A new study found that 85% of people taking an experimental weight loss drug massively reduced their liver fat, holding great promise for one day treating and potentially even preventing fatty liver disease. This and other similar treatments, some of which are FDA approved, are promising tools for managing obesity and related conditions. They can also be a powerful catalyst for helping people learn to eat less and adopt dietary practices that can sustain a healthier weight and lifestyle over the long term without medication. This approach will provide the greatest benefit to individuals struggling with excess weight, and to society as a whole.
The key to these blockbuster drugs is mimicking the body’s hormones that regulate hunger. By suppressing appetite, people on treatment eat less frequently and quickly lose weight. The results are miraculous for many people who have struggled with obesity. But no drug is a perfect solution. The injections have unpleasant side effects, and people taking them don’t just lose fat—they lose muscle too. And virtually everyone gains back the weight as soon as they stop treatment.
Here's the important thing to understand: excessive consumption of unhealthy food is the problem. Our shared goal must be to help people take control of this behavior—and keep it—to live healthier lives.
Human beings survived on a diet of mainly lean protein for thousands of years, fasting for most of our waking hours and often eating only one large meal during the day. That changed dramatically in the 20th century, culminating in the U.S. Department of Agriculture publishing a “food pyramid” in 1992 recommending a diet heavy in bread, cereal, rice and grain. Thirty years later, we can see the tragedy of these good intentions. Americans are addicted to carbohydrates and other processed foods that our bodies metabolize as sugar—constantly spiking anxiety, accentuating hunger, and fueling an obesity epidemic that is driving higher rates of chronic disease.
There is growing insight on new approaches to eating that can help reverse this trend. The science is especially promising on intermittent fasting. This isn’t really about eating less food, but rather eating during specific times of the day. This strategy taps the body’s natural ability to process fat and sugar stored in the body and stimulates the immune system by helping the body clear out damaged cells and replace them with newer, healthier cells. It lowers blood sugar and cholesterol, helps the body maintain growth hormone, and reduces insulin resistance which causes fatty liver disease, diabetes, and high blood pressure. New evidence shows intermittent fasting can also help increase cancer survival rates by starving tumor cells, and even reduce the chances of developing Alzheimer’s disease.
It’s important to understand that there is no right or wrong way to do intermittent fasting. The approach can be adapted to individual preferences and lifestyles in a number of ways. My recommendation to patients is to start by skipping breakfast one day a week. Then try it a second day when ready. We can adjust the number of days and time between meals based on how the body responds. Over time, they can create a sustainable change in eating patterns and dietary practices.
Understanding, teaching and sharing these health benefits should be a top priority for the medical community. My organization connects physicians, healthcare practitioners and patients to share information about healthcare strategies like intermittent fasting and healthy eating, creating communities that can drive change. Ultimately, we all to need to join forces as doctors, patients, and people to address the fact despite record rates of health insurance coverage, more Americans are suffering from preventable chronic diseases.
The American Medical Association has called for insurers to cover new obesity drugs, but it hasn’t discussed the benefits of intermittent fasting since March 2020, just before the COVID-19 pandemic began. It’s time to revive this conversation. Doctors, dieticians, nutritionists, and public health leaders should educate people seeking obesity treatment on the benefits of intermittent fasting, too. People taking these drugs will obtain the greatest, long-term benefits if the medications can catalyze sustainable changes in their dietary practices.
Paul Marik, MD is Co-Founder and Chief Medical Officer at the FLCCC.
