This transcript has been edited for clarity.
Hi. My name is Dr Sarah Barenbaum. Today we're going to be talking about who qualifies for weight-loss medications.
Losing weight is really hard, and it's important to know when to consider antiobesity medications as an adjunct to lifestyle modification. Diet, exercise, and behavioral interventions will always be the cornerstone of weight management and will be necessary to ensure lifelong weight loss.
Even with these changes, weight loss is extremely challenging due to adaptive physiologic responses that counteract weight loss. Biological forces work to limit weight loss and to promote weight regain over time, and this is where weight loss medications can really help.
Our current guidelines recommend considering antiobesity pharmacotherapy in adults who have tried lifestyle changes for at least 6 months and have been unsuccessful, and who also have a body mass index, or BMI, greater than or equal to 27 and a weight-related medical condition like type 2 diabetes, hypertension, hyperlipidemia, or sleep apnea, or anybody with a BMI greater than or equal to 30.
It's important to note that BMI is just a measure of mass and not health. BMI does not take age, sex, or ethnicity into account. It also does not differentiate between lean mass and fat mass, and it does not distinguish body fat distribution. Therefore, it does not give us any information about an individual's level of illness or health.
We know that abdominal fat is more harmful to health, so many professional societies have started recommending additional indicators to assess health, including waist circumference, waist-to-hip ratio, and waist-to-height ratio.
These additional measurements can be helpful in determining the overall risk associated with excess weight and may help determine who qualifies for weight-loss medications in the future, but our current guidelines still use BMI as the primary screening tool, and by extension, this is what most insurance companies often use to cover treatment as well.
COMMENTARY
When Should You Consider Weight-Loss Meds for Obesity?
DISCLOSURES
| March 27, 2025This transcript has been edited for clarity.
Hi. My name is Dr Sarah Barenbaum. Today we're going to be talking about who qualifies for weight-loss medications.
Losing weight is really hard, and it's important to know when to consider antiobesity medications as an adjunct to lifestyle modification. Diet, exercise, and behavioral interventions will always be the cornerstone of weight management and will be necessary to ensure lifelong weight loss.
Even with these changes, weight loss is extremely challenging due to adaptive physiologic responses that counteract weight loss. Biological forces work to limit weight loss and to promote weight regain over time, and this is where weight loss medications can really help.
Our current guidelines recommend considering antiobesity pharmacotherapy in adults who have tried lifestyle changes for at least 6 months and have been unsuccessful, and who also have a body mass index, or BMI, greater than or equal to 27 and a weight-related medical condition like type 2 diabetes, hypertension, hyperlipidemia, or sleep apnea, or anybody with a BMI greater than or equal to 30.
It's important to note that BMI is just a measure of mass and not health. BMI does not take age, sex, or ethnicity into account. It also does not differentiate between lean mass and fat mass, and it does not distinguish body fat distribution. Therefore, it does not give us any information about an individual's level of illness or health.
We know that abdominal fat is more harmful to health, so many professional societies have started recommending additional indicators to assess health, including waist circumference, waist-to-hip ratio, and waist-to-height ratio.
These additional measurements can be helpful in determining the overall risk associated with excess weight and may help determine who qualifies for weight-loss medications in the future, but our current guidelines still use BMI as the primary screening tool, and by extension, this is what most insurance companies often use to cover treatment as well.
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
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