The announcement that a weight management medication is now being widely distributed has reignited the debate over whether pills can effectively help people shed pounds.
Officials at the biotherapeutics company Gelesis announced today that Plenity is now broadly available in the United States.
Here’s how the pill works:
- Three Plenity capsules are taken with water 20 minutes before lunch and dinner. The effects mimic that of eating raw vegetables.
- The “naturally derived building blocks” form an absorbent and dissolvable hydrogel.
- During digestion, the particles absorb the water around them and grow to 100 times their size.
This method of helping you feel fuller is said to provide “meaningful change,” so you can eat less and lose weight without depriving yourself of the food you love, according to the official website for Plenity.
This mechanism may be the missing link for people requiring weight management support, according to experts, like Dr. Adrienne Youdim, FACP, an internist who specializes in medical weight loss and nutrition.
“If eating less and exercising more was enough, nearly 80 percent of Americans would not be facing excess weight,” she told ishonest. “While lifestyle is a cornerstone of managing healthy weight, additional tools, like FDA approved pills and medications, are a welcome addition.”
Do weight management pills help people lose weight?
The answer is more complex than a simple “yes” or “no.”
“If you’re only looking at the end point of weight loss, it appears taking this pill (which is technically a medical device) can help someone lose weight and maintain the lost weight,” said Caroline West Passerrello, MS, RDN, LDN, a spokesperson for the Academy of Nutrition and Dietetics.
“This protocol [of drinking water and taking the capsules before meals] involves a behavior change and forces individuals to plan ahead and be more mindful of their behaviors,” she told ishonest.
Passerrello pointed to a 2019 study that looked at weight loss associated with Plenity. The control and treatment group are both asked to maintain a reduced calorie diet and perform physical activity.
“However, I don’t believe the study looked into the behaviors around these changes, nor was the participants’ adherence to these recommendations monitored,” Passerrello said.
A Gelesis spokesperson told ishonest that adherence to protocol among clinical trial participants is generally high.
“Other than prescribing Plenity/GS100 versus placebo, we did ask for the same behavior changes across groups and there is nothing in the data that suggests one group might be more likely to pick up one of these behaviors than another,” she said.
Passerrello pointed out another important item to consider. In these studies, she researchers should look at who the treatment works for.
For example, in the study mentioned, the population categories included 85 percent white participants, 11 percent Black/African American participants, and 4 percent “other.”
This population breakdown doesn’t take into consideration the ways in which systematic racism plays a role in weight management.
Health inequities affect all of us differently. Visit our dedicated hub for an in-depth look at social disparities in health and what we can do to correct them.
Healthy weight management basics
Weight management is a complex issue influenced by individual behaviors, such as eating and exercising, and systematic designs (i.e. social determinants of equity or access to affordable nutrition), Passerrello said.
“A healthy approach for one person may be unhealthy for someone else,” she explained.
Youdim added that, while taking a pill combined with diet and exercise is a healthy way to lose weight, people need to be careful what they’re considering “pills.”
“I am wholeheartedly against over-the-counter supplements for weight loss, as they are not FDA approved. Therefore, [they’re] not tested for efficacy and maybe more importantly for purity,” Youdim said.
“We know that weight loss supplements are often adulterated, meaning they have additional ingredients not disclosed on the label, and sometimes these added ingredients are harmful,” she added.
There are a handful of FDA approved medications for weight loss that are effective when combined with lifestyle changes to help people lose weight, Youdim said.
However, no medication is without side effects or contraindications, and therefore it should be discussed on an individual basis with a physician, she added.
Addressing the root cause of weight gain
Passerrello said, when people are addressing weight management, many focus on the symptom (weight gain) instead of the root cause.
“Until the root cause is addressed, any attempts to manage the symptom will likely be short-lived,” she explained.
“Think about someone who is cold,” Youdim said. “This person can manage the symptom of being cold (by putting on more clothes) or they can address the root cause.”
Now, you might think the solution to the root cause would be to turn up the temperature on a thermostat. But, Passerrello said, it’s important to consider this person’s unique situation.
“What if there are financial barriers that prevent them from turning up the heat (or even having heat)? What if there is any underlying condition that affects how the body regulates temperature?,” she said.
“I challenge everyone to think deeper about the root cause of their weight concerns, and focus on addressing that root cause — not the weight,” she added.
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