Mount Sinai South Nassau

New poll finds one-third of area is overweight

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Each year millions of America’s make resolutions on the stroke of midnight to exercise more, eat healthier and lose weight, but for a variety of reasons many fail.  Now, with the Food and Drug Administration’s approval of Ozempic, Wegovy and other weight loss injections, many are turning to off-label prescriptions who don’t necessarily need them. Mount Sinai South Nassau decided to investigate and clarify the purpose of the therapies, who needs them most, and the risks in their newest Truth in Medicine Poll.

The poll, which was conducted between Feb. 16 and Feb. 21 using both landlines and cell phones included 600 Long Island and New York City residents and uncovered that nearly one-third of metro area residents consider themselves overweight and almost one-quarter say they would take a prescription weight-loss drug to shed extra pounds.

Ten percent of poll respondents are currently taking or know someone who uses the prescription drugs Ozempic, Mounjaro, or Wegovy to lose weight. Most of them are women under 50 and Black. While all three drugs can generate weight loss, only Wegovy is FDA approved for weight management in obese or overweight teens and adults with at least one weight related comorbidity. Ozempic, the most well-known brand name, and Mounjaro are only approved for patients with type 2 diabetes to control blood glucose levels.

Adhi Sharma, the president of Mount Sinai South Nassau said that the “biggest danger is what we call the yo-yo diet.” He stated since our bodies have a certain metabolism that is set by various factors internally, when we diet, we alter those factors. “So, healthy diets don’t impact those factors as much as actually how our body is designed to consume food,” he said.

So, when locals go on fad diets, it teaches the body to go into starvation mode, Sharma explained, which in most low-calorie diets isn’t sustainable. People then begin to binge eat or allow one cheat day to becomes two or three. Now, Sharma said, the diet has failed, but the body has slowed down the metabolism and now the opposite effect is happening: you’re gaining weight.

The poll found that one-half of respondents admit to binge eating. Some 60 percent confirmed they eat two or more fast-food meals per week, and 22 percent said they consume four or more fast-food meals regularly. Meanwhile, 60 percent of area residents reported that inflation has changed their buying habits at the grocery store.

Off-label use of prescription drugs as an alternative to dieting and exercise to lose weight is contributing to supply shortages in the United States and globally for the people — most of whom have diabetes — that they were created to help.

“These treatments were not intended to serve as an alternative to regular exercise and healthy eating to lose a few extra pounds quickly,” said Glatt, the chair of the Department of Medicine at Mount Sinai South Nassau. “They were created to manage type 2 diabetes and obesity.”

Glatt said those using the drugs appropriately are fine, but many are not, and when they’re not the consequences can lead to more harm than good. He found it unfortunately ironic that, “when people take these medications, and they really don’t have a good indication for them there are other unintended consequences besides just the drug that is available for people that need it.”

He continued to say the major reason people take these types of drugs is to look better, lose weight, but that very few of these people are taking it because they want to be healthier.

“And it’s interesting,” Glatt said, “that some of these patients ultimately then go on to need plastic surgery, there’s been an increase in various types of plastic surgery. Because while these drugs are effective in causing weight loss, they also cause people to sometimes look older.”

A lack of communication between patients and their medical providers about the management of their weight appears to be a contributing factor, according to the poll results.

Overall, 28 percent of all respondents have spoken to a health care provider about their weight. Of those who have not, 39 percent say they failed to do so because the provider did not bring it up and 12 percent said there is nothing a health care provider can do.

Far fewer, seven percent, were uncomfortable discussing the subject with their provider, and two percent were embarrassed or fearful of being judged — even though only eight percent of respondents said a health care provider made them feel uncomfortable about their weight.

“I strongly encourage all adults and parents of children who are struggling with their weight to talk about it with their health care providers and work to develop a short- and long-term program to manage it,” Sharma said. “At the same time, physicians are in an ideal position to talk with patients about their weight and prescribe a plan of action to successfully manage it.”

Other important findings of the survey included that those most likely to say they binge eat are Blacks, those who are overweight, those committed to weight loss resolutions, men under 50, and those who take Ozempic or are familiar with the drug. Another is that nearly one-third say the thought of gaining weight causes them stress and anxiety. Nearly half of women younger than 50 agree with that statement.

According to a study published in Diabetes, Obesity and Metabolism, one year after the withdrawal of a once-weekly 2.4 milligram injection of Ozempic, participants regained two-thirds of the weight lost.

The key ingredient in Ozempic and Wegovy is semaglutide, which stimulates insulin release from the pancreas when needed. It also helps with weight loss by targeting areas of the brain that regulate appetite and slowing down the speed at which food travels through the digestive tract. Mounjaro lowers plasma glucose concentrations after eating, decreases food intake, and reduces body weight in patients with type 2 diabetes. All three are given by injection.

“The increasing use of these drugs as a convenience to lose a few pounds concerns me,” said Efie Tsomos, the endocrinology division chief at Mount Sinai South Nassau. “It’s becoming increasingly difficult for some of our patients to get their prescriptions filled at their local pharmacies.”

The Truth in Medicine Poll is a component of Mount Sinai South Nassau’s mission of improving education around critical public health issues. This is Mount Sinai South Nassau’s 15th Truth in Medicine Poll and first of 2023.

The poll seeks to evaluate public knowledge and sentiment toward key public health issues. Sponsored by Bethpage Credit Union, the poll aims to gather data about attitudes on key public health topics and helps spur education to improve public health.

“Bethpage is proud to partner with Mount Sinai South Nassau in advocating and prescribing exercise and a balanced diet to achieve a healthy weight,” said Linda Armyn, chief strategy and marketing officer at Bethpage Federal Credit Union.