We Are Not On The Same Page About Weight Loss Medications

Navigating the health landscape can be dicey, even for those of us who make a living being involved in it.

There’s an old joke and I’ll use “fat loss coaches” as the subject to highlight my point.

How many fat loss coaches does it take to screw in a lightbulb?

One to screw it in and the rest to say: “I could do it better.”

I recently saw a lengthy post by a fellow fat loss coach and it was a frightening reminder of how tone deaf many of us in the field can be.

We’ll call the coach “Joe” to protect the uh, innocent.

Joe starts his post off by stating that weight loss drugs make people fatter. He then opts to bolster his argument by stating that the doctors who prescribe them don’t get to the root cause of problems, they only look for medicinal drugs as a band aid to offering a true solution. In addition, many doctors can flat out be wrong and this error in judgment can be the difference in cases of someone living and dying.

Sound harsh?

Let me push back on this and state that: No, weight loss drugs (the ones which are very popular in use right now) make people leaner. That’s precisely why they’re in such high demand. If they didn’t work, people wouldn’t want them. They not only make people leaner but they can aid in reversing Type II diabetes, high blood pressure and high cholesterol. They are literally life saving medications.

Is he right that doctors don’t get to the root cause of problems? Perhaps some don’t. Assuming that every person with M.D. or D.O. after their name is the all knowing expert in all things related to the body is short-sighted. No medical professional is perfect and many of them seek out areas of specialization because the human body (and mind) are so incredibly complex. So, yes, it stands to reason that the doctor you’re working with (no matter how long you’ve worked with them) may not have every possible solution to what ails you.

If a patient comes in complaining of pain, it can take a series of questions from nurses, to P.A.s to M.D.s to try and pull together enough information to solve a problem.

Is the process foolproof? No.

Is the first line of defense for a problem the best option? No.

Sometime it takes trial and error and bloodwork and scans and specialists to be involved to get to the root cause of anything. Sometimes, the best option is a medication which may (or may not) be helpful. I should also add that every medication (no matter how much research is behind it) has a risk of side effects. Then again…so does cough syrup.

Let’s move on.

Joe then goes on to explain that weight loss medications are nothing more than “magic pills.” They work to suppress the appetite, meaning you eat less food which equates to fat loss. He then lets the narrative spin that if you remove the medication that you will regain the weight. And why? Well, because you didn’t actually change your behaviors and that if you would just follow these simple tips of: gaining more knowledge about how fat loss works, adding more protein to each meal, strength training 2x/week for 30 minutes, drinking more water and oh yes…learn about portion sizes and macros then you basically don’t need the medication.


May I sidestep this for a few? I promise to come back to it.

I’d like you to think about depression for a moment.

Perhaps you struggle with it or you know a friend who does. In this case, medication may be warranted and advised. Of course, other factors in their life could contribute to improvements in depression such as exercise and a mostly nutritious diet. That being said, medication may still be what allows this person to live their best life. Sometimes, it may take the right medicine at the right dosage and some trial and error may be needed. However, antidepressants are not only socially acceptable but medically acceptable and you generally can appreciate that if the medicine is working then it stands to reason you may be on it indefinitely. In other words, no other interventions can have as dramatic of a positive effect as the medication itself and if you remove the medication, the depression will come back in full swing.

Now, let’s get back to our weight loss medications.

Hormones influence how we eat, as does our environment, and our stress levels and our sleep habits. A person who has struggled with their weight for most of their life may be faced with more environmental challenges than the person next to them. Maybe trauma, neglect or poverty has influenced how they eat.

So, can a “simple” intervention of strength training, a nutrient rich, “protein-centric” diet, hydration and more knowledge about fat loss help someone reach and maintain their goals. Absolutely!

But what happens to the people who just can’t make the pieces fit? Are they broken? Do they just lack willpower and motivation? Do they just need to hustle harder?

Think about that person with depression again. Wouldn’t life be simpler if they just smiled more often and could cheer the hell up?

Sorry, Joe, I know you meant well but you were way off base with this one.

Fact of the matter is this: weight loss medications are game changers and they give hope to people who have bounced from coach to coach to diet to diet who have all but given up on their goals because of weight stigma, fat-phobia, coaches who have little to no empathy, and decades of negative self-talk that they might never be able to succeed.

The weight loss medications can’t solve every problem though. Those who can take them DO still need to strength train, and they DO still need to drink plenty of water and they DO need to be more aware and conscious of nutritious foods and portion sizes appropriate to the bodies they want to achieve and maintain.

What the medications do successfully is help people achieve a deficit where they have previously struggled to do so. The medications will not make obsolete the help of a good strength coach or a good nutrition coach, they just make achieving the deficit easier to do.

These medications, as powerful as they are, don’t come without potential side effects and for some people those side effects are more pronounced than others.

One of my clients (who recently started one of these medications) said to me: This medication is life changing. Now I know how skinny people think.

I asked her to clarify that statement.

She said: I never understood how someone could just walk away from food on their plate. Now, the medication makes me want to eat healthy food and I don’t feel like I’m broken anymore. For years, I just thought something was wrong with me.

And Joe (knowing you may never read this), this is what hope can feel like. It’s not simply a “magic pill” (or shot to be more accurate), it can take someone from four medications down to one. And, there is a really good chance they may need to be on the weight loss medication long-term, just like our friend with depression.

So, rather than shame people for taking it and accusing them of short cuts, embrace them, support them, coach them and watch them thrive.

(Photo courtesy of Julian Wallner)