What Obesity Medications are Available in Canada? (RETHINKING OBESITY Part 5 of 5)

Welcome back!

We've been on a journey with my five-part podcast series called RETHINKING OBESITY. We've explored the complexity of obesity, the necessity of multimodal treatment, and last week, we discussed the pillars of obesity treatment.

Today, we are focusing on the medical therapy pillar. With all the media coverage that anti-obesity medications have received recently, it is no surprise that this has been a long awaited topic.

Before we dive in, I'd like to invite you to my upcoming free masterclass titled "Mindset and Medicine."

We held this masterclass before, and it was such a success that we had to increase our zoom meeting capacity for this round. It's scheduled for Thursday, November 2nd, and I'd love to see you there. 

To register, simply visit sashahighmd.com/registration-masterclass

Now, without further delay, let’s get into the final topic of the RETHINKING OBESITY Series.

When it comes to treating obesity, we need to consider three aspects: psychology, behaviour, and physiology. Often, people assume that just improving one's lifestyle, like eating healthier or exercising more, is sufficient for weight loss. 

But that's a misconception.

The truth is, the brain plays a significant role in weight regulation and appetite control, making it challenging for some people with obesity to shed excess weight, despite their best efforts to adopt a healthy lifestyle. Genetics, a history of yo-yo dieting, and certain medications can contribute to this physiological resistance to weight loss.

This is where medical therapy comes into play. 

Obesity is a medical condition and should be treated as such. Just as you would take medication for heart disease or diabetes, obesity may require medical treatment for some individuals. 

It's important to call out the misconception that taking medication for obesity is a sign of failure or cheating. We don't expect patients with other chronic diseases to manage them without medical intervention, so why should obesity be any different? This bias against obesity treatment is a challenge that both patients and healthcare professionals must overcome.

In Canada, we have five approved anti-obesity medications:

Orlistat (Xenical): 

This oral tablet, taken three times a day with meals, inhibits the absorption of fat in the gut, causing the excretion of approximately 30% of dietary fat. While it has some side effects like oily stool and gastrointestinal discomfort, it's not the most commonly used medication.

Liraglutide (Saxenda): 

An injectable medication taken once daily, Saxenda belongs to the GLP-1 receptor agonist class. It reduces appetite, increases satiety, and helps with blood sugar control. The average weight loss with Saxenda is around 8-10%.

Naltrexone-Bupropion (Contrave): 

This combination medication is taken in pill form twice a day. Naltrexone blocks opioid receptors in the brain, reducing cravings, while bupropion acts on dopamine pathways, further helping with appetite control and cravings. Weight loss with Contrave is also in the range of 8-10%.

Semaglutide (Ozempic): 

Semaglutide is another GLP-1 receptor agonist, similar to Saxenda. However, Ozempic is taken once a week, which can be more convenient than daily injections. With higher doses, it can lead to weight loss of around 17%.

Tirzepatide (Mounjaro): 

While this medication has been available in the United States for a while, it has just been released in Canada. It's a combination of GLP-1 and GIP and has shown impressive results, with weight loss up to 20.9%. However, it's currently indicated for type 2 diabetes in Canada, but research is ongoing for its use in obesity.

Additionally, there's another off-label option: Metformin, which has been shown to contribute to sustained 10% weight loss in people with obesity and type 2 diabetes.

It's important to consult with a healthcare provider, especially an obesity specialist, to determine the most suitable treatment based on your individual circumstances. Each medication has its benefits and potential side effects, and the choice should be tailored to your specific needs.

Remember that the ultimate goal of obesity treatment is not just weight loss for aesthetic reasons but to improve health, quality of life, and overall well-being. If you're already on an anti-obesity medication and it's working for you, there may not be a need to switch to a newer one, especially if the existing medication has demonstrated cardiovascular benefits.

There are several medical options available for obesity treatment in Canada. As always, your best approach will depend on your unique circumstances and needs. The important thing is to be open to the idea of medical therapy if it's necessary for your health and well-being. 

Thank you for joining me on this journey through the world of obesity treatment. If you have any questions or would like to discuss your options further, don't hesitate to reach out.

You can listen to the whole episode by listening to the High on Life podcast: HERE