New research adds to our existing knowledge and experience that some medications may inhibit weight loss, even when lifestyle interventions such as diet and exercise are prioritized.
The Look AHEAD randomized study followed over 5000 middle-aged diabetic participants for 13.5 years and found overweight or obese participants taking obesogenic medications, or drugs that tend to cause obesity such as alpha‐glucosidase inhibitors, biguanide, orlistat, and sibutramine, were less likely to lose weight from lifestyle interventions. The lifestyle intervention included 175 minutes of weekly physical activity and a reduction in caloric and fat intake. People taking one or more obesogenic medication had a 32% lower chance of 5% of more weight loss within the first year of intensive lifestyle intervention (OR 0.68). For those taking two or more obesogenic medications, they were 42% less likely to achieve weight loss from lifestyle interventions within the first year (OR 0.81). The association between obesogenic medications and weight loss was dose-dependent: antidepressants were the only drug that significantly reduced the likelihood of larger weight loss of 10% of more of a person’s weight.
This reflects our experience in practice with some individuals. It can be really disheartening for folks and likely is in part due to do changes in the gut microbiome composition. But don’t lose heart! A functional medicine approach emphasizing lifestyle interventions is a powerful tool for metabolic disorders. We look at each person’s situation from a very individualized perspective since there can be many underlying contributors to metabolic disorders and weight gain.