Augusta, GA (WJBF) Do you know someone who has lost weight losing Ozempic, Wegovy, or other medications? We talked to Dr. Ron Eaker about their long-term effectiveness. Dr. Eaker specializes in weight loss and has some interesting insights on how we can maintain a healthy weight. Watch our interview and be sure to join us for The Means Report. It’s on Monday afternoons at 12:30 on WJBF NewsChannel 6.
Welcome back to “The Means Report.” Let’s talk about weight loss and your overall health. And let’s get right to Dr. Ron Eaker. I do not want our time to get away from us. Dr. Eaker well known in this community for sure. He is an ob gyn, also board certified in bariatric medicine. And that distinction’s gonna come in handy for this talk. Dr. Eaker, thanks for being with me.
Thank you, Brad.
Let’s talk about Ozempic. I’m not joking when I say that it feels like everybody is on it. So I thought this was for diabetes. How did the whole weight loss usage come about?
Well, this is an interesting class of medicines. This whole class of medicines that ozempic is a part of is actually approved for type two diabetes. And it’s been around for a number of years over a decade now. And these medicines are kind of three tiers where the ozempic is the middle tier of that. Well, they discovered is they were doing the studies on ozempic for type two diabetes that people were losing weight and they were saying, wow, I wonder if it’s because the diabetes is becoming under controlled or is maybe something else going on. So they started looking at this medicine strictly for weight loss. This medicine is generically is called semaglutide and they’ve discovered that it’s not just the diabetes control, but it’s actually something in the medicine itself, and we can talk about the science if you want, that actually controls a lot of things going on as far as appetite, as far as satiety. So they began looking at this semaglutide medicine for weight loss. And in fact, they actually have a medicine called we Wegovy which is FDA approved now just for weight loss but it’s exactly the same medicine as ozempic.
Is this some sort of loophole that big pharma has found?
Well in a way, there’s an economic factor there. Whenever you come out with a new medication, you get a new indication, you get a new lease on the economics of it. So it is exactly the same medicine. They have packaged it a bit differently from a dosing standpoint. The maximum dose of Ozempic is two milligrams and maximum dose of Wegovy is 2.4. So there’s some little tweaks there, but people are using them crosswise.
So is it easy to get, do I have to check a couple of pre-diabetic boxes to get the ozempic or does the doctor just say, look overall you’re in great health, no signs of diabetes. Take the Wegovy.
Well, that’s an interesting question because that’s where a lot of the rub is because these are extremely expensive medicines. If you pay out of pocket, I mean somewhere upwards between 800 and $1,200 a month sometimes. Now some insurances will cover Ozempic. For example, if and only if you have the diagnosis of type two diabetes, occasionally someone can get by with something called insulin resistance which is a pre-diabetes diagnosis, but insurance is not going to cover it if you don’t have one of those diagnoses. However, Wegovy, its sister is approved by the FDA for weight management. So you can have no other comorbidities no other medical problems, and if you meet the weight requirement, you can qualify for Wegovy. Now the question is, is your insurance gonna cover that? Are they forward thinking enough to know that weight loss and preventive medicine makes sense for them? A lot of insurances still don’t cover ’em.
Is this sustainable? It is jarring the amount of weight that I am witnessing people losing long-term. Does Wegovy or Ozempic work?
They work, but they work in tandem with nutrition, exercise. Here’s the analogy that I think makes sense to most of the patients I work with. Think about a campfire and lighter fluid. Well, the campfire is nutrition, exercise, stress management, sleep, all the things we’re familiar with to lose weight and to do it healthy. The lighter fluid is the drug. Well, if that campfires out if you’re not doing any of the right stuff you could pour a whole can of lighter fluid on there and it’s not gonna do very much at all. That’s what happens with these medicines. You’re gonna get some effect. But if it’s combined with building that campfire, if it’s combined with the nutrition, the exercise, the lifestyle changes, then it can work extremely well. There’s also a number of studies now looking at it being used over a longer period of time. There’s been a complete mind shift in how we view weight loss medicines in the last several years and it’s largely because of this category of medicines. You think about all the old timey drugs like Adipex or Phentermine, which were used since the 1960s. They were only approved for three months of use because the mindset at that point was, oh we just treat this because it’s something you start and something you stop like a diet. We now understand weight loss is way more complex than that. There’s so much more involved and it really is a chronic medical problem and it needs to be treated as such. In fact, obesity has finally been recognized by the AMA as a medical problem. So these medicines like Ozempic and Wegovy are now being studied 1, 2, 3 years of use and even for longer periods of time.
