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medullary thyroid cancer, cardiovascular risk, substance use disorder, psychiatric illness or sleep apnea, as well as women planning pregnancy, should avoid prescription weight-loss drugs. “All those factors should be taken into account. Overall, patient selection should be individualized,” says Sidhu, explaining that persons taking weight-loss drugs should do so only with medical supervision. She recommends consulting a licensed provider who has experience and checking in with these professionals monthly. “First and foremost, look at contraindications and evaluate baseline labs,” she advises. Sidhu prescribes weight-loss medications that have FDA approval only. Some can be self-injected into fatty tissue just below the skin in the abdomen, upper arm or thigh, while others come in tablet form. Zepbound is administered as a once-weekly injection, with doses up to 15 mg, and studies show a 15 to 20.9% reduction in body mass at 72 weeks. Wegovy shows a 14.9% loss at 68 weeks. Sidhu stresses that medication does not work alone and must be in conjunction with changes in diet and exercise. For medications to work, “you have to use them as an adjunct to lifestyle changes,” she says. Patients need to ensure that they get enough protein daily, and resistance training two to four times a week is important for maintaining muscle mass.
“If you lose muscle, it affects your overall metabolic health,” she explains. A nutritionist or dietitian can help one build a lifestyle foundation and make sure that an individual is getting enough protein and fiber. She advises starting with dietary changes first and increasing physical activity slowly. “You start with small, little changes, nothing too aggressive,” she says. As mobility increases, patients can go to the gym and walk regularly, gradually building up their activity level. On the downside Side effects can occur, and the most common are gastrointestinal, such as nausea, vomiting, diarrhea, constipation or oily stools and vitamin deficiency. More serious conditions include pancreatitis, gall bladder issues, dehydration, low blood sugar, worsening retinopathy and intestinal obstruction. Other contraindications are dry mouth, mood changes and headache. Women should not become pregnant while taking these medications, as they are known to cause birth defects. In addition, if patients plan to undergo any procedures that require anesthesia, including colonoscopy, they need to stop taking medication a week before. Sidhu also recommends screening an individual’s psychological status before starting treatment, as dramatic weight loss can impact a person’s identity and social dynamics.
32 NorthBaybiz
March | April 2026
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