East Montgomery Times

Research from the Perelman School of Medicine at the University of Pennsylvania, published in Nature Medicine, suggests that introducing anti-obesity medication earlier than currently recommended can significantly enhance weight loss outcomes for patients. The study found that adding medication just one month after beginning behavioral therapy—rather than waiting six months—can more than double weight loss for individuals struggling with lifestyle changes alone.

Obesity, affecting over 40% of American adults, is associated with heightened risks of heart disease, stroke, type 2 diabetes, and certain cancers. While both behavioral therapy and anti-obesity medication can aid in achieving weight and health goals, their effectiveness varies among individuals. This research aims to fill a gap by showing that combining treatments may benefit those who struggle with one method alone.

Current guidelines recommend at least six months of behavioral interventions before considering medication. These interventions include dietary changes, increased physical activity, and behavioral strategies like tracking food intake. However, many patients do not achieve significant weight loss through these methods alone. "Surprisingly little is known about how to help patients who struggle to lose weight when they are already receiving frequent lifestyle counseling sessions," said Jena Shaw Tronieri, PhD.

The study led by Tronieri evaluated an early intervention approach for patients losing less than 2% of their initial body weight after a month of weekly sessions. Participants were randomly assigned to take either phentermine hydrochloride or a placebo while continuing behavioral intervention for 24 weeks. Those taking phentermine lost 5.9% of their starting weight compared to 2.8% for those on a placebo.

"Our results strongly support the addition of anti-obesity medications for patients who do not achieve meaningful weight loss with behavioral methods alone," said Tronieri. The findings suggest that early introduction of medication could prevent discouragement and treatment discontinuation among patients not seeing immediate results.

While this study provides a framework for healthcare professionals aiding patients struggling with diet and exercise alone, further research is needed on other FDA-approved medications like semaglutide or tirzepatide. "If the people who were early non-responders took one of the newer approved medications... it’s likely they could easily double or triple their weight loss compared to phentermine," noted co-author Thomas A. Wadden, PhD.

The study received funding from the NIH/National Institute of Diabetes and Digestive and Kidney Diseases.

Editor’s Note: Tronieri has received grant support on behalf of the University of Pennsylvania from Novo Nordisk. Wadden has received grants on behalf of the University from Novo Nordisk, Eli Lilly, Epitomee Medical, and advisory board fees from Novo Nordisk and WeightWatchers.