A ScientificAmerican.com article published last year was not alone in raising a valid point or two. Writer McKenzie Prillaman speculated on the validity of welcoming the GLP-1 drugs as some sort of medical messiah:
Another unknown is who will respond to these drugs — and who won’t. It’s too early to tell now, but the drugs seem to be less effective for weight loss in people with type 2 diabetes than in those without. Conditions such as fatty liver disease and having fat around the organs, known as visceral body fat, might also affect how people respond to different drugs.
Aspersions have been cast by, among others, Matthias Tschöp, a German physician and scientist. Who will respond to these drugs and who won’t? Hesitancy and caution bring up other questions that many professionals feel really must be answered first: exactly who needs to respond to these drugs, and why do they need to? Because there is still doubt in some minds about whether “obesity” is such an enormous problem after all.
The link between excess weight and health is not proven to the satisfaction of everyone. Why?
One study found that nearly 30{e60f258f32f4d0090826105a8a8e4487cca35cebb3251bd7e4de0ff6f7e40497} of people who are considered obese are metabolically healthy. Another showed that other health problems tend to be a better predictor of someone’s risk of death than is weight, demonstrating the need to consider factors other than weight when judging health.
And indeed, it is possible that a person whose eyelashes fall out or whose fingernails show grooves is more likely to develop some fatal condition than an obese person is. Biology and medicine are two fields that never run out of surprises, so who knows?
Keeping up, or being led by the nose?
Then along comes another expert, like biologist Timo Müller, to point out that times have changed, especially after semaglutide arrived on the scene. Previously, using pharmacology to reduce weight by more than 10{e60f258f32f4d0090826105a8a8e4487cca35cebb3251bd7e4de0ff6f7e40497} had proven to be unsafe for patients’ overall physical well-being.
Still, these newer drugs held out the promise of performing other services, like improving cardiovascular health. Tirzepatide increased the “wow” factor even more, with its ability to rival the effectiveness of bariatric surgery by enabling the loss of, in some cases, 20{e60f258f32f4d0090826105a8a8e4487cca35cebb3251bd7e4de0ff6f7e40497} of the patient’s body weight.
And yet… did that individual really need to be changed into four-fifths of their former self? Misgivings were expressed by psychologist Sarah Nutter, whose main areas of interest are body image and weight stigma. The particular concern here is that patients are letting themselves in for a lot of misery, what with nausea and vomiting and so forth — “to escape weight stigma, rather than to serve a true health need.” There is also concern that people are overly influenced by reports from celebrities, and by news stories aiming to convince folks that once they lose weight, all their pesky life problems will disappear.
Celebration or desperation?
There is a feeling in some quarters that the public is being brainwashed into paying well over $1,000 a month to solve what just possibly might be a non-problem. Perhaps these individuals could be better served by spending that money on psychological counseling, or any kind of therapy, rather than ingesting substances that may not offer permanent health, and indeed might cause actual harm.
The insurance companies that balk at dishing out the dollars may not be solely motivated by reluctance to part with the cash. Their reluctance to pay for “vanity drugs” might even indicate genuine concern for the patients’ well-being. After all, stranger things have happened. But then, the other side comes along with multiple proofs of the enormous damage that can be caused by untrammeled obesity.
When a large number of 20-year studies about GLP-1 drugs and their close relatives have been completed, we can rest assured that someone will always say, “That is all well and good, but what about the 30-year studies? We need those.” It might be that some answers will never satisfy.
Your responses and feedback are welcome!
Source: “Breakthrough’ Obesity Drugs Are Effective but Raise Questions,” ScientificAmerican.com, 01/10/23
Image by airpix/Attribution 2.0 Generic
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