Recent groundbreaking advancements in drug therapy have offered new hope for those struggling with obesity and diabetes. New medications have demonstrated remarkable effectiveness in aiding weight loss and improving blood sugar control. However, while these drugs represent a significant milestone in healthcare, they are not a panacea, and optimal long-term outcomes require a holistic approach that combines medication with lifestyle changes.
Recent development of a range of effective medications helped modern medicine make significant strides in the treatment of excess weight and diabetes. Some of new drugs can play a crucial role in managing the conditions by targeting specific physiological mechanisms like facilitating glucose uptake or inhibiting the gastrointestinal enzymes. Other medications work with the appetite mechanism, ultimately leading to a healthier blood glucose level, like Eli Lilly’s recent diabetes drug tirzepatide, marketed as Mounjaro. The medicine has become a recent hit in its field thanks to its ability of “allowing nine out of ten diabetics to reach their blood sugar goal and one out of two to reach normal blood sugar,” according to Marcel Lechanteur, President of Eli Lilly France.
Apart from diabetes treatment, tirzepatide has also been approved at higher dosage for use in weight loss programs in the USA, sold as Zepbound for this purpose. It may seem strange that one active ingredient is used for treating the two different diagnoses; however, if we consider the link between diabetes and being overweight, we can see that there is nothing surprising about it. The conditions can be intertwined, with excess weight contributing to insulin resistance, a key factor in developing type 2 diabetes. Conversely, diabetes can make it difficult to stick to a healthy weight due to increased hunger, fatigue, and other symptoms, and this is why we are seeing a surge of medications intended both for diabetes and weight management. With the new drugs just off, it may seem that the magic pill has been found, but management of diabetes and excess weight requires a little more than just swallowing medications.
Lifestyle Changes Are Necessary
“Different approaches are needed in terms of the types of interventions that are more likely to be effective, but also how to improve uptake and adherence, not only in the short-to-medium term, but also in the long-term. As such, there is a clear need to address the inaccurate and often misleading simplification of the causes and treatment of obesities,” says Rachel Batterham from UCL Centre for Obesity Research, University College London. Indeed, while drug therapy can be a valuable tool in managing obesity and diabetes, it is still a second-line treatment, prescribed only after failure of a multi-factorial approach based in particular on the application of simple hygienic and dietetic rules combined with a low-calorie diet and physical activity. Moreover, some of the drugs, like Wegovy, are intended for patients with severe obesity only, which leaves behind people with low and moderate excess weight levels.
Now, healthcare specialists agree that firmly established positive results in managing obesity and diabetes often hinge on adopting new healthier habits rather than swallowing pills. Numerous scientific studies warn against any quick fixes but support the effectiveness of lifestyle interventions in improving glycemic control, reducing weight, and alleviating diabetes. For instance, the national UK Diabetes Prevention Program demonstrated that diet and exercise added to patients’ routine could significantly reduce the incidence of type 2 diabetes in individuals at high risk. Other researches have also consistently demonstrated the powerful impact of lifestyle interventions on combating obesity and diabetes.
The British Dietetic Association and the British Nutrition Foundation also underscore the importance of holistic support and management from a multi-disciplinary team — including physicians, psychologists and specialist dietitians — to treat obesity and type 2 diabetes and help patients make and sustain required dietary and other lifestyle changes. “Dietary and physical activity advice that promotes maintenance of muscle mass and function is key alongside behavior change support; people should not be prescribed the medication alone,” reads the statement.
Thus, the link between the two phenomena – diabetes and obesity – is obvious, but following all the prescriptions and radically changing one’s lifestyle is not always easy. Patients with these conditions often struggle with healing as it is difficult for adults with fixed habits to change their diet and adopt a generally new lifestyle. In addition, they may be affected by physiological changes in the body which results, for example, in difficulties with physical exercises due to excess weight and fatigue. In turn, insulin deficiency or tissue resistance caused by diabetes mellitus prevents glucose entering the body cells, which causes stimulation in the brain’s hunger center. All these complexities put a brake on the patient’s progress, and call for an approach that could span all the factors.
Benefits of a Holistic Approach
The relationship between obesity and diabetes, the individual characteristics of each particular patient as well as the difficulties in maintaining a healthy lifestyle can be a major challenge. Therefore, comprehensive treatment requires not just prescribing specific drugs from the attending physician and monitoring blood glucose levels, but also working with no-medication weight management professionals.
“Nutrition, exercise, and behavioral counseling are important parts of managing the disease,” explains Rachel Batterham. Indeed, patients with obesity and diabetes often require professional help to navigate the complexities of their conditions, and professionals can provide those personalized guidance, tailored to individual needs and medical history, like the French RNPC® program (for Rééducation Nutritionnelle et Psycho-Comportementale, i.e. Nutritional Psycho-Behavioural Reeducation) implemented in weight management centers across France. The program helps patients develop strategies for managing hunger, fatigue and frustration commonly associated with dieting, with the help of RNPC dieticians cooperating with the patient’s physician.
The holistic approach that combines medication with lifestyle changes offers numerous benefits for individuals with obesity and/or diabetes. By working with healthcare professionals, patients can receive the support and guidance they need to improve their quality of life and manage their conditions effectively: forming new habits takes time and effort, and the program provides continuous maintenance by starting with a rapid weight loss phase that gradually shifts to a weight stabilization phase, where the patient learns how to tackle the danger of weight regain after the initial loss.
By addressing both the biological and behavioral factors that contribute to these conditions, approaches like this can lead to more sustainable and long-lasting results, not only for diabetes and obesity but for other excess weight-related diseases in general. This has been confirmed by research: a retrospective study of the same RNPC Programme found overall improvements in most metabolic parameters demonstrating a better control of diseases associated with metabolic dysfunction and subsequent weight management. Another study showed that participation in long-term weight management programs, where drug therapy was combined with mentorship by dieticians, increased the chances of long-term remission for diabetic patients. “By acting on the cause of the co-morbidities associated with overweight and obesity, it is possible to prevent the onset, development and worsening of these co-morbidities. This is why structures such as RNPC centres are invaluable partners in the fight against overweight and obesity,” explains Prof. Arne Astrup, Senior Vice President and Head of the “Obesity and Nutritional Sciences” department at the Novo Nordisk Foundation and an internationally renowned expert in the fight against obesity and overweight.
These findings, the availability of psycho-behavioral programs and new diabetes and weight management medications offer a new hope for patients – provided that the approach to treating these conditions is not one-sided and simplistic, but comprehensive and holistic. By combining effective medication with lifestyle changes, individuals can significantly improve their health and quality of life. At that, it is important to remember that the best approach may vary from person to person, and consulting with healthcare professionals is crucial for developing a personalized treatment plan that addresses individual needs and goals. And when all the facets of the condition are taken care of, the holistic approach can empower individuals to take control of their health and achieve long-term success.
The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.
