Body Mass Index Body mass index (BMI) is a measurement of body fat in adults that uses height and weight to determine an individual’s category. BMI Category BMI Range Underweight Below 18.5 Healthy 18.5 to 24.9 Overweight 25.0 to 29.9 Obese 30.0 and above To determine your BMI, go to https://www. nhlbi.nih.gov/ calculate-your-bmi# Source: NIH National Heart, Lung, and Blood Institute
While many people have an improved quality of life, some experience body dissatisfaction, because losing a large amount of weight tends to result in loose skin. Older people, 65 years of age and up, have special considerations, because they are more likely to discontinue the use of weight-loss medication, either because of side effects or the high cost of prescriptions. Sidhu explains that rapid weight loss can disproportionately reduce muscle and cause patients to be more susceptible to osteoporosis, a condition in which bones become weak and are vulnerable to fractures. If older patients are taking other medications, the addition of weight-loss drugs could promote dehydration, low blood pressure or malnutrition. Sidhu suggests starting slowly with the lowest dose and increasing the dosage less frequently. Patients should make sure their protein intake is sufficient, and resistance training is essential f or maintaining muscle. Physicians should monitor older patients more closely, and if cost is an issue, they can refer them to a patient assistance program that provides medication for those who can’t afford it. Sidhu does not recommend non-prescription medications because of the lack of FDA regulation which makes their safety and efficacy unknown. In addition, a prescription requires a doctor who can assist with medical advice and overall supervision.
Over time Losing a large amount of weight with the help of medication is a long-term commitment, and seeing results takes patience. In certain cases, patients may see results appear in the first couple weeks but more commonly it can take about two to four months. Sidhu reevaluates the treatment program for each patient at the end of one year and once patients have reached a desirable weight they need to embark on a maintenance program, or the lost pounds are likely to come back. Trials show that if patients stop medication, they regain about two-thirds of the weight they’ve lost in the following year. “Once you stop, I think you need to treat obesity like a chronic disease,” she says, and she suggests strategies such as reducing the amount of medication, trying an alternative and intensifying lifestyle changes. Using prescription medication to drop pounds is an increasingly popular method for achieving what was once a near-impossible objective, but it takes forethought and planning. “If you’re considering taking a weight-loss drug, start with a goal,” Sidhu advises. Weight is only one metric; blood pressure, mobility and joint pain matter just as much. g
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March | April 2026
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