Too Good to Be True? What You Need to Know About Weight Loss Drugs

Jim Hill: Welcome to Weight Loss And, where we delve into the world of weight loss. I'm Jim Hill.

Holly Wyatt: And I'm Holly Wyatt. We're both dedicated to helping you lose weight, keep it off, and living your best life while you're doing it.

Jim Hill: Indeed, we now realize successful weight loss combines the science and art of medicine, knowing what to do and why you will do it.

Holly Wyatt: Yes, the “And” allows us to talk about all the other stuff that makes your journey so much bigger, better, and exciting.

Jim Hill: Ready for the “And” factor?

Holly Wyatt: Let's dive in.

Jim Hill: Here we go.

Jim Hill: Welcome to Weight Loss And… Holly, I am excited about today's episode.

Holly Wyatt: I am too. There are so many questions out there circulating about these new weight loss medications. You can't go anywhere. There's a song about them. So many questions out there. They're everywhere.

Jim Hill: There's lots of excitement, but there's also some confusion and maybe some misconceptions. Today, I believe our focus should be on discussing our knowledge and potential gaps regarding the new medications..

Holly Wyatt: And I think that's key. We do know a lot, but there's so much they're new. There is a lot that we don't know about them. And I think that's an important piece to cover today too.

Jim Hill: We always like to start our episodes with why. Why are people going to care about this?

Holly Wyatt: Why do you care about it, Jim? Why are we doing this episode? Why do we think this is so important?

Jim Hill: I think these new medications represent a major leap forward in weight management. Let me preface that by saying they're not the magic bullet. They're not the end all be all. But for the first time, we have tools that help many people achieve or nearly achieve their weight loss goals.

That's why I'm excited. We have powerful new tools. I think we don't quite yet know exactly how to use those tools. I think this is an exciting time for our field. We've been spending years trying to help people lose weight. We have a great new tool to help us do that.

Holly Wyatt: I agree. We've been talking for years about how this obesity epidemic is just getting worse and worse and worse and worse. And we really haven't had enough tools. We need more tools. Finally, we have a medication that I believe can significantly contribute to weight loss and make a real difference. Like you said, that can maybe even we'll see reverse this epidemic. Could this help us stop more people from becoming overweight or obese? I think that's an exciting piece. This really may be something that's going to reverse that epidemic. That's why I think I like to talk about them. And I think from an individual's point of view, this may be a tool that can really help people who have struggled for a very long time.

Jim Hill: But Holly, there are some things we don't know. There are some potential watch-outs and there are limitations in what we know over the long term. So we're going to talk about that too.

Holly Wyatt: Always. With any medication, with anything that has a big impact on physiology appetite, and blood glucose, there are always some risks. Because then I think we need to talk about that. We need to be informed of both what the good side is and what potentially you need to watch for.

That might not be something that you want to experience. All right. Should we jump in? Let's jump in.

All right. So I think the first thing is what are these new drugs? There's all these names. I get, I even get confused. There's what with the multiple names. What are the drugs that we're talking about?

Jim Hill: Okay. Let's go through it. And number one, I want a job is naming these drugs because whoever names these drugs, I don't know. I don't know where you come up with these names. But let's simplify it. We're going to talk about two major classes of drugs.

Okay. The first class we're going to talk about, the drug's name is Semaglutide. Now you aren't going to see that in the prescriptions.

That's a drug made by the company Novo Nordisk. And there are two forms of Semaglutide. One is called Ozempic. And you would get a prescription for Ozempic if you had type 2 diabetes, for example. The same drug is marketed under a different name, Wegovy. And Wegovy is prescribed for weight loss.

Okay. Two different names, the same drug. Now Semaglutide works by increasing the level of a substance produced in your GI system. In your gut. It's called GLP1.

This goes to the brain and somehow in the brain, this results in you being less hungry and eating less. Okay. We don't know exactly how it works. There are a lot of researchers working on that. But it's something produced in the GI system that works in the brain.

