There is No Magic Bullet

Let me guess. You made a New Year’s Resolution to diet and exercise, and you’ve already faltered. You’re not alone. Based on a study published by Drive Research, 23% of adults quit their New Year’s resolutions by the end of the first week, and 43% quit by the end of January. If only there were a magic bullet.

So many people have turned to prescription weight loss drugs, and they make it look easy. Is it a magic bullet?

I am a believer in the efficacy of these medications. They may save or lengthen the lives of overweight people. But they are not for everyone.

• Diet medications can have drawbacks, including negative side effects. Common side effects include nausea, diarrhea, constipation, fatigue, and upset stomach. Rare but serious side effects include pancreatitis, cholecystitis, kidney injury, and suicidal ideation.
• Diet medications can be expensive and may not be covered by insurance.
• Many people regain weight after stopping the medication.
• Not everyone responds the same way to weight loss drugs, and some people may lose little or none of their weight.
• Roughly two-thirds of patients discontinue weight loss medication within a year. (The Year of Ozempic, by Dhruv Khullar, Dec 14, 2023) Medication nonadherence is common. About half the time, patients don’t always take their medications as prescribed. For example, 30-50% of people with type 1 diabetes fail to stick with their treatment plan. 50-70% of people who are asthmatic fail to take their medicine. 50-70% of people with chronic high blood pressure don’t take their hypertension medication as directed. Medication non-adherence leads to worsening of disease, death, and increased health care costs.

I believe in skills over pills for weight loss maintenance. Prescription weight loss drugs are an adjunct to weight loss, but it is necessary to adjust your behavior, learn tools, and utilize techniques to keep it off.

Authors Evan M. Forman and Meghan Butryn, in Effective Weight Loss: An Acceptance-Based Behavioral Approach, talk about the importance of willingness. What they mean by willingness, in the context of weight loss, is to willingly engage in difficult or unpleasant activities in pursuit of your goal. We must first accept discomfort to be willing to engage in healthy behaviors.

For example, you willingly turn down the donut you are offered and eat the apple, even though you prefer the donut.

The authors talk about the difference between “only if” and “even if.” Examples of “only if” thinking are, “I’ll only go for a walk if it is not raining.” Or “I will only stick to my diet if there are no chips and cookies in the house.”

They advise that we employ “even if” thinking, such as, “I’ll go for a walk today even if it is raining.” Or, “I’ll stick to my diet even if there are chips and cookies in the house.”

Although weight loss medications can assist your goals, they are not magic. Even if you take weight loss drugs, you have work to do. What are you willing to experience to meet your goal? Are you willing to have less pleasure? Are you willing to have sore muscles, shortness of breath, and sweating? Unless you accept discomfort, you will not reach your goal.