However, approximately 10% to 15% of patients in these trials did not respond to treatment and lost less than 5% of their body weight.
Now that millions of people have used these drugs, several obesity experts revealed to The Associated Press that about 20 percent of patients may not respond well to the drugs. It’s a little-known consequence of the obesity drug boom, according to doctors who advise impatient patients not to expect uniform results.
“It’s about explaining that everyone reacts differently,” said Dr. Fatima Cody Stanford, an obesity specialist at Massachusetts General Hospital.
The drugs are known as GLP-1 receptor agonists because they mimic a hormone in the body known as glucagon-like peptide 1. Genetics, hormones and the variability in how the brain regulates Energy can all influence weight – and a person’s response to medications, Stanford said. Medical conditions such as sleep apnea can prevent weight loss, as can some common medications, such as antidepressants, steroids, and contraceptives.
“This is a disease that originates in the brain,” explained Professor Stanford. The dysfunction can be different from one patient to another.”
Despite these warnings, patients are often upset when they begin receiving the weekly injections but the numbers on the scale barely move.
“It can be devastating,” said Dr. Katherine Saunders, an obesity specialist at Weill Cornell Medicine and co-founder of the obesity treatment company FlyteHealth. “With expectations this high, there is so much room for disappointment.”
Medications are usually prescribed along with dietary and lifestyle changes.
According to Dr. Jody Dushay, an endocrinology specialist at Beth Israel Deaconess Medical Center, it’s usually possible to tell within a few weeks whether a person will respond to medications. Weight loss usually begins right away and continues as the dosage increases.
For some patients this does not happen. For others, side effects such as nausea, vomiting and diarrhea force them to stop the medications, Dr. Dushay said. In such situations, patients who relied on new medications for weight loss may feel they have run out of options.
“I tell them it’s not over,” Dr. Dushay said.
Trying a different version of the new class of drugs may be helpful. Other people respond well to older medications, experts say.
Changing diet, exercise, sleep and stress habits can also have profound effects.
Figuring out what works usually requires seeking help from a doctor who specializes in treating obesity, Dr. Saunders noted.
“Obesity is such a complex disease that it needs to be treated very comprehensively,” she said. If what we prescribe doesn’t work, we always have a backup plan.”
