Better together: doctors find a winning combination for weight loss

In medicine, there are few silver bullets. It’s rare for any illness to have just one cure or one treatment. Usually it’s a tailored blend of therapies, medication and behavioural changes that add up to a solution that works for the patient’s unique needs. For example, chemotherapy and surgery for cancer patients, or dietary adjustments and insulin for people living with diabetes. Obesity is no different.

In my last article, I talked about the impact that our circadian rhythm can have on weight loss and appetite. Of course, changing when you eat is not going to achieve your goals on its own. For that, we need to change our behaviour — sometimes intensely.

Intensive Behavioural Therapy (IBT) is how doctors refer to “high-intensity” lifestyle changes like diet, exercise, and psychological therapy. In other words, a concerted regimen supported by doctors with the goal of losing weight. Through in-person counselling, physical therapy, clear goals and a strategy to meet them, IBT has been proven to be one of the two most reliable ways to achieve a 5-10% reduction in body weight. And it seems to work best when combined with the other one.

There are several medications approved for treating chronic weight management that can be relied on to achieve a 5% reduction in body weight. Each has their own benefits and side effects that must be managed by the patient and their doctor. Recently, scientists have shown that some medications can be paired with IBT for an even more effective treatment. Patients who underwent the therapy while taking a liraglutide drug called Saxenda achieved nearly double the weight loss of those who only underwent IBT. The single-approach patients lost an average of 6.1% of their weight, while the combined-approach patients lost 11.5%. That’s a serious improvement.

This study serves as good reminder to anyone frustrated with their own progress: just because one approach doesn’t seem to be working doesn’t mean it isn’t working at all. It may just need the right complement. In fact, the study even added a third layer: some patients also went on a strictly controlled diet of nutrient shakes and salad. While the addition didn’t dramatically change the results for this group, in the end they did lose the most weight.

There will always be another tool, however minor, that can help you reach your goals. But it’s never going to be a silver bullet on its own. So start small and keep layering. Set achievable goals to find a regimen that balances ambition with sustainability.

What’s critical is that you don’t simply add medications or diets at random. Don’t take risks: talk with your doctor about moderate additions that can bring out the best effects of the others. It may take a while to discover the formula that works best for you, but it’s worth it in the end.