Weight loss is critical to maintaining overall health, particularly in light of the widespread prevalence of obesity and overweight conditions. According to the Centers for Disease Control and Prevention (CDC), approximately 42.4% of adults in the United States are obese.

Body mass index

Overweight and obesity can be determined by calculating body mass index (BMI), a measure that considers an individual's weight and height. For adults aged 20 and above, the table below provides a range of BMIs that indicate overweight and obesity.

BMI of Adults Ages 20 and older

Calculate your BMI with this: https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

Factors Affecting Weight& Health

• Lifestyle Habits
• Choices of diet, physical activity, smoking, alcohol consumption, and stress management can have a significant impact on our weight and health.

• Sleep Quality and Duration
• Not getting enough sleep is also linked to weight gain. Experts recommend that adults aged 18 to 64 sleep 7 to 9 hours a night. Lack of sleep can make you feel hungrier, consume more calories, and be likely to eat unhealthy foods and beverages.

• Health problems
• Some medical conditions can affect weight and health, such as endocrine diseases (e.g., Polycystic ovary syndrome (PCOS), Cushing's syndrome, and hypothyroidism) and medications (such as steroids, anti-depressants, and birth control pills).

• Family History and genes
• The Chances of being overweight or obese are greater if one or both of your parents are obese or overweight.
• Genes may affect the amount and distribution of fat in the body and the appetite and physical activity levels.

Health Risks associated with overweight and obesity

Obesity and being overweight present significant public health concerns and are associated with a range of health risks and complications. There are several health risks associated with obesity and overweight:

• Chronic illnesses - Excess weight can increase the risk of high blood pressure, cholesterol, and glucose, leading to heart disease. Maintaining a healthy weight through diet and exercise is crucial for preventing these health problems.

• Type 2 diabetes - Nearly 9 out of 10 people with type 2 Diabetes are overweight or obese.

• Overweight and obesity are associated with a higher risk of breast, colon, endometrial, kidney, and pancreatic cancers.

• High Blood Pressure - Being overweight and obese may raise the risk of high blood pressure, which can damage the heart and blood vessels.

• Respiratory conditions can affect breathing due to excess weight on the chest and abdomen. Some examples are sleeping apnea, hypoventilation syndrome, and asthma.

• Osteoarthritis is a prevalent and chronic health condition that causes pain, inflammation, rigidity, and limited joint movement. Obesity is a significant risk factor for osteoarthritis in the knees, hips, and ankles, as it exerts additional pressure on the joints.

• Pregnancy problems - Overweight and obesity raise the risk of developing health problems during pregnancy that affect the pregnancy and the baby’s health, such as gestational diabetes, preeclampsia, and congenital disabilities.

• Fertility problems - Obesity is linked to lower sperm count and sperm quality in men, and obesity is linked to problems with menstrual cycle and ovulation in women, which can affect chances of conceiving.

• Sexual Function problems increase the risk of developing sexual function problems such as the risk of developing erectile dysfunction in men and reduced sexual satisfaction in both genders.

• Mental Health problems increase the risk of developing.
• Longterm stress
• Body image problems
• Low self-esteem
• Depression
• Eating disorders

• Fatty liver diseases- Development when fat builds up in the liver, which leads to severe liver damage, cirrhosis, or even liver failure.

Treatment for Obesity and Overweight

Healthcare professionals treat overweight and obesity by helping adopt lifestyle changes, tailored weight-loss programs, and weight-loss medications.

• Lifestyle Changes
• Healthcare Professionals often treat overweight and obesity by recommending lifestyle changes, such as adopting a healthy diet plan and increasing physical activity, to help lose weight safely and effectively.

• Tailored Weight-loss program
• In Some cases, health professionals may refer the patient to a specialist trained in weight management. These specialists will design a customized plan and help in executing the plan, which may include behavioral counseling, nutrition education, and exercise guidance.

• Weight-loss medicines
• Weight loss can be difficult to achieve and maintain. When lifestyle changes are not enough, the health professional may prescribe medicine to treat overweight and obesity. Some medicines can help maintain weight loss, but they are not suitable for healthy eating and exercise. It is recommended to continue with lifestyle changes while taking the weight-loss medication.

Compounded Treatment

Compounded option offers personalized approaches to weight loss medication, providing customized formulations that address individual patient factors and preferences. These pharmacies offer a range of evidence-based treatment options, emphasizing patient-centered care and adherence to regulatory standards.

