Lots of people have an increasing number of questions about GLP-1s and other weight-loss medications. Horsham-based female personal trainer, Becky, decided it was time to educate herself further…
As I’ve mentioned previously, weight-loss medications have been a topic so hot they’re almost untouchable. There’s commentary everywhere, and social media is teeming with posts about what it’s like to be on it, or speculating about those who are. It’s also something I’m getting increasing questions on from clients, and the truth is that I knew far too little about them – I’m not interested in taking them myself, so I’ve stayed away. But it was time to get informed, and I wanted high-quality information (as always), so when the opportunity to attend a study day run by the British Society of Lifestyle Medicine came up, I jumped at the chance.
Study day on weight-loss medications
This event was pitched mostly at medics, but it was made clear that many people were welcome. I’m used to reading and understanding scientific information as best I can, so I wasn’t put off by the fact that some of the content would be above my typical level academically. In this situation, I trust myself to absorb the information that applies to me, level up where possible and relevant, and ignore the stuff that I’m not going to need personally or professionally.
Sure enough, when the event arrived, the vast majority of those in the room were GPs, with some nurses, pharmacists, and other medical disciplines represented. I didn’t feel out of place – I felt sad that there weren’t more people from the fitness industry present. Because I see us as part of the care package here: we are working with people who are undergoing or recovering from treatment for a variety of conditions, and our job becomes easier and more effective if we have a better understanding of what they’re going through. It literally pays to be informed.
Topics covered during the day
The full-day agenda was packed. There were talks from a number of professions on topics such as: current NICE guidelines; behavioural change and how it fits into the care plan; patient experience; physical activity being used to support patients; general obesity treatment. I tried to keep an open mind throughout – my stance is fairly negative on these medications, and I knew beforehand that it would take a lot to sway me.
Credit where it’s due, the patient who shared their experience did present very well. And it did kind of prove something I already felt – for the right people, and with the right standard of care delivered, these medications can be incredibly positive.
And therein lies the problem: I get the sense that in addition to them being made available to too many people who don’t fit the correct patient profile, there is a huge lack of what’s known as wraparound care being provided. In simpler terms: these medications are most effective when they’re not just handed out with any other support given; patients need help with behaviour change, nutrition, physical activity, and ongoing management of their condition as well.
Key takeaways on provision of weight-loss medications
There were a number of brilliant pieces of information I took away, including:
- Now that there is a drug available to treat it, lots of people are suddenly interested in working with obesity – we need to slow down, and avoid giving generic advice (e.g. “eat less, move more”), because patients don’t understand the latter (personalised advice is critical)
- Doctors have to consider other medications the patient is taking – I can’t believe I previously didn’t think about particularly oral contraceptives and HRT. These medications are well known for interacting with certain others, thereby rendering themselves ineffective, and the same can happen here
- Obesity should be considered not in terms of BMI and categories, but whether it is at a pre-clinical or clinical stage – this means, does the condition require medical treatment (of any type), or is it at the warning stage? This really made me stop and think, and I thought it was a fantastic way of framing someone’s situation
- NICE guidelines include elements such as that we should use non-stigmatising language (in all forms of communication, whether it’s patient-facing or not), and to focus on improvements in wellbeing rather than just weight-loss – this was another bombshell, as I haven’t seen these recommendations in any discourse, but they are so important!
- The famous Eat Well Plate isn’t just bad, it’s culturally inappropriate for the vast majority of people
I learned a lot more besides the above, and my favourite things came in response to a question I asked at the end of Dr Paul Chadwick’s behavioural change talk. My question was: it feels as though we’ve been through a similar thing before, when bariatric surgery first became more widely available (Paul had mentioned that these things go in cycles, and that’s what triggered my thought); what can we learn from that cycle in order to improve care this time?
The answer was brilliant, and twofold. First, he witnessed the moral panic die down in the wake of the rise of bariatric surgery, and he believes that the same thing will happen again – it will get easier as a society to handle these experiences and this information. Secondly, the reason that a lot of bariatric surgeries have failed, or been less successful than hoped is because wraparound care wasn’t provided – people were given surgery and left to it, without lifestyle change and psychological issues being addressed. Please read that paragraph again!
Final thoughts on weight-loss medications
I left the day feeling inspired… but still not particularly hopeful. Those in the room were the choir – it was fantastic to meet like-minded people, and ones who are also intelligent and focused on giving good care.
There aren’t enough of them.
More people need this type of education. Many more.
At the start of the day, we were told that this is an arms race: pharma has entered the chat when it comes to treating obesity, and it has dangled what is perceived as a golden bullet in front of the salivating public. We need to consume that bullet responsibly, and deliver a full care package, or risk the consequences coming around to bite us in the future.