Treatment is always multidisciplinary. There are diets a dime a dozen, but simply prescribing less food and more exercise is like saying to a person with depression, ‘Just laugh more often.’ If it were that easy, we wouldn’t have the numbers we use have now. Data from the Austrian Positioning Commission shows that the number of Austrians with higher degrees of obesity doubled from 2003 to 2018.
When I do therapy, I still start with eating and exercise first. The diet should be consistent and reduce calories. When moving, every step counts. Gastric banding is a thing of the past, but weight loss surgery is still the most efficient.
Recently, drug therapy has been on everyone’s lips again. Ozempic and Wegovy are just the most effective weight loss drugs available. They cause a feeling of satiety, and on average patients lose 17 percent of their weight after a year. There is a hype about the drugs, especially on social media. Host Jimmy Kimmel even mentioned Ozempic at the Oscars.
I also treat with Ozempic, but prefer to call it the active ingredient: semaglutide. It is injected into the stomach or thighs like in insulin therapy. Before the patients can do this independently, they are trained by me or my team. If the effect is there, the patient loses weight, then the therapy is de facto open-ended.
The fact that in the USA it is mainly celebrities who inject themselves with semaglutide without a clear indication, just to lose weight quickly and easily, is abusive use of the drug and should be clearly rejected. I also have patients who call me and say, ‘I’d like to lose four kilos.’ And I say, ‘Yeah, me too! But I’m not taking Ozempic, nor am I prescribing it for you without an indication.’ It’s all about the cult of the body, and ultimately that leads to a shortage of the drug.
Studies show that patients are still affected by the yo-yo effect even with semaglutide therapies. A year after stopping the drug, they regained an average of 10 percent of their weight. After a longer period of therapy, however, the eating behavior seems to level off more sustainably. Only: A study does not mean spring, so it is still quite speculative. What I do with my patients is that when they reach their goals, they stop taking the medication and get it prescribed again if necessary.
I hope that the debate will bring about a rethink in society. Many people who, despite years of trying, didn’t work, now notice with Semaglutid that losing weight suddenly works ‘automatically’. Hunger cannot be influenced as consciously as one might think.
The fact that some believe that everyone will take Ozempic in the future is part of the hype. The obsession with being slim is more of a problem. I also have patients who don’t want to lose weight at all, who feel good about their bodies. They then come to me for a check-up and clarify any risk factors. This is more in the direction of body neutrality and should be respected. •
To person:
Bianca Itariu (39) is the former head of the internal obesity outpatient clinic at Vienna General Hospital. In her practice, she treats those affected with semaglutid, which makes headlines around the world under the trade names Ozempic and Wegovy.