Pharmacotherapy plays a significant role in weight loss management by targeting various mechanisms involved in appetite regulation, energy expenditure, and fat metabolism. Compounding pharmacies can formulate customized medications to address specific patients’ needs and preferences, including Appetite suppressants, metabolic boosters, and customized nutraceutical blends tailored to meet the unique needs of each patient. These medications are available in diverse forms, including injectables, lozenges, capsules, creams, and nasal sprays, providing flexibility and convenience.

There are currently three FDA-approved semaglutide products:

• Ozempic Injection and Rybelsus tablets have been approved to help lower blood sugar levels in adults who are suffering from type 2 diabetes mellitus. These medications should be used in combination with a healthy diet and regular exercise. Furthermore, Ozempic has been approved to reduce the risk of heart attack, stroke, or death in adults who have type 2 diabetes mellitus and a history of heart disease.

• Wegovy Injection has been approved to aid adults and children aged 12 years and above who suffer from obesity or some adults who have excess weight (overweight) and also face weight-related medical issues. It helps in losing weight and maintaining the same when combined with a healthy diet and exercise.

All three medications require a prescription. No approved generics are available.

Boulevard Compounding Pharmacy does not offer any injectable forms of semaglutide. However, we do offer the following sublingual formulations by utilizing FDA-approved commercial products such as Rybelsus and Tirzepatide.

• SEMAGLUTIDE 1 MG/ML SUBLINGUAL SUSPENSION
• SEMAGLUTIDE 2 MG/ML SUBLINGUAL SUSPENSION
• TIRZEPATIDE 2.5 MG/ML SUBLINGUAL SUSPENSION
• TIRZEPATIDE 5 MG/ML SUBLINGUAL SUSPENSION

Patients should not use a compounded drug if an approved drug is available commercially. Compounded products are not FDA-approved as they are not tested for safety or efficacy.

Appetite suppressants

Appetite suppressants like Phentermine, also known as Adipex or Adipex-P, can be prepared in modified-release formulations by compounding pharmacists to help control hunger and reduce caloric intake. Additionally, compounded medications containing ingredients like caffeine, green tea extract, or bitter orange extract may enhance metabolic rate and thermogenesis, facilitating weight loss.

Oral Appetite Suppressants are available at Boulevard Pharmaceutical Compounding Centre

• 1. PC #1/PC#2
• 2. PCH #1/PCH #2
• 3. PCT

Phentermine Compound #1 and Phentermine Compound H # 2 contain a lower dose of Phentermine of 18.75mg. PCH #1 and PCH #2 have a higher dose of Phentermine of 37.5 mg. Additionally, they also include St John’s Wart and Chromium. Drug-drug interactions should be considered when prescribing St. John’s Wort.

Personalized nutraceutical blends containing vitamins, minerals, amino acids, and botanical extracts to support weight loss and overall health. Ensuring the safety and efficacy of compounded weight loss medication is paramount. Healthcare providers can collaborate closely with compounding pharmacists to select appropriate ingredients, dosages, and formulations based on evidence-based guidelines and clinical judgment. Ongoing monitoring and evaluation of patient response are essential to assess treatment effectiveness and mitigate potential risks.

Regulatory Standards

Compounding pharmacies must adhere to regulatory standards and quality assurance practices to ensure product integrity and patient safety. Compounding pharmacies must comply with applicable such as United States Pharmacopeia (USP) standards, state pharmacy laws, and Good Manufacturing Practices (GMP) guidelines. Healthcare providers can partner with reputable compounding pharmacies that demonstrate a commitment to quality, transparency, and regulatory compliance.

Conclusion

Effective weight loss management involves comprehensive patient education and counseling to empower individuals to make informed decisions about their health. Healthcare providers play a crucial role in educating patients about the risks and benefits of compounded weight loss medication, including potential side effects, contraindications, and lifestyle modifications. Studies have shown that weight loss medications approved for long-term use- more than 12 weeks- produce a higher weight loss medication, and lifestyle changes result in greater weight loss than lifestyle changes do alone.

Compounding weight loss medication offers a personalized and flexible approach to addressing the complex and multifactorial nature of obesity and overweight. By leveraging the expertise of compounding pharmacists and the collaboration of health providers, patients can access customized formulations that enhance treatment adherence, efficacy, and safety. As part of a comprehensive weight loss management strategy, compounded medications have the potential to improve patient outcomes and contribute to long-term success in achieving and maintaining weight.