In most weight loss programs, semaglutide is used to drive weight loss exclusively. In this situation, patients are at high risk for weight regain due to the focus on outcome rather than process.
In the Vitality Program, our focus is on metabolic health and helping patients develop the skills to survive and thrive in a world that is designed to promote weight gain and chronic illness.
While almost all patients will come into the Vitality Program with a weight loss mindset, our goal is to help them develop the habits, routines, and behaviors so they can maintain their improvements in metabolic health and prevent weight regain in the future.
By reducing both nutritional and emotional hunger, patients find it much easier to make the necessary changes–and maintain them for long enough that they become life skills.
We counsel patients to use semaglutide as a behavioral change tool not as exclusively as a weight loss drug. While the majority of out patients want to lose weight, they also don’t want to be on a drug for the rest of their lives. As patients improve their metabolic health and feel so much better (more vitality/energy), the weight loss mindset becomes a stay healthy mindset.
It’s important to mention that patients can differ significantly in motivation and drives that control eating behavior. As healthcare providers we need to assess for pathological eating behaviors that go beyond the scope of our program. Patients with moderate to severe mental health problems may not have long term success without having their emotional health addressed. Similarly, patients with severe cravings may often find it extremely challenging to taper off of semaglutide and may require long term treatment. The clinician should be alert to patients who do not progress or who find it very difficult to reduce their dose of semaglutide due to food cravings. It may be appropriate to maintain some patients long term on semaglutide as well as consider referral to a mental health specialist.