So bottom line, are you a fan of these drugs or do you support or endorse a more sustainable longer term weight loss program? Our society is not very patient. These ozempic results are pretty impressive. Why should we do the old school change our whole lifestyle route to dropping some pounds?
Mainly because of the data. What happens when people come off the medicines if they’re not doing the right thing. They do see substantial weight regain after stopping the medicines. So like any quick fix diet or any kind of medication that’s used in the short term, even with these medicines, you’re gonna see residual weight gain after coming off the medicines if it’s not combined. Now, what’s interesting about some of these medicines and and truly I am a fan I do think they have a very important place. They’re changing the way we manage weight in this day and time. So there’s a lot of really good things and I use these medicines a lot in my own practice but I use them in the appropriate fashion only in the context of appropriate monitoring. You’ve gotta have someone who’s knowledgeable about how to use these medicines because every medicine has a side effect, but you also gotta have people understand that there’s so much more to it. You’ve gotta sit down and we meet with people on a regular basis. We coach ’em on things like nutrition and the changes that they’ve got to make to not only make the weight loss occur with the medicines but more importantly to make it sustainable once they come off the medicines.
If I come see you for weight loss is there a possibility you could get some Wegovy for me and then I’ll just use you as my manager for the next X number of months to help me stay where I need to be?
Absolutely.
Yeah, that’s what we do. You know, we encourage people, if we’re working with somebody to have the mindset they’re gonna be working with us for at least a year because we want to see people through all different seasons of their life, stresses, holidays, illnesses the many things that can impact weight management and we want to be there to help ’em navigate those issues. Medicines, I would say probably seven outta 10 people we work with are using one of the six or seven FDA-approved weight management medicines. So it’s a part of the process, but it’s only a part of the process.
How do we know our ideal weight? I look at these charts or I Google it and it says I should I mean, I would be a skeleton if I weighed what the internet says I should weigh. How do we know?
Throw all those ideal weight charts out the window. In fact, I don’t even look at BMI anymore which is one of the things most people think about when they think about where they should be. We look at what we call the body composition analysis. We look at things like percent body fat, lean muscle mass, visceral fat. That’s where fat is in the body. When you lose weight, you always lose fat, muscle and fluid. We wanna make sure that the vast majority of what you’re losing is body fat because that’s where the health risks are. I mean, we want you to look good and feel good and be self-confident but our goal really is to get you healthy and that means losing body fat. So you have to measure that directly. You can’t just go by the scale. In fact, a lot of times I don’t even look at that top number, which is just the total body weight. I want to know what’s making up that weight. That’s the critical factor.
Let me try to get two more questions in. One is, what’s the bare minimum amount of exercise I can do that helps me? If a sedentary person is watching is it walking up and down their hall a couple of times?
It is just moving more. There’s a lot of studies now that indicate that just small frequent movements throughout the day can be just as beneficial as going to the gym for that half hour or going out for that walk. So it doesn’t necessarily have to be a formal setting of exercise. Just get in the habit of moving more. Those little frequent movements act like compounded interests and they add up over time. So those count, I tell people who are in call centers who are sitting all day, every hour get up and just move around. Even if it’s doing jumping jacks where you are for three minutes if you’ll do that every hour, it’ll be amazing. The difference it’ll create in your metabolic health.
Last question. What can we as family members do to support those loved ones who are facing a weight loss situation who want to take that first step toward a better life? Can we lift them up?
Absolutely, that support is key not only in what we call the weight loss phase but in the weight maintenance phase. The studies indicate that one of the key indicators of people getting the weight off and keeping it off is support and accountability. And it doesn’t have to be in a formal setting. It can be a family member, a friend, a physician someone you’re working with. But we know that that that social interaction and that positive feedback ties into these neural pathways that even help control hunger and satiety. So it’s all intertwined, it’s all interrelated. Your mindset plays a very close role with how your body functions and that support is key.
That’s a hundred percent true. Dr. Eaker, thank you so much for this insight and thanks for what you do to make us healthier and happier.
Thank you, Brad.
Absolutely. Dr. Ron Eaker. Look him up and go see him and begin that journey to better health.