Are GLP-1s The Right Weight Loss Treatment For Your Patient?

Today, over 70% of U.S. adults ages 20 and older are considered overweight or obese, and its prevalence is growing. In fact, it’s expected that half of U.S. adults will be obese by 2030, with 25% having severe obesity. 

While many people see being overweight as a cosmetic problem, those in healthcare see the health risks that come with it. Research shows that carrying excess fat can increase one’s risk of type 2 diabetes, heart disease, some cancers and more. However, as a provider, it’s important to stay empathetic when approaching a patient about their weight.

In many cases of obesity, there are also underlying mental health issues such as depression and various eating disorders that enable it. Therefore, we will explore four ways you can address obesity care with your patients to help them see the most long-term success.

Speaking with patients about their weight

Although these discussions may be uncomfortable, you’re in a unique position as a provider. It’s important to approach any obesity related concerns in a professional but empathetic manner.

Your approach matters

Let’s look at some examples. To start the conversation, you might say “I see your weight has increased by about 30 pounds since your last visit. Tell me a bit more about that.” 

In this instance, you aren’t using accusatory language but instead giving them a chance to explain the weight gain. It can also help you get a more holistic view into a patient's external health factors.

Another example might be, “Your BMI and weight are a little higher than I would like and there are a couple of concerns I want to address.” 

By giving data-based reasoning, you stay away from language that attacks their physical appearance or becomes accusatory, which can cause a patient to shut down. However, by also raising your concern, you ensure any health issues are communicated. 

As a rule of thumb, it’s typically best practice to ask the patient if it’s okay to talk about their weight. That being said, you know your patient and their health history best. Look over their chart and make note of any external factors that may affect the way you approach the conversation.  

Identifying obesity-related risks and treatment options As a provider, you can assess a patient's risk of developing obesity-related health conditions by reviewing their body mass index, weight size, blood test results, and more. In addition, you may evaluate other factors (their goals, age, ethnicity, sex, medical history, etc.) to determine the most appropriate weight management plan for them. 

4 weight loss treatments to consider for your patients

GLP-1 drugs, like Ozempic, are a popular go-to medical weight loss option and have truly saved lives. However, that doesn’t mean they’re the best choice for all patients. We’ll review the different weight management tools you can use as a clinician and when GLP-1s might be the most appropriate. 

1. Lifestyle changes and weight-loss programs

One of the first steps to achieving weight loss for most patients is making lifestyle changes. 

Studies show that much of the food Americans consume today is highly processed, with endless combinations of fat, salt, and sugar provided in large portions. Research also shows that U.S. adults have higher levels of sedentary behaviors than before, which is linked to early mortality.

Therefore, many people could achieve weight loss by consuming nutritious foods in healthy portions and working out for 30 minutes five days a week. However, this is easier said than done. 

Solutions like lifestyle modification programs can help and have been shown to reduce the risk of developing chronic diseases while losing weight. These programs usually involve following a calorie-restricted diet, doing physical activity, and participating in behavior therapy. 

Finding the right program for your patients depends on many factors, including their work schedules, transportation needs, caregiving responsibilities, etc. Telemedicine weight loss programs may be a beneficial option for those with busier schedules. 

One study found that telemedicine interventions are an effective and safe alternative, especially for harder-to-reach populations. They also can support long-term and/or ongoing interventions, as many participants regain one-third of their weight lost within a year of their program ending. 

2. Medications for weight management

Thanks to celebrity blogs and social media, GLP-1 agonists are thought to be a solution for nearly anyone seeking medical weight loss. However, as you know, these medications aren’t meant for everyone. Most are intended for patients with a BMI of 30 or greater. Patients with a BMI of 27 or higher and at least one weight-related condition, like high blood pressure, may also qualify. 

In addition, GLP-1 drugs aren’t meant to be the first step toward obesity care. Patients should initially try making lifestyle changes, and if that doesn’t work, consider introducing GLP-1s.   

Studies show that GLP-1 drugs can lead to a weight loss of about 10.5 to 15.8 pounds, and if paired with lifestyle changes, patients may lose approximately 33.7 pounds. Therefore, clinicians should encourage their patients to use it alongside diet and exercise, as these medications aren’t a magic bullet. Those who discontinue use and haven’t made any lifestyle changes will likely experience weight regain. 

During the COVID-19 pandemic, a retrospective observational study was done to observe patients on anti-obesity medications who had in-person visits, in-person and video visits (hybrid), or video visits only. Researchers found that those who completed video-only or hybrid visits experienced clinically significant weight loss, so telehealth solutions may also be advantageous for your patient population. 

3. Weight loss surgery

If patients have a BMI of 35 or higher, have at least one obesity-related medical condition, and have completed at least six months of supervised weight loss attempts, bariatric surgery may be appropriate. However, you should take precautions with patients who have sleep apnea or kidney, liver, or heart disease. Individuals with blood clotting disorders or other health conditions that prohibit the safe use of anesthesia shouldn’t get bariatric surgery. 

One study showed that telemedicine is also useful for bariatric preoperative evaluations, as it improves patient attrition rate and reduces travel time and carbon emissions. This, in turn, alleviates patient burdens and allows you to reach a larger population. A 2024 study found that pre- and post-operative telemedicine care for abdominal surgery was aligned with decreased rates of 30-day readmissions and ED visits.

4. Weight-loss and weight-management devices

Currently, there are five types of FDA-approved devices for obesity care, and none of them permanently change one’s small intestines or stomach. These are often used temporarily to help patients adapt to healthier eating habits and increased physical activity. Like all other options, these are meant to be combined with lifestyle interventions. 

These devices include:

• Gastric band

• Gastric balloon systems

• Endoscopic suturing devices for altering gastric anatomy

• Oral Removable Palatal Space Occupying Device

• Ingested, Transient, Space Occupying Device

Improve obesity care with telemedicine

It can be challenging to discuss weight loss and weight loss concerns with patients. While GLP-1s have revolutionized the way we approach patients who are obese or overweight, it's not the best option for everyone. Being open and honest about the various treatment options and your recommended course of treatment is a great place to start. You know your patient best, it's up to you to make note of any external factors or comorbidities that may disqualify them from certain treatments.

Additionally, telemedicine as a mode of care has proven highly effective in the treatment of weight loss. It tackles healthcare barriers like cost, geography and access to specialists. If virtual care is something that interests you, we'd love to introduce ourselves and our Clinician Network!

At OpenLoop, our network of NCQA-credentialed, multi-state licensed providers enjoy the flexibility to work from anywhere and treat patients at some of the industry's leading digital health companies. Sound interesting? Apply to join our network today!