Obesity increases the risk of diabetes and cardiovascular disease! Is it suitable to inject "Slim Pen" for weight loss?

**Introduction to weight loss medication

With the change of lifestyle and the prevalence of refined, high-fat, high-sugar processed foods, it is easy to consume too many calories and become obese if we are not careful. According to statistics from the National Health Administration of the Ministry of Health and Welfare, the rate of overweight and obesity among adults over the age of 18 has been rising year by year, and the average obesity rate from 2016 to 2019 reached 47.9%, which is equivalent to almost one in every two people being overweight.

The problem of obesity is not limited to Taiwan. According to the World Obesity Federation, the number of overweight or obese people in the world will increase from 2 billion in 2014 to 2.7 billion by 2025. Therefore, the World Obesity Federation calls on governments and the general public to take action to address the obesity problem, reduce the prevalence of obesity and prevent obesity-related diseases, because obesity increases the risk of type 2 diabetes and cardiovascular disease, and also increases the incidence of certain cancers. Conversely, for people who already have obesity-related diseases, such as metabolic syndrome, degenerative arthritis, sleep apnea, etc., weight loss can help control the disease, improve the three highs, pain symptoms, and apnea index. Maintaining an ideal weight for other physical health has also received considerable support in medical research.

There are two main indicators for obesity

 There are two main indicators for determining obesity. The first is the body mass index (BMI), which is the weight (kg) divided by the height (kg).

The value obtained by square the height (in meters). If the BMI is between 24 and 27, it is overweight. If it is greater than 27, it can be further divided into mild, moderate, and severe obesity.

The second indicator is waist circumference, which should be less than 90 cm for men and less than 80 cm for women. To control weight, non-drug treatment is generally preferred. Drug treatment is for obese patients who have not achieved their target weight loss after diet and exercise therapy, and is used after a detailed evaluation by a physician. Currently, there are only two types of drugs with approved indications by the Food and Drug Administration of the Ministry of Health and Welfare. One is an oral dosage form, and the other is an injectable pen needle. Our hospital has introduced both. The following will introduce them one by one:

There are two types of drugs that require medication to control obesity: oral dosage forms and injection pen needles.

Xenical

The drug ingredient is orlistat, which can inhibit the enzyme that breaks down fat in the small intestine, making the triglycerides in food unable to be absorbed by the human body, thereby reducing calorie intake and controlling weight. It is usually taken three times a day, during the main meal or at the latest within one hour after a meal, and should be taken with a balanced and low-calorie diet. It is recommended that the calories from fat in a meal should not exceed 30%. It is not necessary to use it if you do not eat or the meal does not contain fat. After taking the medicine, you are more likely to experience discomfort such as bloating, oily stools, and increased bowel movements. Since the drug blocks fat absorption, it may cause insufficient intake of fat-soluble vitamins. Although most patients' vitamins A, D, E, K and beta-carotene were maintained within the normal range during the four-year treatment, it is recommended to consider multivitamin supplementation to ensure proper nutrition. If you are taking other medications, you should also inform your doctor or pharmacist to avoid potential interactions.

Saxenda

The drug ingredient is liraglutide, an analog of human glucagon-like peptide 1 (GLP-1). It is absorbed by specific brain areas that regulate appetite and then specifically activates GLP-1 receptors, increasing key satiety signals and reducing hunger signals, thereby reducing appetite and food intake, leading to weight loss. The drug is injected subcutaneously once a day at a fixed time without adjustment according to meal times. The dose needs to be increased gradually from low to high at intervals of at least one week to the maintenance dose. This drug is suitable for adults with a BMI ≥ 30, or ≥ 27 to < 30 and at least one weight-related comorbidity, such as type 2 diabetes, hypertension or dyslipidemia. If the initial body weight is not reduced by 5% after 12 weeks of treatment with 3 mg per day, treatment with SanofiZa should be stopped.

The more common gastrointestinal side effects of injection of SanofiBeta include nausea, vomiting, constipation, diarrhea, etc. This drug is contraindicated for patients with medullary thyroid cancer or family history, as well as patients with multiple endocrine neoplasia syndrome type II. Since the safety and efficacy of SanofiBeta for weight control in people over 75 years old and with severe liver and kidney dysfunction have not yet been established, it is not recommended for use. In addition, for diabetic patients, since this drug and Victoza have the same active ingredient, the two cannot be used together. When you first start using SanofiZa, you can discuss with your doctor and consider reducing the dose of insulin or insulin secretagogue used concurrently to reduce the risk of hypoglycemia. It is important to self-monitor blood sugar to ensure appropriate use of the drug.

 Ozempic injection

Our hospital also has another drug: Ozempic, which contains semaglutide. Although the US FDA has approved it for weight loss, it is currently only indicated for type 2 diabetes in Taiwan. Without professional evaluation, it is not recommended to use it on your own. If it is used off-label, it may cause serious consequences.

There are serious side effects and drug injury relief is not available. You must bear all risks yourself.

Be careful with unapproved and unknown weight loss drugs

In addition, some medicines for treating other diseases may cause weight loss as a side effect, but these are not indications approved by the Ministry of Health and Welfare, and are not recommended for people to use on their own. This includes many products on the market that claim to help with weight loss, and they are not recommended for purchase or use without the evaluation of professional medical personnel. In addition to Western medicine, special attention should also be paid to Chinese herbal weight loss products. Some people believe that Chinese medicine is safer and harmless than Western medicine, so they take products of unknown origin without being evaluated by Chinese medicine practitioners. This may also cause health problems.

There was once a news report about a 26-year-old woman in Chiayi who bought Chinese herbal weight-loss pills online in pursuit of a slimmer figure. After taking them for half a year, she developed symptoms of edema, nausea, and vomiting. She went to the doctor and found out that she had uremia and eventually had to undergo dialysis. Therefore, whether using Chinese or Western medicine, weight loss requires seeking appropriate channels and methods to allow professional medical personnel to evaluate and assist, so as to avoid failing to lose weight and instead harming the body.

Final Reminder

Obesity has been medically proven to be highly correlated with many chronic diseases, such as type 2 diabetes, metabolic syndrome, cardiovascular disease, degenerative arthritis, specific cancers, etc. Therefore, maintaining a healthy weight is also a good way to prevent chronic diseases!