Obesity is a supersized global challenge. Being overweight links to serious health conditions including hypertension (high blood pressure), diabetes and a range of potentially life-threatening cardiovascular diseases. As the battle against obesity intensifies, more people than ever are turning to weight loss medications for controlling weight and lowering blood pressure. So, what are the challenges, considerations and future for weight loss drugs?
The World Health Organization (WHO) reports a significant global concern with obesity as the condition has more than doubled since 1990 among adults and quadrupled among adolescents. In 2022, approximately 2.5 billion adults were overweight, of which around 890 million were living with obesity – about 43% of the global adult population being overweight and one in eight people living with obesity.
These figures highlight the urgent need to address this growing health crisis, which is linked to increased risks of hypertension, diabetes, and heart disease. The rising prevalence of obesity also underscores the importance of healthy lifestyles and proactive public health strategies around food education and physical activity.
Increasingly, where medical intervention is deemed necessary, weight loss drugs are seen as cost-effective solution. There’s also a growing number of patients who have experienced positive results using these medications. While long-term outcomes remain uncertain, the spotlight is on weight loss drugs to make an impact on global obesity.
Understanding obesity and hypertension: Impacts on heart health
Excess body weight can significantly increase blood pressure by forcing the heart to work harder, as the body requires more blood to supply oxygen and nutrients to the tissues. This increased blood volume circulates through more blood vessels as body fat increases, putting additional pressure on the artery walls, and raising blood pressure levels. In some cases, obesity can lead to inflammation and other changes in the heart’s structure and function, increasing the risk of heart attacks and heart failure.
Managing weight is critical for both blood pressure control and the prevention of cardiovascular disease. Weight loss can lead to a reduction in blood pressure, which is significant because even a small decrease in blood pressure can reduce the risk of heart diseases and stroke. For example, reducing systolic blood pressure by just 5 mmHg can decrease the risk of stroke by 14% and coronary heart disease by 9%.
Using the Aktiia system to monitor blood pressure can motivate you to make healthier lifestyle choices. Observing your weekly averages encourages a balanced diet and regular physical activity.
Weight loss drugs and their impact on blood pressure
Weight loss medications have been studied extensively for their effects on body weight and associated health outcomes, including blood pressure. Medications such as GLP-1 agonists (e.g. liraglutide and semaglutide) have shown to be effective at not only reducing body fat, but also in lowering blood pressure. Studies indicated that these drugs can lead to an average systolic blood pressure reduction of 5 to 10 mmHg, which substantially reduces the risk of cardiovascular diseases like heart attacks and strokes.
However, these significant benefits have potential risks and side effects associated with weight loss drugs. These include gastrointestinal issues such as nausea, diarrhoea and constipation, which can affect a person’s ability to continue the treatment long-term. More serious concerns include the potential for increased heart rate and, in rare cases, events linked to cardiovascular problems, especially in drugs that significantly alter metabolic rates or hormone levels.
Key considerations for using weight loss drugs
Side effects can vary widely from person to person, which underscores the importance of monitoring and managing these effects with medical supervision. It’s also crucial to monitor blood pressure regularly, as changes induced by weight loss drugs can affect cardiovascular health. And, crucially, these medications are most effective when combined with a healthy diet and exercise.
Given the complexities and varied effects of these medications, if you’re considering weight loss drugs, talk to a healthcare professional. They will help to ensure your personal health history, current health status, and potential benefits and risks are thoroughly evaluated. For general information on the efficacy and safety of different weight loss drugs, the Mayo Clinic has a useful guide to weight loss medications and their use.
Weight loss drugs and the highs and lows
A few celebrities have revealed their experiences that show the upsides and downsides to weight loss drugs. Sharon Osbourne shared her journey with the weight loss drug Ozempic which helped her lose 42lbs (nearly 20kg). The drug’s potent effects led Sharon to warn of its potential to be addictive, and her story highlights the psychological and physical impacts of rapid weight loss. Sharon also points to a need for public health education about the potential risks of dependency and the importance of setting realistic health goals.
Elon Musk has openly discussed his use of weight loss drugs, specifically semaglutide. Musk has attributed part of his weight loss success to this medication. But he also pointed out the need to manage expectations and potential side effects. While the drugs contributed to significant weight loss and improved physical health, he also shared concerns about the potential for misuse and addiction, especially given the drug’s powerful effects.
In contrast to Elon Musk’s reliance on semaglutide, Oprah Winfrey’s weight loss strategy incorporates a more comprehensive approach. Winfrey has been open about her use of weight-loss medication as part of her regimen, but she emphasises its role as just one component of a broader lifestyle commitment. This commitment includes rigorous exercise routines and significant dietary adjustments. Following knee surgery in 2021, she adopted new habits like hiking up to ten miles on weekends and maintaining an early dinner schedule. She integrates these activities with a mindful eating plan based on the principles of Weight Watchers.
Weight loss comes with cost and safety challenges
Celebrities aside, weight loss drugs are becoming more mainstream. Not least because they have been shown to work. Clinical studies show that drugs containing the active ingredient semaglutide, such as Wegovy, can lead to substantial weight reduction, with a significant proportion achieving an average of 15% weight reduction of their body weight on average after nearly 16 months of treatment.
However, the success of these drugs is accompanied by significant cost challenges which can make long-term use unsustainable for many patients. The demand for these drugs has also led to shortages, highlighting their popularity but also the challenges in supply and access. This situation has been exacerbated by some patients turning to the black market to obtain these medications, which raises concerns about the safety and efficacy of non-regulated products. Considering the risk of significant side effects, including gastrointestinal issues and potential cardiovascular impacts, weight loss drugs need to go hand in hand with health monitoring and the involvement of healthcare providers.
To the future: Innovations in treatment
The future of obesity treatment looks promising, with ongoing research into new medications that could offer more significant benefits with fewer risks. Innovations in pharmacology continue to push the boundaries of what’s possible in weight management. Weight loss medications can be a valuable tool in managing obesity and its associated health risks, including hypertension. However, they should be viewed as part of a broader strategy that includes dietary changes, exercise, and other lifestyle changes.
Disclaimer: If you are struggling with obesity and related health issues like hypertension, consult with your healthcare provider to discuss the best strategies for your health needs. Together, you can decide if weight loss drugs are right for you and how best to integrate them into a comprehensive plan for healthier living.
Sources:
One in eight people are now living with obesity, WHO, 2024 – https://www.who.int/news-one-in-eight-people-are-now-living-with-obesity
Lowering blood pressure is even more beneficial than previously thought, BHF, 2021 – https://www.bhf.org.uk/news-from-the-bhf-lowering-blood-pressure-is-even-more-beneficial-than-previously-thought
Lowering blood pressure reduces the risk of heart disease, stroke and death, NIHR, 2023 – https://evidence.nihr.ac.uk/lowering-blood-pressure-reduces-the-risk-of-heart-disease-stroke-and-death
Wegovy, European Medicines Agency, 2024 – https://www.ema.europa.eu/en/medicineshuman-wegovy
