Can drug help non-obese patients?

Can drug help non-obese patients?

We use Victoza a lot,” explained Marcey Robinson MS, RD, CSSD, BC-ADM, co-founder of Achieve Health & Performance in Colorado.

The company’s clients include patients with type 2 diabetes and prediabetes.

“I’ve been using liraglutide with my patients since 2005,” Robinson told Healthline. “In terms of the GLP-1 drugs, it’s become the ‘go-to’ for weight loss.”

In her practice, Robinson says she sees success when using liraglutide in patients with prediabetes who need to lose a little weight, reduce their HbA1c (glycated hemoglobin test), and in a sense, “re-set themselves.”

“It’s not a miracle drug, but it does make it easier for people to lose weight because they aren’t as hungry between meals. And they feel full more quickly, to the point that if they do overeat they will feel sick,” explains Robinson.

If a patient is experiencing strong symptoms of nausea, Robinson continues their current dose for at least two weeks, giving their body time to adjust to the medication before making another increase.

Another important part of preventing nausea is simply eating less. Robinson instructs all her patients to begin by putting two to three fewer tablespoons of food on their plate in order to avoid any gastrointestinal distress.

“For weight loss, it works,” said Robinson.

But that weight loss comes not without effort.

Both Robinson and Camilleri emphasize that liraglutide should be used in conjunction with behavioral changes around nutrition and exercise.

Due to how expensive liraglutide is, whether prescribed as Saxenda or Victoza, many insurance providers will not cover the drug unless the patient is enrolled in a weight loss program.

Certain people, particularly men, seem to be able to eat through that “fullness” feeling, preventing them from successfully losing weight.

Robinson recalls a male patient who only lost three or four pounds on the drug and eventually gained it back.

“But I see other patients where it completely changes their metabolism, and they’re able to eat less, cut their calories, and lose weight,” she said. “I had a patient who was diagnosed with prediabetes; then she was diagnosed with type 2. She was drinking a half or full bottle of wine nearly every night, eating a lot of junk food, a very unhealthy lifestyle. When she started taking Victoza, she stopped drinking, changed her diet, started exercising. She lost 40 pounds in 6 months.”

Unfortunately, for those who just want to “drop a few pounds,” getting insurance coverage may be nearly impossible.

“Some insurance policies will require that you have an indication for weight loss with a BMI [body mass index] greater than 30 to be prescribed Saxenda, or greater than 28 with comorbidity diagnoses,” explained Robinson.

This insurance obstacle means a percentage of the U.S. population will have to rely on good old-fashioned willpower, nutritional changes, and exercise in order to slim down.


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