Popular anti-obesity drugs must be paired with healthy habits, experts say

Whether they’re using weekly shots or daily pills, more Americans than ever are turning to anti-obesity drugs to lose weight and boost health.

About 1 in 8 U.S. adults say they are taking a GLP-1 drug, according to a recent survey by the health research group KFF.

Just since January, more than 600,000 prescriptions have been written for Novo Nordisk’s new Wegovy pill, the company said. Early analysis suggests that more than a third of users are new to the drugs, according to Truveta, a health care data company.

But medication alone isn’t the answer, experts caution. It also takes lifestyle changes — healthy diet, exercise, adequate sleep and stress management — to reap the biggest benefits from the drugs known as GLP-1s.

“The biggest mistake people make with GLP-1 medications is thinking the prescription is the treatment,” said Dr. Katherine Saunders, an obesity medicine expert at Weill Cornell Medicine and co-founder of FlyteHealth, a weight-loss treatment company.

GLP-1s can spur weight loss and health benefits on their own, but the effects are larger and last longer when the drugs are combined with lifestyle changes, a recent review of nearly three dozen studies found.

Here’s what experts say you should know about GLP-1 drugs and healthy habits:

It’s not all about weight

Obesity is a big driver of chronic disease, including conditions such as heart disease and diabetes. But the focus should be overall health and not just the numbers on a scale, said Dr. Jody Dushay, an endocrinologist and obesity expert at Harvard Medical School.

“Health is what you eat, how much you move your body, what is your blood sugar, what is your blood pressure, what is your cholesterol,” she said. “All of those things are really important.”

The GLP-1 drugs work by targeting hormones in the gut and brain that slow digestion and target appetite and feelings of fullness. That effect “levels the playing field,” said Saunders, making it easier to adopt healthy habits like eating less and moving more.

“Social media and advertising sometimes create the impression that these medications are a quick fix, but obesity is a complex, chronic, progressive disease” that requires ongoing medical management, she added.

What does research show about GLP-1s and lifestyle changes?

The clinical trials of anti-obesity medications like Wegovy and Zepbound included structured lifestyle programs along with the medication, which are advised along with every new prescription.

That results not only in significant weight loss, but improved health markers.

A February study of more than 98,000 U.S. military veterans found that those who used a GLP-1 and adhered to six to eight healthy habits had a 43% lower risk of serious cardiovascular events such as stroke and heart attack than those who didn’t use the drugs and followed three or fewer such habits.

Lifestyle habits “can substantially amplify the benefits of modern medications” noted Dr. Frank Hu, a lead author and chair of the nutrition department at the Harvard T.H. Chan School of Public Health.

Which changes are most important?

To maximize the benefits of GLP-1s and reduce potential side effects like nausea, vomiting, constipation and muscle loss, Dushay and other experts offer specific advice.

Maintain muscle by eating 20 grams to 30 grams of protein per meal, which could include fish, poultry, yogurt and beans. Eat more fiber and drink more water — as much as 8 to 12 cups a day. If heartburn or nausea is a problem, avoid fried foods and spicy foods, and don’t lie down after meals.

Aim for 150 minutes of aerobic exercise a week, or, ideally, about an hour a day. Add in 30 minutes of strength training two or three times a week, such as lifting weights or using resistance bands.

Get enough sleep — seven to nine hours a day for a healthy adult. Take steps to reduce mental and emotional stress.

Finally, check in with a health care provider about your progress. The GLP-1 drugs can have rare but serious side effects, the experts noted.

“Someone really does need to keeping track of: What is the pace of your weight loss? What are your side effects? And not just mailing you a prescription every month,” Dushay said.

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