The Challenge with Obesity

David Poon, BSc. Immunology and Infection, PharmD Student

A Growing Concern

In 1978 – 1979, 49% of adults were considered either overweight or obese. Jump forward to 2004, and the number increases to 59%. Even more startling is that in 2017, 64% of Canadian adults are considered overweight or obese. Being overweight or obese can put individuals at risk of developing diabetes, cardiovascular disease, and other health problems.

Managing Obesity without Medications

A healthy diet is one key component to managing obesity. However, diets may only last for a short period of time; many people fall off the “bandwagon”. Meeting with a dietician may help combat this problem by creating a personalized diet plan that works and is more feasible to stick to long-term. Physical activity is another important component to successfully manage obesity. Exercising for at least 30 minutes a day for 5 days each week is typically recommended. This can be done by walking, jogging, biking, playing hockey, etc. Find something you enjoy doing and stick with it! For example, join a spin club, or a local recreational sports team. Just remember to stay active! Of course, all of this is easier said than done. In some circumstances, bariatric surgery may be considered for those who are obese. At this point, it’s important to have a discussion with your physician.

Medications Are Available, But Aren’t That Great

There are 3 main medications available that can be used to treat obesity. Of course, before starting any of these medications, it’s important to speak with a physician.

1. Bupropion/Naltrexone (ContraveⓇ)
   1. Works by suppressing appetite and pleasure response from food.
   2. Associated with weight loss of ~4.8%
   3. Side effects include dry mouth, insomnia, constipation, agitation
   4. Costs ~$3400/year, but may vary depending on insurance coverage
2. Liraglutide (SaxendaⓇ)
   1. Works by suppressing appetite
   2. Associated with ~5-10% weight loss
   3. Side effects include nausea, vomiting, constipation, diarrhea
   4. Costs ~$4500/year, but may vary depending on insurance coverage
3. Orlistat (XenicalⓇ)
   1. Reduces absorption of fats by the body
      • Can also reduce absorption of vitamin A, D, E, K (may require supplementation)
   2. Associated with ~2.9% weight loss
   3. Side effects include abdominal pain, oily stools/diarrhea/spotting, flatulence, bloating
   4. Costs ~$2000/year, but may vary depending on insurance coverage

The Bottom Line

Being overweight or obese can have severe long-term health consequences. The preferred way to manage obesity is still through diet and exercise. When those interventions fail, medications can be added. Bariatric surgery is typically only considered in severe cases. If obesity is affecting your daily life, it’s recommended to have a discussion with your healthcare professional. It’s an important first step in an individual’s weight loss journey.

We hope you took away something valuable from this piece. If you have any questions or concerns regarding this article or others, feel free to reach out to us on Instagram, Facebook, or at ask@orbishealth.ca with your feedback. We’d love to hear from you.

RESOURCES

1. Sharma, A.M.. (2018). Obesity. RxTx