Disclaimer: In this article I share my professional opinions as general information to support the public on their health journeys. These views are intended as general opinions, but should not take the place of personalised psychological and/or medical care. Please consult your treating medical professional and/or mental health professional before making decisions relating to your health care.
Last Sunday, I shared with you some of the things we aren’t being told about weight loss medications – including the reality that most people regain weight after stopping them, the real risk of losing muscle mass along with fat, and the possibility of serious adverse psychological effects.
If you missed it, you can read it here.
I also told you that – thankfully – there was a lot we could do to minimise the potential risks of taking weight loss medications, whilst also maximising the potential benefits.
Today I want to talk to you about the first – and in my mind, a vital – piece of the puzzle.
A Great Doctor Can Make All the Difference
Many GPs are absolutely able to prescribe weight loss medications, and some do so with great care and attention. At the same time, due to rapidly emerging advances in the medications themselves, ever-increasing demand from the general public, and – of course – their areas of professional interest, some GPs are making weight loss medicine their main focus.
Over the past few years, we at Weight Management Psychology have been fortunate enough to make some special bonds with GPs that have weight management pharmacotherapy as their main clinical focus. I have co-presented with them, we have welcomed them in to upskill our clinical team (and vice-versa), and – perhaps the best way we learn from each other – we have shared many clients together.
And through working closely in interdisciplinary teams with these doctors, we have learned that there can be a significant difference between receiving a standard prescription and being closely supported by a doctor with a passion for and wealth of experience in metabolic medicine.
Let me share a couple of examples with you:
Case Study 1 – Titrating up slowly. One of my clients, let’s call him John, had tried weight loss medications with a local GP early on in our therapy. Unfortunately, he experienced extreme side effects – severe nausea, persistent headaches, and vomiting upon drinking even small amounts of alcohol – that were intolerable. He had given up on weight loss medications altogether, assuming they weren’t for him. However, after making some improvements to his habits and telling me he still wanted to lose weight, he decided to take my suggestion of exploring the care of a GP who had a specific focus in weight management pharmacotherapy. He started the same medication at a much lower dose than the standard protocol – and titrated up incredibly slowly. The side effects this time became manageable, and the weight loss followed. At the time of writing, he is still taking the medication.
Case Study 2 – Finding the right medication. Another client, let’s call her Jane, began her weight loss medication journey with a GP I recommended to her. Unfortunately, quite quickly, she experienced severe psychological adverse effects – a highly depressed mood, pervasive rumination, and even suicidal ideation. We contacted her GP straight away, she was booked in for a review within days, and discontinued the medication immediately. After following a GP-recommended month off weight loss medications altogether, she began a different medication. At the time of writing she is titrating this medication up slowly, and experiencing tolerable side effects that she is managing well using psychological strategies.
My Practical Recommendation
Many people can take the weight loss medication journey effectively with their regular GP – particularly if they have an existing relationship and their GP has a genuine interest in weight loss medications.
But many others will benefit from seeing a GP who has a special interest in weight loss medications. If there are any extra considerations – such as challenges with choosing between or titrating medications, experiencing intolerable physical or psychological side-effects, or difficulties with losing weight – then we would often recommend seeing a doctor who has a focus area in weight loss pharmacotherapy.
Given weight loss medications are a significant financial investment, ensuring that you see someone who can help to optimize your experience – reducing the likelihood of risks and maximising the potential benefits – is, in my view, an investment worth making.
At our clinic, we see many clients who want better than average results. And we often tell them that if you want better than average results, it helps to enlist the support of better than average care.*
The Next Steps
Soon I’ll be sharing about the second and third pieces of the puzzle: the behavioural and psychological elements of the weight loss medications journey.
These elements work in conjunction with the medical elements to help you minimise risks and maximise results – and they are equally important – especially when it comes to the name of the game in weight management – creating changes that last.
I look forward to talking with you soon!
Yours in caring, experienced, and collaborative care,
Glenn
*We follow a similar approach with the Bariatric Surgeons we work closely with. Rather than recommending surgeons who are qualified to perform bariatric surgery, we tend to refer to surgeons with a focused sub-specialty and a high degree of experience in performing bariatric surgery.
