Fighting Obesity in Canada: Safer Alternatives to GLP-1 Drugs
We’ve all seen the latest news on GLP-1 Drugs and the laundry list of side effects and issues that keep mounting. So, what are the safer alternatives? Dr. Shantanu Gaur, a Harvard Medical Graduate and Global Obesity Specialist, helps us tackle these important questions and is available for an interview.
As the landscape of obesity treatments continues to evolve, a pertinent issue demanding attention is the safety and efficacy of various approaches. In light of the growing interest in GLP-1 injectable drugs and the mounting controversies surrounding their use, there’s a pressing need to highlight safer and more holistic alternatives.
Obesity in Canada: Let’s look at the facts
According to data from Statistics Canada, obesity among adults aged 18 and older is over 27.4% and climbing.
That’s over 10 million adults living with obesity in Canada, which has significantly increased from previous years.
The World Obesity Federation predicts that there will be over 2 billion people worldwide living with obesity by 2035. We must address this issue head-on in Canada.
Obesity is linked to various health concerns, including heart disease, type 2 diabetes, certain cancers, high blood pressure, and more. It significantly increases the risk of developing these conditions.
The economic burden of obesity in Canada is substantial, with costs related to healthcare, productivity loss, and other factors estimated in the billions annually.
Obesity Treatments: What are the options?
GLP-1: Injectable weight loss drugs
WHAT: GLP-1 (glucagon-like peptide-1) receptor agonists are a class of medications used to treat type 2 diabetes by stimulating insulin production and reducing blood sugar levels. However, they are now being used for non-diabetic individuals.
PROS: This helps individuals feel fuller longer as it retards food digestion and prolongs the sensation of fullness.
CONS: While this medication has yielded weight loss benefits for some, it also has inherent risks.
Side effects may include nausea, vomiting, diarrhea, and, in some cases, pancreatitis or an increased risk of developing thyroid tumours.
When it excessively retards stomach function or leads to intestinal blockages, it results in a condition called "ileus"(a lack of movement or function of the intestines). The US Food and Drug Administration had received 18 reports of ileus linked to GLP-1’s use as of late September 2023.
GLP-1 injectables need weekly self-injections and potentially alter one’s biology.
With injectables, patients will see a 15% body weight reduction after 68 weeks of use at the cost of $950 US per month, which means that it would cost the patient $19,000 to see a body weight reduction of 15% in 17 months.
Additionally, injectable weight loss management programs result in rapid re-gaining of all of the lost weight.
A staggering 68% of individuals starting on GLP-1s discontinue usage within a year due to side effects, cost factors, or discomfort with injections.
Gastric Sleeve & Bypass: Permanent Surgical Procedures
WHAT: A gastric sleeve, also known as sleeve gastrectomy, is a surgical weight-loss procedure where a portion of the stomach is removed, creating a smaller, banana-shaped stomach. This limits the amount of food the stomach can hold, leading to reduced food intake and aiding weight loss. On the other hand, gastric bypass surgery, or Roux-en-Y gastric bypass, involves creating a smaller stomach pouch and rerouting the small intestine to bypass a part of it. This restricts both the amount of food intake and the body's ability to absorb nutrients, promoting weight loss.
PROS: Both procedures are used to assist individuals with severe obesity in losing weight and improving obesity-related health issues.
CONS: There are risks associated with surgery.
Wait times can be up to two years if you want the Canadian government to cover the cost, and if you go to a private clinic, you will likely spend $16k-$25k.
The surgery is permanent, and some individuals may not fit the criteria for surgery.
Allurion Program featuring the Allurion Balloon: Non-surgical, non-permanent, no-medication, powered by AI.
WHAT: One of the newest non-surgical options that Health Canada has approved for patients is the Allurion Program (Non-Surgical Gastric Balloon).
The Allurion Program consists of three pillars. The first is the balloon, which is a truly revolutionary weight loss device: the world’s first and only procedureless swallowable gastric balloon. The second is the digital platform supported by Artificial Intelligence. The third is a behaviour change program.
The Allurion Balloon is a pill balloon capsule which is swallowed under the guidance of a certified Healthcare Professional without anaesthesia, surgery or endoscopy.
