Weight Loss After 50: New Tools for Lasting Change

Many of us, especially those over 50, know the challenges of maintaining a healthy weight. Just look at the scale if you dare. Now, compare your weight today to when you were 25. Ouch!

Metabolism can slow down, and busy lives can make sticking to a diet and exercise routine difficult. The good news is there's help beyond the traditional methods. Modern medicine offers new tools to aid weight loss for people like you.

The Growing Obesity Problem

The World Health Organization (WHO) reports that over 650 million adults worldwide are classified as obese. Obesity is a serious condition that increases the risk of heart disease, diabetes, and certain cancers. This problem is particularly concerning for adults over 50, as these health risks become even more significant with age.

For years, weight loss advice has focused on diet and exercise. While these remain essential cornerstones of a healthy lifestyle, they can be difficult to maintain over long periods of time. Many people struggle with restrictive diets and find it hard to stick to regular exercise routines.

This cycle of weight loss and regain, often called yo-yo dieting, can be frustrating and discouraging and is not good for your health.

Obesity, defined as having a body mass index (BMI) of 30 or higher, is more than a cosmetic concern. It is a significant health concern that increases as we age. The health issues of being overweight also increase the future need for long-term care.

Women seem to have a harder time with weight as they get older. OB/GYN Stacy Weiss, MD says that as women age, they lose lean muscle mass, slowing their metabolism. She also notes that women tend to decrease their activity and burn fewer calories.

It's gradual, but around age 40-50, that's when women tend to notice the creeping weight gain. Maybe in the past, they could cut out a snack and lose weight. But now, when they do that, the scale doesn't budge.

Traditional Weight Management Approaches

Diet and exercise have long been the cornerstones of weight management. Popular diet plans range from low-carb diets like Keto to plant-based diets like veganism. Regular physical activity, whether through structured workouts or daily activities like walking, is essential for maintaining a healthy weight. Women have a specific weight goals compared to men. 

However, these traditional methods often have limitations. Many individuals struggle with maintaining long-term adherence to restrictive diets and rigorous exercise routines, leading to cycles of weight loss and gain, commonly known as yo-yo dieting.

Behavioral Therapy

Behavioral therapy helps individuals change their eating and activity habits through self-monitoring, setting realistic goals, and developing coping strategies for stress and emotional eating. While beneficial, behavioral therapy alone may not be sufficient for everyone, particularly those with severe obesity.

Surgical Options

For individuals with severe obesity who have not had success with other methods, bariatric surgery can be an effective option. Procedures such as gastric bypass, sleeve gastrectomy, and lap band surgery have been shown to result in significant weight loss and improvement in obesity-related conditions. However, surgery carries risks and is not suitable for everyone. Lifelong changes in diet and lifestyle are necessary to maintain the benefits.

New Hope: Modern Weight Loss Medications

Pharmacotherapy, the use of medications to help manage weight, is becoming an increasingly important tool, especially for those over 50 who are seeking to lose weight. These medications work in various ways, such as curbing appetite, increasing feelings of fullness, or reducing fat absorption. These drugs can make it easier to stick to a reduced-calorie diet and achieve weight loss goals.

Types of Weight Loss Medications

• Appetite Suppressants: These medications, like Phentermine and Diethylpropion, work by affecting brain chemistry to reduce hunger. While effective, they can cause side effects such as increased heart rate, trouble sleeping, and jitters.
• Fat Absorption Inhibitors: Orlistat is an example of this type of medication. It works by blocking the enzyme needed to digest fat, leading to less fat absorption and potentially weight loss. However, side effects like gas, bloating, and bowel urgency can occur.
• GLP-1 Receptor Agonists: These medications, such as Liraglutide (Saxenda) and Semaglutide (Wegovy), mimic a natural hormone that regulates appetite and blood sugar. They can significantly increase feelings of fullness, leading to less calorie intake and weight loss. For those seeking this treatment, Wegovy in Canada has been gaining attention for its availability and effectiveness. Side effects may include nausea, vomiting, and pancreatitis.
• Combination Medications: Some medications combine different approaches, like Phentermine-topiramate (Qsymia), which combines an appetite suppressant with a medication that also promotes weight loss. These can be effective but may cause side effects like dry mouth, constipation, and mood changes.

Important Considerations

Even if your doctor approves your use of medication to help with weight loss, you should still combine that with a good lifestyle. The drugs will work better if you do your part.

Here are other things to consider:

• Evaluation and Monitoring: Consulting with a doctor is crucial to determine if weight loss medication is right for you. They can assess your individual health needs and recommend the most suitable medication. Regular monitoring is also important to manage any side effects.
• Long-Term Success: Studies show that weight loss medications can be very effective, but lasting weight loss requires a comprehensive approach. Combining medication with healthy lifestyle changes, such as a balanced diet and regular exercise, is critical.
• Emerging Medications: Research continues to develop even more effective and safer options for obesity treatment. The future holds promise for even more tools to help people achieve and maintain a healthy weight.

Taking Charge of Your Health

Oprah Winfrey recently interviewed Amanda Velazquez, MD, director of Obesity Medicine in the Department of Surgery at Cedars-Sinai, about the global impact of new prescription weight loss medications on healthcare, the economy, patients, and culture.

Millions watched the ABC prime-time special "An Oprah Special: Shame, Blame and the Weight Loss Revolution," in which Velazquez, along with other experts and Winfrey, discussed obesity as a chronic disease and the transformative effects and side effects of weight loss medications.

"A multipronged approach is essential," Velazquez emphasized.

People often think they can just take the medication without any other counseling, but working with a multidisciplinary healthcare team is key.

Velazquez noted that obesity is a complex medical condition and that diet and exercise alone might not suffice for long-term weight loss and disease prevention

If you're over 50 and struggling with weight loss, talk to your doctor. They can discuss your options and create a personalized weight management plan that includes lifestyle changes and may incorporate new weight loss medications. Remember, you're not alone in this journey. With the right approach and support, you can achieve lasting weight loss and improve your overall health and well-being.