| HN Mirror

There are scores of medications necessary for chronic conditions that we give to patients without intention of stopping that have not been around for a lifetime of testing for “long-term safety.” If your cardiologist prescribes you an SGLT2-i for heart failure because we have studies that show it has significant mortality benefit, you probably won't bat an eye before taking it---yet they have only been FDA approved since 2013. (As an aside, people also don't generally rag on heart/kidney/liver failure patients for poor lifestyle habits that may have contributed or continue to contribute to their disease, as they do for patients with obesity.) GLP-1 receptor agonists like Ozempic have been on the market since 2005. Obesity is among the most prevalent, morbid diseases that itself accounts for 20% of US health expenditure; it will lead to diabetes, hypertension, OSA, heart failure, arthritis, depression, cirrhosis, even cancer and then some. Our scientific and clinical understanding of obesity is evolving beyond it being a self-imposed and self-treatable lifestyle choice, but as a complex neurohormonal disease; one that is chronic like hypertension, and that must be treated chronically (like hypertension) as well. As doctors, counseling patients to diet and exercise (even offering nutritionist referrals) is the equivalent of sitting idly by as patient after patient rotates through our clinic having tried diet/exercise for years all the while developing obesity-related comorbidities.