or crash dieting, this requires a perspective change.

Keep in mind that achieving weight loss alone does not automatically equal health, nor does being overweight necessarily mean being unhealthy. Therefore, I prioritize overall health when considering weight management, avoiding an isolated focus on weight loss.

Additionally, the source of consumed calories is important. Our bodies need a variety of nutrients, not just energy. A hundred calories from candy have a different health impact than a hundred calories from vegetables.

Two Outdated Myths

1. 'Losing weight is only about willpower'

This statement oversimplifies a complex issue. Overweight and obesity are influenced by numerous factors including genetics, underlying conditions (e.g., thyroid disease), sleep quality, stress, work and home environments, childhood experiences, access to healthy food, among many others.

2. 'Carbs are bad for you'

This is inaccurate and misleading. Complex carbohydrates in whole foods like whole grains, fruits, vegetables, and legumes are beneficial and rich in fiber, which offers many health benefits. In contrast, simple carbohydrates found in highly processed foods, like candy, can negatively affect your health. Portion sizes matter.

Medications
There are several classes of medications available today for the treatment of obesity. Recently, semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro/Zepbound) have gotten a lot of media attention. These two fall into the GLP-1 (glucagon like peptide 1) agonist and dual GLP-1/GIP (Glucose-dependent Insulinotropic peptide) agonist class of medications, respectively. These medications can be life changing for many people.

Pros

• They work. They help control appetite and improve blood sugar levels, making it easier to lose weight.

• They are generally well tolerated, with the most common side effects being gastrointestinal in nature (e.g., nausea, vomiting, diarrhea, constipation, abdominal pain).

• There is some data emerging that suggests potential benefits beyond just weight loss.

Cons

• They are expensive, and not covered by all insurances.

• The high demand for these medications has resulted in inconsistent supply.

• Their popularity, along with the proliferation of clinics/medical spas offering compounded versions (not approved by FDA) and low prescribing thresholds, has led to unscrupulous use. Many individuals risk undernourishment, lean muscle loss and subsequent health issues by using these drugs when not medically indicated.

As with starting any medication, a thorough risk versus benefit analysis should always be conducted in each individual case, followed by close monitoring while on the medication.

Fad Diets
Popular fad diets often promise quick results. While these diets can indeed lead to short-term weight loss, they are often not sustainable and can lead to nutrient deficiencies.

• The Ketogenic (Keto) Diet: It involves eating extremely low amounts of carbohydrates and high amounts of fats. Generally, it is difficult to maintain long-term and may increase your blood cholesterol levels, as well as potentially lead to nutrient deficiencies.

• Detox Diets: These involve consuming only liquids or very restrictive foods. The body already cleanses itself of toxins. Detox diets are unnecessary, potentially harmful and there is no scientific evidence to support their use.

• The Carnivore Diet: This diet involves consuming only animal products and raises several concerns. It excludes fruits, vegetables, grains, and legumes, leading to potential nutrient deficiencies and digestive issues. The high intake of saturated fats increases the risk of heart disease.

Sustainable Weight Loss
A comprehensive approach is key to sustainable weight loss. This means not only adopting a nutritious diet, but also engaging in regular physical activity, managing stress, getting enough sleep, nurturing positive relationships and engaging your support network. It's particularly important to address emotional and psychological needs. Developing a healthy relationship with food should be at the core of any sustainable weight loss journey. When we exercise patience and compassion with ourselves during this process, we are rewarded with transformative changes that can rewrite our future.

You can start right now by contacting us at 404-443-3833 or [email protected].