And at the end of the day, you lose, you eat less and you lose weight. Okay. That's Semaglutide. Now the other class is tirzepatide.

Boy, these names. Tirzepatide is made by Eli Lilly Company. And again, there are two forms of tirzepatide. If you're getting a prescription for type two diabetes, you would see this as Mounjaro. Okay. If you're getting a prescription for weight loss, it's Zepbound.

Catchy, catchy names, Holly. So again, same medication, two different brands. One for type 2 diabetes, and one for weight loss.

Now the type 2 diabetes drug produces weight loss too. But they're prescribed by different things. Now the difference between somagletide and tirzepatide is that both of them increase GLP1. But tirzepatide also creates a second substance, gastric inhibitory polypeptide. So two substances, again, that somehow go to your brain, cause you to eat less and lose weight. So you're going to see the four brands prescribed for type two diabetes. You're going to see Mounjaro and Ozempic. For weight loss, you're going to see Wegovy and Zepbound. Is that clear?

Holly Wyatt: And I think we're just starting. That's a combination. So you see this drug now which has GLP1 and GIP, which are two gut hormones produced in the gut that we think have an impact on the brain. But not sure. I will tell you that.

But we know that the outcome is to have increased satiety, not eat as much food. But you're going to start seeing combinations. So there's going to be all different kinds of names that come out.

But I do think it's interesting. You have this generic name. We call it the generic name, which is the Semaglutide or tirzepatide. And then you have the consumer-friendly name that they come up with marketing like the Ozempic or the Zepbound, which, oh my goodness. And what does Zepbound even mean? I don't know, but it kind of looks like a Zep in your step.

Jim Hill: I think it's- Well, these are the marketing people that make a lot of money at the companies that come up with the name. So I'm sure there's a good reason.

Holly Wyatt: Oh, and whoever did the Ozempic, that was- I mean, everybody sings that song now. So they'll remember that. So they are. It's marketing trying to get you to remember what it makes you feel, right? That's what marketing does.

As physicians, we often focus solely on generic names like Semaglutide or tirzepatide. That's how we speak to each other. But then we have this whole marketing push. That's how the consumer sees it. So it is confusing. It's all the same drugs, but multiple names.

Jim Hill: Holly, what sets these drugs apart from the numerous others designed for weight loss or type 2 diabetes?

Holly Wyatt: Then we have some other drugs that are out there for weight loss, but these drugs have produced a greater amount of weight loss. We were in the range of 5 to 7%, maybe 10%, but these drugs kind of hit a whole new level of weight loss, which, I think, made them take off. So, it's what people want, and how much weight they want to lose is starting. These are more effective.

Jim Hill: You and I have never been able to get people very excited about losing 5% of their weight, have we?

Holly Wyatt: No. When we know medically, that's good.

Jim Hill: But it's a hard sale when someone wants to lose lots more. We've talked about it before. For many people, not everybody. For many people, these drugs can help you get near your gold weight. They can help you lose an amount of weight that is satisfying for you.

Holly Wyatt: And I think when people are saying how much - I mean, I think we're talking around 15%. It's always an average. Some people lose less, and some people can use more, but around 15%, that is huge. So, someone weighs 200 pounds, let's say. 15% would be a 30-pound weight loss.

Jim Hill: While it's true that weight loss has a significant impact on overall health, it's important to acknowledge that not everyone's primary motivation for wanting to lose weight stems solely from health concerns.

Holly Wyatt: I did my math wrong. Oh my goodness, I'm so used to a 200 would be a 30-pound.

Jim Hill: Is that what he said? A 30-pound. I think he said that. Oh, okay. He said that. 30 pounds. So, 30 pounds we know it improves your metabolic health, but also makes you look a lot better.

Holly Wyatt: Well, and that's important to some people.

Jim Hill: And that's okay. I argue about that. The only reason to lose weight is not to just improve metabolic health. That's a good reason. I think it's perfectly fine for people to want to lose weight to look better and feel better.

