New Weight-Loss Drugs Come at a Cost

At a recent gathering with a group of women in New York City, the discussion focused on recent developments regarding prescription drugs for weight loss. It appeared that just the idea of losing weight with the help of medication elicited feelings of happiness from them. They named the many benefits they perceived these drugs would bring to their lives—spending less time working out, reducing the likelihood of exercise-related injury, curbing appetite, and focusing on more enjoyable activities.

This conversation was timely, people aspire to make lifestyle changes at this time of year. It is anticipated that 39 percent of Americans will establish new goals related to physical fitness, with 26 percent related to diet, and 18 percent related to hobbies (American Psychiatric Association, 2023). However, as most of us have experienced, making any kind of change can be hard and even short-lived—the second Friday of January has been named Quitter’s Day.

One woman, who has been prescribed a weight-loss drug for diabetes, indicated she stopped taking the medication as it was no longer effective in helping to manage her symptoms. Several of the women, who are not obese or overweight, asked, “Can we have the remaining doses?” And I asked the most unpopular question: “Will being skinny make you happy?” Everyone at the table responded with a resounding Yes.

But, as a clinical psychologist specializing in health psychology, I felt my heart sink hearing these answers from my brunch pals. I’m trained to help people modify their unhealthy behaviors (substance use, unhealthy eating, cigarette smoking, vaping, exercising more). Health psychologists evaluate people using a biopsychosocial model or a holistic perspective. This means that we take a person-centered approach to understand how biological mechanisms (genetics), psychological context (beliefs, attitudes, ability to cope with stress) and social and cultural influences (age, socioeconomic status, gender, traditions, religion) affect an individual’s overall well-being.

I shared with these women that weight-loss drugs may assist them to feel more youthful or confident or to achieve a body type similar to stereotypical Barbie. However, I challenged them to contemplate how changes to their physical appearance would affect them socially and psychologically. Consider whether losing weight will make managing life stressors and societal pressures less challenging—ease relationship problems with friends and significant others, reduce work pressure, or reduce overwhelming feelings related to caring for children or aging parents. Maybe losing weight will help in the short term; maybe it won’t. But I don’t believe our life difficulties will disappear alongside the weight if we do not take a closer look at all aspects of our lives.

Psychologists are no longer alone in helping individuals reflect on different spheres of their lives. Physicians who practice lifestyle medicine assess individuals from a holistic perspective, too. They inquire about an individual’s exercise habits, diet, stress levels, sleep cycle, substance use, and socialization. Instead of only prescribing medications to address these areas, they also prescribe lifestyle interventions. By engaging in this practice, these physicians remind patients that they have the power and ability to take control of specific aspects of their health. They also reinforce the idea that optimal well-being is achieved by looking at the big picture rather than a narrow slice of life.

Furthermore, similar to psychologists, they establish SMART (specific, measurable, attainable, realistic, and timely) goals with their patients. This approach is in stark contrast to only taking medication to moderate our appetite; such goals can be a lengthy process. However, once individuals develop this skill set, they can use it to change various behaviors throughout their lives to improve their self-care. Another upside to utilizing such goals is that we can start this process on New Year’s Day or any other day of the year.

Goals aren’t all-or-nothing in nature. Long-term goals don’t need to include returning to the younger version of yourself, participating in every available activity, contacting every friend, meditating all day, completing a one-hour exercise class, or removing all processed foods from refrigerators and cabinets.

Ultimately, our minds and bodies may thank us by striving for moderation. Anthropologist Alan Morinis asserts that most of us prefer a life of moderation. He believes that challenges and obstacles we encounter are due to “straying away from moderation.” We either stop engaging in activities we enjoy or we overindulge. As much as I would like to tell my friends that this new year will be different from past years, with weight-loss drugs unlocking the secret ingredient to happiness, the truth is that there are many complex layers to feeling good in our minds and our bodies.