Q&A: Weight-loss drugs, muscle preservation among highlights of Obesity Medicine 2024

Key takeaways:

• Comprehensive care was a key theme at the Obesity Medicine Association’s annual conference.
• A past president of the OMA shared his biggest takeaways.

Last month, the Obesity Medicine Association held its annual conference, where clinicians across the country came together to discuss the latest developments in obesity care.

The conference included sessions on best nutrition practices, exercise guidelines and health care costs related to weight loss.

Another important topic was the limited availability of certain weight-loss medications, which is a major issue in the field, according to Ethan Lazarus, MD, MFOMA, DABFM, DABOM, owner of the Clinical Nutrition Center, past president of the Obesity Medicine Association and delegate of the AMA.

Healio spoke with Lazarus about what he took away from the conference, supply issues of anti-obesity medications and more.

Healio: What are some of the biggest takeaways from the conference?

Lazarus: The biggest is that it was the biggest conference that this organization has had. We had about 1,400 health care providers in Denver to learn about obesity, which is ridiculously exciting. There's just a buzz in the air that hasn't been there before. I think there's a lot of hope and excitement that we're going to be moving obesity treatment forward and getting more treatments to patients who need them.

Obviously, there's a lot of interest in the new medications. But there's also a lot of interest in exactly what are we going to do with these patients and how are we going to monitor them. We can't just put everybody on a new GLP-1 receptor agonist injection. We need to give them comprehensive care. They need to be managed by a properly trained physician.

There was quite a bit of discussion around body composition, and that we need to not just be looking at BMI but following body composition. Patients are losing too much muscle, and there’s a lot of interest in monitoring fat vs. muscle loss and strategies for muscle preservation.

I also think that there's more than one treatment option, and not everybody has to go on a GLP-1. It’s reasonable to put people on intensive lifestyle intervention, oral medications and things like that. Those were some of the top things that I was left with.

Healio: Can you expand on the supply issue of anti-obesity medications?

Lazarus: The orals are fine, so if you want to use any of the orals, great. Go to the pharmacy, pick it up. They're not expensive. No problems whatsoever.

Zepbound [tirzepatide, Eli Lilly] and Wegovy [semaglutide, Norvo Nordisk] have been problematic. Zepbound was okay until about a month ago, and then all the pharmacies in my state ran out and lot of patients got discontinued because they just couldn't find it.

Wegovy had a really successful launch in 2021, and then was basically unavailable for new starts for about a year. Now we're starting to see Wegovy filtering back into the market so we can get some patients on it. The top two doses of Wegovy are readily available, but the lower doses are still a little bit tricky to find.

Healio: What kinds of topics could you see at the forefront of next year’s conference?

Lazarus: I think first and foremost, it's that obesity is a treatable medical problem, and pharmacotherapy is becoming part of that treatment. So, I think utilization of the medications has increased a ton. We're going to get more patients on an FDA-approved treatment.

I think there's definitely a trend toward using the newer medications that have a higher percentage weight loss, and I think we're resetting the bar for what we would consider a good result and starting to think about helping patients lose 10% or more of their body weight, or even 15% or more compared with 5% or 10% in the past. So, we're looking for a higher impact factor from the treatment.

Healio: Anything else to add?

Lazarus: For the primary care crowd, obesity is a disease like diabetes. We’ve got to learn to treat it. We can't just not know anything about it, and we can't assume we know something, because it hasn't usually been taught at primary care conferences.

Patients with obesity deserve comprehensive care. That comprehensive care includes a structured food plan and behavioral intervention, physical activity intervention and medical management. We can't just do one thing, so we can't just put them on medication. We can't just do the food plan. We have to do the comprehensive approach.

I would emphasize to my primary care colleagues to come to a conference and learn this stuff. It's fun, patients love it. You'll help them get healthier. But if you don't know how to treat obesity, then refer to somebody who does until you take the time to learn.

For more information:

Ethan Lazarus, MD, MFOMA, DABFM, DABOM can be reached at ethanlazarus@gmail.com.