Holly Wyatt: I agree. You get to choose why you want to lose weight. Now, we know there is a benefit to weight loss, especially when you lose weight from an excess body weight. But I think the reasons are- we don't have-it didn't have to all be about your health.

Jim Hill: So, who are these drugs for? Or maybe a better way is to say, who are they not for?

Holly Wyatt: Well, these drugs are prescribed for people who have a body mass index that's over 30. And that's just a way that we kind of gauge weight and height. And it allows us to say, who do we think would have a benefit from this medication?

Jim Hill: And if you want to get your body mass index, just Google body mass index, and you can- it asks you for your height and weight, and it'll calculate it for you.

Holly Wyatt: Which is a whole other story we got to talk about. Is that the best way to do it? But that's how we do it. If your body mass index is higher than 30, you may need to consider taking medication. Similarly, if your body mass index is 27 and you have a comorbidity, you should also consider these medications. So, you have type 2 diabetes, or you have high blood pressure, or high cholesterol levels, or something like that, cardiovascular disease. Then even at a lower body mass index, you can consider using these drugs. That's who they're indicated for. That's what the FDA has approved them for, for people with body mass indexes in that range. So, who are they not for? Your body mass index is 25. Technically, you are not supposed to be using these medications when we talk to the FDA.

Jim Hill: Unless you live in Hollywood, right?

Holly Wyatt: Unless you live in Hollywood, or a lot of places. This seems to be that people are using these even when they don't necessarily have a body mass index that's elevated overweight or obese.

Jim Hill: And the reason is that, right, all these medications have potential downsides, and you don't want to use them in people that don't need to use them.

Holly Wyatt: I agree. We don't know for sure. We're always trying to balance the risks and the benefits. When you have a body mass index that's 30, there is a risk of having that body mass index or having that much body fat. We're willing to take a little bit of a risk on a drug. There's always some risk. So, we're already at a risk because we have elevated body fat. We're willing to take a risk on a drug. BMI of 25. You're not at that much risk based on it.

Jim Hill: So, what are the risks? What sorts of things might, what are the side effects? What are the potential negatives taking these medications?

Holly Wyatt: So, these medications, we've done some clinical trials and so, we've seen these. The majority of the side effects are gastrointestinal, meaning GI. So, there's nausea and vomiting and diarrhea. You titrate them up slowly, so you can tolerate them. But some people can't tolerate them at all. And when they're on them, that continues, and it just isn't a good drug for them. So, GI effects, as you might expect, may get better over time. But that can be definitely a risk.

That's something that you want to think about. Low blood sugar, if you're on a medication, another diabetes medication, when you combine it with this, you can have low blood sugar. That's a potential risk. There are some kidney and gallbladder problems and pancreatitis. But all these drugs were pretty well accepted. We didn't have a ton of side effects.

Jim Hill: In my experience, if you can get 30 pounds of weight loss, you can work through, some GI side effects, right?

Holly Wyatt: You can. It is important to acknowledge that some individuals experience persistent episodes of nausea and vomiting, even after taking gradual measures and following the recommended course of action. If you have continued nausea and vomiting, this is not going to be a good drug for you, right? That's different.

Jim Hill: So, which emphasizes, you need to work with your physician to get these drugs. These are prescription drugs, right?

Holly Wyatt: Their prescription, they're injectable. You need to titrate them. There are potential side effects. Working in collaboration with a healthcare provider is essential to achieve optimal results and ensure the highest level of safety.

Jim Hill: I'm on social media all day long, and I see all these ads, works like Ozempic or works like Mounjaro. Should people be leery of those things?

Holly Wyatt: When you are taking a medication with such promising potential to improve your health, it becomes crucial to consider the associated risk factor. Therefore, it is essential to ensure that you are receiving the correct medication and that you are being closely monitored during the testing process. You need to be monitored on these drugs. So, I would stay away from that.

I would get the real deal. I would talk to my healthcare professional about this. So, Jim, the other question is, though, that I get is, okay, I want to be, I want to take this medication. How long do I have to take it?

