How you’ll lose weight when you’re on weight loss meds
WRITTEN BY: REKHA KUMAR, MD, CHIEF MEDICAL OFFICER
Some of the new medications for weight care are pretty amazing. For example, semaglutide, which was just approved by the FDA for weight loss in 2021, was called a “game changer” by the New York Times for, among other results, producing more weight loss than other prescription treatments. (That said—even medically groundbreaking drugs work differently for everyone, because each person’s biology is different.) Obesity is a complex disease—there’s a lot more contributing to it than the old-school concept of calories in, calories out. But even with a breakthrough like semaglutide and other GLP-1s (glucagon-like peptides), weight care is still challenging.
Even for game-changing drugs.
When you first start treatment with medications, it usually takes a few weeks for weight loss to kick in. Some prescriptions require a smaller dose for the first month to get your body used to it before you start taking a larger dose that’s actually going to work to produce weight loss.
But later in your weight care journey, you may hit a point when the pace of weight loss slows. The cause isn’t necessarily because of slipping habits or a lack of willpower. Instead, it’s likely human biology and the nature of excess weight and obesity. Fortunately, the latest science supports an approach that uses multiple strategies to help outsmart your body.
Your body tries to regain lost weight
When you’re changing your lifestyle to lose weight without medication, the first week you might initially lose two pounds or more—often, a lot of it’s water weight, but it’s still encouraging. Then your weekly weight loss levels off and continues at a good pace, perhaps a pound or so a week.
Once you lose about ten percent of your body weight, you’re likely to hit a plateau. Your weight loss stalls, and it’s not necessarily because of your habits or willpower, but because of a phenomenon called metabolic adaptation. Your body wants to defend its set point weight, and so it changes your metabolism and your appetite and satiety hormones to encourage weight gain. (Exactly what you don’t want!)
How weight loss happens on medication
So what happens when you start a weight care journey with lifestyle change and prescription medication? The same metabolic adaptation phenomenon kicks in: Even with the lifestyle and Rx combination, your body wants to defend its set point weight. Medication gives you an advantage because it targets a specific pathway your body uses to try to regain the weight. For example, phentermine suppresses appetite. Different drugs target different pathways. Even when you’re on a prescription, it will start to adapt through other pathways to defend the set point weight and attempt to regain weight. (This is a point where you’ll likely hit a plateau again.) This is why, even on prescription medication, weight loss can slow down or stop.
This isn’t the time to panic that you’re not doing everything perfectly. For Found members, it’s time to check in with your Found medical provider.
Weight care strategies can outsmart your biology
To keep up with your biology’s metabolic changes, it’s important to work with your medical provider and keep them in the loop of what’s happening on your weight journey.
At Found, our medical providers use prescriptions in combination with each other. Our providers work with the widest set of medications available on the market so that they have multiple options to customize your treatment. By addressing more than one pathway with medication, your treatment can help you get past plateaus and move you closer to your goal.
Weighing in on a routine schedule—like Found’s Weigh-in Wednesday—and keeping a food log can help you tell your provider what you’re experiencing so they can strategize your next step. (If the scale intimidates you even a little, here’s how you can approach it with a new mindset.) Because there are more options available now for treatment than there have been in the past, your medical provider can tailor your treatment for you along your journey including weight loss and maintenance.
Take some time to log your meals, movement, and other dailies in the app to track your progress. It gives you time to reflect, and science shows it supports your success.
About Rekha Kumar, MD, Chief Medical Officer
Rekha Kumar, MD, MS, is the Chief Medical Officer at Found. She is a practicing endocrinologist who specializes in treating patients with obesity.