Doctors define obesity based on a person’s “body mass index,” or “BMI.” For adults, weight and height are used to calculate BMI. For people who are White, Hispanic, or Black: “Overweight” means a BMI between 25 and 29.9. “Obesity” means a BMI of 30 or greater. For people who are Asian, the cutoff numbers are a little different: “Overweight” is a BMI between 23 and 25 and “Obesity” means a BMI of 25 or greater.
For most people BMI is an inaccurate measure of your weight. Sometimes we use your measurements (waist, neck, thigh and hip circumference) or an instrument called skin fold callipers to determine your body fat percentage. Obesity increases the risks of many different health problems. It can also make it harder for you to move, breathe, and do other activities.
Much of the time people can avoid obesity by changing the foods they eat. In the simplest terms possible I tell people to “Eat meat and vegetables, nuts and seeds, some fruit, little starch and no sugar”; an axiom first credited to Greg Glassman, the founder of crossfit. Understanding what foods fit into which categories can require some education (hint: that’s something we’re good at here at Good Company Wellness). Some people have difficulty following this dietary advise and so some weight loss medication can be used to make that easier.
The US Food and Drug Administration recently approved subcutaneous tirzepatide, a dual glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist, for chronic weight management. Two randomized trials in adults with obesity demonstrated mean losses of 15 to 21 percent body weight with the highest dose of tirzepatide (15 mg weekly) [references below]. In the larger of the two trials, over 80 percent of participants in all tirzepatide treatment groups (5 to 15 mg weekly) lost ≥5 percent of body weight, compared with 35 percent of those assigned to placebo. Dose-related gastrointestinal side effects (nausea, diarrhea, constipation) were common but generally mild. Although direct comparisons are limited, the magnitude of weight loss with tirzepatide appears greater than that with other agents; thus, tirzepatide and semaglutide are considered preferred medications for chronic weight management. In addition to these studies you see others discussing the use of semaglutide which shows benefits in weight loss as well as reductions in the risk of heart attacks, strokes and improved heart failure control. These medications do come with some risks however the benefits for many obese patients outweighs those risks.
Tirzepatide Once Weekly for the Treatment of Obesity. AUJastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, Kiyosue A, Zhang S, Liu B, Bunck MC, Stefanski A, SURMOUNT-1 Investigators SON Engl J Med. 2022;387(3):205. Epub 2022 Jun 4.
Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. AUGarvey WT, Frias JP, Jastreboff AM, le Roux CW, Sattar N, Aizenberg D, Mao H, Zhang S, Ahmad NN, Bunck MC, Benabbad I, Zhang XM, SURMOUNT-2 investigators SOLancet. 2023;402(10402):613. Epub 2023 Jun 26.