Jim Hill: Now there is a fascinating question. So, one model that a lot of people espouse is, well, it's like blood pressure medications. You take it the rest of your life. What do you think about that?

Holly Wyatt: Well, I understand that, and I understand it's a chronic condition, and it makes perfect sense to me. And when I treat somebody with type 2 diabetes, I don't expect them. I put them on medication. They're on medication for the rest of their life, unless something changes drastically. Same thing with blood pressure. It's a chronic disease. You wouldn't expect it to work if you stopped taking the medication.

So, I get it, but I don't think that's the way most people are thinking about this. They're thinking about, let me take the drug, let me lose the weight, and then I'm going to stop the drug.

Jim Hill: Well, what happens when you do that? We have some information about that from clinical trials of people who stop, right?

Holly Wyatt: So, if we look at the data, when you stop the medication, as you might expect, the weight, you regain the weight. The weight comes back. So, that's something to think about when you start this. I think a lot of people think, I just get the weight off. However, the data indicates that if you only take the medication for a short period, you are highly likely to regain weight once you stop using it.

Jim Hill: So, one model then is you take it forever for the rest of your life, and you keep the weight off. We don't even know if that's true, because we don't have long-term data. But at least one hypothesis is, that as long as you take the drug, you're going to keep the weight off. Are there alternatives? Are there different ways of thinking about losing weight with the drug, but not taking it forever?

Holly Wyatt: I think you can think about it, but we don't have data at this point to support it. But I would like to think about it. If you take the drug, get the weight off, and have made some lifestyle changes. You've increased that physical activity especially. You have worked on some dietary changes that you can continue. But the way the medication is working is it helps with satiety. It decreases gastric emptying and slows the food. It's changing how your thinking is. Thinking about food stops that food noise that so many people are talking about. They don't think about food anymore.

Jim Hill: I like that term, food noise. That's pretty cool.

Holly Wyatt: I know what they're talking about. When you take that medication away, that's coming back. That's then gone.

Jim Hill: But we get, as we're getting more and more people coming to us saying, I took the drugs, I lost weight, I love it, but I want to get off the drugs, but I don't want to gain the weight back. What do we have for those people right now?

Holly Wyatt: Once again, it's lifestyle change, it's behavioral change. And can you make those changes when you come back?

Jim Hill: Diet and exercise, how boring, right? But that's what works. Well, that's the hope. You and I have talked about this, is part of the problem. We've always been focused on weight loss maintenance, helping people lose weight over the long term. But what we found is, that if people don't reach their weight loss goals, it's hard for them to think of anything other than losing more weight.

Could the availability of drugs that assist people in achieving a desirable weight potentially enhance their focus on adopting healthier behaviors and sustaining weight loss efforts?

Holly Wyatt: That's one theory. And I guess we're going to see. And I think for some people, that can be the case. So, now I've got 30, 40, 50 pounds off. And now it doesn't hurt as bad to go out there and walk. It doesn't hurt as bad to go out there and move more. And so if that is a path that people take, then I think there could be some room.

So I think it may help people be able to do that. But we don't know that. That's not what the studies have shown. That's not what we've studied thus far.

Jim Hill: Well, keep in mind, these medications are fairly new, right? We're just beginning to study them. And we don't have a lot of people that have been on these medications very long, more than perhaps a couple of years. And we need to know over the long term.

Holly Wyatt: I think it's important to say that we don't know what being on this medication for five to 10 years is. It's in a new medication, right? It's not just weight loss medications. So I think that is important. And there's lots that we don't know. So what are some of the things we don't know?

Jim Hill: I have a lot of questions I want you to answer. Here's one I'm very, very fascinated with. And I can't get the answer from the published data. When you lose weight, right? You lose fat, and you want to lose fat. But you also lose lean body mass, which includes muscle and other kinds of things. Do these medications affect that? Are you going to lose the same proportion of fat and fat-free mass on these medications, as you would say, on a lifestyle program?

