Extra Body Fat Could Be Your Secret Weapon Against Disease, Doctors Say

Recent studies indicate that medications like semaglutide, marketed as Wegovy, and tirzepatide, sold as Zepbound, are demonstrating substantial effectiveness in weight management for adults with obesity or overweight conditions. At the same time, medical experts emphasize the importance of proper usage and monitoring.

These injectable weight loss medications, which received approval specifically for adults who are overweight or have obesity along with conditions such as high blood pressure, Type 2 diabetes, or high cholesterol, operate by mimicking specific bodily hormones. According to physician Louis Aronne, director of the Comprehensive Weight Control Center at Weill Cornell Medicine in New York City, these drugs replicate hormones released during eating, which trigger insulin production and create a sensation of fullness.

Research published in JAMA, the American Medical Association's journal, in 2023 revealed that adults with obesity or overweight conditions who used Zepbound experienced an average weight reduction exceeding 20% of their body weight within nine months.

The medications have demonstrated additional health benefits beyond weight management. A 2023 study in the New England Journal of Medicine found that semaglutide reduced the risk of death from heart disease and nonfatal heart attacks or strokes by approximately 20% in obese or overweight individuals. Weight reduction can also decrease stress on joints and potentially offer kidney protection.

However, medical professionals identify several considerations, particularly for older adults. "Safety data in older adults is lacking, and in people over age 75, it is virtually nonexistent," says John Batsis, a geriatric obesity specialist at the Schools of Medicine and Public Health at the University of North Carolina at Chapel Hill.

Physician Nate Wood, an obesity specialist at the Yale School of Medicine in New Haven, Connecticut, points out that muscle mass in older adults using these medications may "decrease to the point that they are at risk for complications, such as falls." Wood also notes that maintaining some weight in older adults might be beneficial, as "extra body fat to carry you through an unexpected hospitalization or if you lose weight when you are sick" could be advantageous.

Cost remains a significant factor in accessing these medications. Without insurance coverage, the medicines can cost approximately $1,300 monthly. While Medicare Part D does not cover these drugs solely for weight loss, it generally provides coverage when prescribed for Type 2 diabetes. Wegovy now receives coverage for reducing heart attack and stroke risks in adults with obesity and those who are overweight with established cardiovascular disease.

Medical experts recommend specific steps for individuals considering these medications. Aronne advises that regular exercise can help counteract potential muscle loss, suggesting 30 minutes of moderate activity most days of the week combined with two resistance training sessions. He also recommends that older patients consume at least 1.2 grams of protein for each kilogram of body weight to maintain muscle mass.

To minimize common side effects such as nausea and stomach discomfort, Wood recommends consuming frequent small meals, noting this approach is "especially important for those who suffer from acid reflux."

These medications appear to require long-term use to maintain effectiveness. Batsis emphasizes that "they work best when they are combined with lifestyle changes like following a healthy diet and getting regular exercise."

Healthcare providers stress the importance of discussing potential benefits and risks with a medical professional before starting these medications, particularly for older adults who may experience more frequent side effects such as nausea, stomach pain, diarrhea, and vomiting.