The Balloon is inflated in your stomach (watch it here) with sterile water and checked using quick X-rays before inflation and after. The entire procedure takes approximately 15 minutes with an outpatient visit. Patients are supported by the Allurion Connected Scale,, App and weight-loss Coach Iris powered by AI. After four months, the balloon deflates and is passed naturally.
PROS: This procedure is non-surgical, non-invasive, and drug-free.
Patients placed on the Allurion Program featuring the Allurion Gastric Balloon lose an average of 7.5% of body weight in the first month and up to 15% at the end 4 months at the cost of $7000 CDN. Patients sustain up to 96% of weight loss one year after the balloon has passed.2
The Allurion Balloon Program is non-invasive and doesn’t enter the bloodstream. It prioritizes altering patient behaviour and lifestyle for sustainable, long-lasting weight loss.
The program includes the Allurion Virtual Care Suite, including the Allurion Mobile App for consumers, Allurion Insights for clinicians, and the Allurion Connected Scale device. It is a powerful weight-loss management suite powered by artificial intelligence, designed to power the weight-loss program and to maximize patients outcomes and satisfaction. It offers remote patient monitoring, telehealth and care team collaboration – all under the one digital umbrella.
The Virtual Care Suite is turbocharged by Allurion’s Artificial Intelligence platform: In 2022, the company invested in a software for partner clinics that correlates weight loss data and patient profiles: Success Predictor. The proprietary machine-learning algorithm predicts outcomes as early as 20 days from the start of the Allurion Program, enabling doctors to focus on the right patient at the right time through early identification of patients needing additional support.
This year, AI was extended to the patient app with ‘Coach Iris’. Allurion’s Coach Iris is a new generative AI-powered weight-loss coach designed to enhance outcomes within the Program and maximize a clinic’s efficiency. Coach Iris offers always-on support, education, and motivation on a broad range of health and weight-loss topics, including tailored meal plans, recipes, exercise routines, stress management techniques, and motivational insights. Coach Iris also reaches out to patients to keep them actively engaged in their weight loss program.
Behaviour change program: The Allurion Program is a 6-month medical weight loss program that helps you readjust your mindset towards food to sustain your weight loss, for your long-term health.
A nutritionist will help you re-evaluate your relationship with food: they will keep you strong and healthy, and guide you to healthy, sustainable, dietary choices. You can make use of their coaching for 6-months - well after the balloon has passed.
Patient Retention and Tolerance: Research indicates that Allurion emerges as an ideal second-line option for those seeking effective weight loss without these drawbacks.
CONS: The balloon may be perceived as a non-permanent solution for weight loss. After four months, it deflates naturally and passes, and without sustained lifestyle changes, weight may gradually return. However, the Allurion Program, thanks to the combination of balloon, the digital support and behaviour change program, works to help each patient change their behaviour and habits to ensure the best outcome.
Requires Commitment to Lifestyle Changes. To achieve long-term success, individuals need to commit to adopting healthier eating habits and regular physical activity. Without these changes, the benefits of the balloon might be temporary.
The Allurion Program might involve costs that aren't covered by insurance.
Not all individuals are eligible for the Allurion program. It may not be recommended for people with certain medical conditions.
Traditional Diet and Exercise: Traditional methods based on diet and exercise remain foundational pillars in managing weight effectively. They involve a comprehensive approach focused on caloric intake, nutrient balance, and physical activity.
PROS: It promotes overall health improvement beyond weight loss, reduces the risk of chronic diseases, and enhances overall fitness. By making sustainable lifestyle changes, individuals can achieve gradual and steady weight loss that is more likely to be maintained long-term. Additionally, these methods are usually more cost-effective and accessible to a broader population.
CONS: While effective, traditional diet and exercise methods demand commitment and consistency.
Achieving significant weight loss may take longer compared to certain non-surgical interventions.
Individuals might find it challenging to adhere to strict dietary plans or maintain regular exercise routines consistently, which could impact the rate of weight loss and sustainability of results.
For some, diet and exercise alone have not helped, and they may need to consult with a healthcare professional to seek alternative options.
Dr. Gaur's expertise in obesity management positions him as a crucial voice in reshaping the discourse around safe and sustainable weight loss strategies.
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