Holly Wyatt: And once again, I think that's a huge question. It's not just the quantity. We're focused on the quantity of weight loss. But what you're talking about is the quality of weight loss. Meaning, do I lose muscle or do I lose fat?

Jim Hill: That's important. I don't want to lose muscle. I'm happy to lose fat.

Holly Wyatt: Right. We all want to lose fat, but we forget sometimes forget to lose weight. It's not all fat. And as you mentioned, when we lose weight overall, it is important to note that the distribution of that weight loss includes both muscle and lean tissue, as well as fat. The question that's coming up is because people are losing weight rapidly. It's not clear what they're eating.

How much of the weight loss is coming from muscle and how much is coming from fat? We don't really know. And it probably is going to turn out that some individuals are losing a significant amount and some aren't.

So we really need to be able to dive into that and figure that out because you're right. We don't want to lose muscle. That is not something we want to do.

Jim Hill: Holly, I worry a lot about this quality of weight loss in older patients. And I'm asking for a friend. Uh-huh.

Holly Wyatt: We call that sarcopenia. When you lose weight, especially as you get older, you tend to lose that lean muscle. And what does that mean? It means your metabolic rate goes down and it also means functionally. You're not going to be able to do the things you want to do.

It's kind of funny. You're probably losing weight because you want to go out there and be more active and be able to hike and do different things. And then if you lose muscle, you may not be able to do that. You want to protect that muscle.

Jim Hill: So it might be that in some people, the quality of weight loss is perfectly fine. But for others, we might want to be careful.

Holly Wyatt: I think that's, I think that's very likely. We don't know, but I think that's very likely. Like anything, it's probably going to be individual, and certain groups or certain people will experience different amounts of fat loss versus lean muscle loss.

Jim Hill: So what about the location of weight loss? Do we know anything about if you lose fat, where the fat comes from? There's central fat, peripheral fat, upper body, and lower body fat.

Holly Wyatt: We would love to lose it from the midsection and a metabolic standpoint, from a health standpoint. We tend to think that the fat that's in the middle part of your body, where your waist is, like if you have a large waist circumference, you've got a lot of this visceral fat or internal fat. That's where we would like it to come from, from a health standpoint.

But we can't pick it. And that's what with any type of weight loss, people are like, oh, I wanted to come off here. And I'm like, I have spot reduction, not possible.

And I think it's the same thing with this. It's coming off in multiple places. I know a lot of people have talked about losing weight, and we've seen it in some of the pictures on social media and their faces. So they're talking about the loss of facial fat and how that looks. But you can't choose. The body decides where the fat is coming from.

Jim Hill: I have so many questions, but we don't have unlimited time. So let me ask a couple more. Does insurance cover these drugs?

Holly Wyatt: So some insurance does cover it. Some are not. It's changing. I think more and more insurances, I'm hoping, will cover it. I also want to just point out, though, sometimes I've seen insurance cover it for a short period. And then suddenly they don't cover it.

That can be a problem too, because you do need to think about this as long term. So insurance coverage, I don't know what you're seeing, Jim, but I think we've got some of it, but not everybody. And they are expensive.

Jim Hill: Well, here's the issue. I read an article in Forbes or one of those places that predicted that in the US, 100 million people could be on these medications. If I'm an insurance company, that makes me a little bit concerned.

Holly Wyatt: But these medications could do so much good. We talked about the weight loss, but these medications have shown cardiovascular benefits too. We didn't even talk about that. They had to jump through the hoops with the FDA to show improvements in cardiovascular endpoints. So, if we can see the benefit of these drugs, then maybe that cost will be offset.

Jim Hill: So that's probably what the insurers are looking at. On one hand, if you have 100 million people taking the drugs, you're going to have less cardiovascular disease and less diabetes. Many, many other conditions that are very expensive. And so perhaps the costs of the medications are well worth it down the road in terms of the savings of the other health costs.

Holly Wyatt: I think that's what they're thinking. I hope that's what they're thinking. I believe that investing is necessary, but we anticipate that this investment will yield improved health and reduced costs.

Jim Hill: So if you're on these drugs, Holly, what should you eat?

Holly Wyatt: Well, that is another perfect question. And what are people eating? A lot of times what you eat may affect whether you lose fat or you lose muscle. So I would say thinking about what you're going to combine, what you're going to choose to eat when you're on these medications could be really important in terms of that quality of weight loss that we're talking about. So right now, I think people eat whatever they feel like it. But if I would on these drugs, I would be really specific about what I'm eating. I would eat very nutrient dense to make sure I'm getting my vitamins.

And I would make sure that I'm eating enough lean protein to try to really target the fat loss and really save my muscle. But I don't think we know that either. That's another thing that we don't know.

Jim Hill: I've read some stuff about the fact that the food industry and the restaurant industry needs to be concerned about this. Because at the end of the day, again, if you have 100 million people eating less than they are today, that could change the whole face of our food industry.

Holly Wyatt: Well, I think they'll adjust. I mean, I think that we obviously we have this obesity epidemic. We all probably need to eat a little bit less food is probably going to be a positive. But you want to eat that kind of comes back to make sure what you are eating is nutrient dense. So maybe the food companies could help us out with that.

Jim Hill: There you go. Maybe they could help identify what the optimum diet could be. Our restaurants could actually focus on people on the medication. So there might be an opportunity rather than simply a challenge.

Holly Wyatt: Absolutely! After undergoing bariatric surgery, it is crucial for individuals to adhere to a carefully tailored post-surgery diet. The focus remains on consuming lean protein as a priority, among other important guidelines. I think we need to get a little bit better and do this with the medications to really have more guidelines on what people should be eating when they're on the medications. So I want to ask you a personal question, Jim.

Now, uh, oh, oh, kind of get vulnerable. Would you take these medications if you had the body mass index? If you if you met the requirements, would you take them, or would you have a family member take them? Would you feel like they're safe and would you take them?

Jim Hill: Absolutely. Without hesitation, I have recommended these for family members. I have recommended them for other people. We don't know everything and there could be information tomorrow that changes my mind. But from everything we know, these drugs produce weight loss that improves metabolic health. They improve how you look. They are relatively safe.

We have looked at major problems. You can anticipate everything. But from everything we know, they're effective and they're safe. And yes, the answer is I would recommend them to family members.

Holly Wyatt: I would take them too. If my body mass index was in the range where it made sense and I was at risk for diabetes, or I had diabetes I absolutely would consider taking it. I would do them the right way.

I'd go to my healthcare provider. I would do it the right way. I'd get the biggest bang for my buck. I wouldn't just randomly do it. I would be very strategic in how I did it. But I would do it too if I had that body mass index.

Jim Hill: All right. I'll ask you a question. Have you ever taken a weight loss medication?

Holly Wyatt: So I have in the past when I've had been at a higher body weight than I am now. It was back when Finfin was popular. I took it for a little while, and it was amazing in a sense. And it gave me some insight about drugs because when I was on Finfin, I did not think about food. And that was such an amazing time for me because I didn't realize how much I constantly thought about food. And this is that food noise that they're talking about. And so when I was on that drug, I could have cookies in my cupboard, and they didn't call my name or chips. And they didn't call my name before. It was like I was always thinking about when am I going to eat. There are cookies in there.

Are there ships in there? Oh, my gosh. I got to eat. I got to eat. I got to eat. I was constantly thinking about food and cravings and wanting to eat.

And suddenly I took a weight loss medication and boom, that went away. And it was an amazing feeling. And it gave me insight. It gave me insight to how we all feel differently about food and that you don't really know how someone else feels. And so if I'm telling someone, don't eat that, eat a small portion, I don't know how they feel because I recognize, wow, there could be a difference. And for the people who don't struggle with their weight, I can say, I can imagine this is how they feel where they don't understand. Just leave that cookie alone.

Just don't eat that cookie because they don't think about food like I do. So it was a it was very interesting for me and great insight at that point in my life. So it made me believe that there is a role for weight loss medications. Now, we've had weight loss medications that have had bad outcomes that have had, and we've had to take them off the market. And that's not been good. But in general, the idea that we need weight loss medications, it was from that experience that I really gained that insight.

Jim Hill: I see these as a wonderful new tool. Holly, I think the development of these medications is probably the most significant advancement in weight management that's happened during my career. Now, saying that there are still a lot of questions I have. I want to know more.

I want to know more about body composition and lifestyle and so forth. But as someone who's been a researcher in this area for many, many years, I think these things are wonderful new tools. We just have to figure out the optimum way to use these tools.

Holly Wyatt: I agree. I agree with that. And I do think we need to figure out the optimal way to use them. So if I was going to put some pie on the plate, kind of tie all this up, I would say, ask your doctor, get help, go to your health care provider. If you're going to use these tools, if you're going to use these medications, use it as a tool.

Don't just use the medication. Make sure you are making changes to your diet that you're trying to be more active. I would combine it with a very nutrient dense, not necessarily energy dense, but nutrient dense diet with plenty of vitamins and minerals, good food, vegetables and lean protein. I would be as active as I could, so I could try to target fat loss, and do everything I could to make sure that fat that I was losing, the weight that I was losing was fat. I want to assess my body composition to ensure that most of the weight I'm losing is fat rather than muscle.

Jim Hill: How do you do that, Holly? How are our listeners going to measure their body composition?

Holly Wyatt: Well, it's a little bit easier than it used to be. There are devices available at various health clubs or nutrition stores that utilize BIA (bioelectrical impedance analysis), which can also be found in some scales for purchase. They're not perfect, but they can give you a little bit of an idea of what you're losing. So it's easier than it used to be to get that body composition measurement.

Jim Hill: I'm glad you mentioned being active and moving. We're going to talk about this a lot. This is my thing, the importance of physical activity. And I think we have always felt like being active is one of the keys to long-term weight loss maintenance. And even though you don't have to be active to lose weight, I think you do have to be active to keep it off.

If you are taking medications, it is possible to lose weight without exercising, but it is advisable to consider incorporating more physical activity into your routine. Hopefully, if you lose weight, you're going to feel better. It's going to be easier to exercise. That's going to help for the long term keeping the weight off.

Holly Wyatt: I would say if you want to stop the medication, if you're saying, I'm going to get on the medication and I know I need to be on it. Long-term for it to continue to work. However, I'm not going to do that. I'm going to stop the medication at some point. Then I would say work on getting that activity up as high as you can. That's going to give you the best shot at being able to maintain the weight that you've lost. So I think that's a great, a great tip to give someone who says, I'm not going to be on these medications forever. I'm going to stop them at some point.

Jim Hill: So if you're overweight, give serious consideration to these medications. We give them thumbs up for everything we know. We know they're effective. It looks like they're pretty safe. And I think they're a real viable option for people out there who are serious about long-term weight loss.

Holly Wyatt: I agree. They're a tool. Think of them as a tool, not for everybody, but for some individuals. I think it can make a big difference.

Jim Hill: Wow, well, this helped. I've worked through a lot of things. I still have a lot of questions, but that's what research is for to answer those questions over time. And as we get more new information, we'll update it in future episodes.

Holly Wyatt: I agree.

Jim Hill: Thanks. See you, everybody. See you next time. Bye.

Jim Hill: And that's a wrap for today's episode of Weight Loss And ... We hope you enjoy diving into the world of weight loss with us.

Holly Wyatt: If you want to stay connected and continue exploring the “Ands” of weight loss, be sure to follow our podcast on your favorite platform.

Jim Hill: We'd also love to hear from you. Share your thoughts, questions, or topic suggestions by reaching out at [weightlossand.com](http://weightlossand.com/). Your feedback helps us tailor future episodes to your needs.

Holly Wyatt: And remember, the journey doesn't end here. Keep applying the knowledge and strategies you've learned and embrace the power of the “Ands” in your own weight loss journey.