These injections are indicated for patients with a BMI greater than 30 or overweight with a BMI greater than 27 with pathologies associated with obesity If they are used without control “no one can rule out that an eating disorder does not arise” The AEMPS has warned of the increase in the demand for some of these drugs But the doubt persists. The Spanish Agency for Medicines and Health Products (AEMPS) warned a few days ago that some of the medicines (analogues of GLP-1) were beginning to be scarce. Although the laboratories are going to increase production, what is feared is that demand has increased because some people are using these injections to try to lose weight without being obese, which could be dangerous. “We cannot ignore that there are no studies of the effects in people who just want to lose a couple of kilos. These drugs are indicated for people with BMI greater than 30 or overweight with BMI above 27 with pathologies associated with obesity. The studies that have been done show that they are very effective. But you have to abide by the instructions given by the authorities, “he explains Cristobal Morales.P. It seems that there is evidence that in some private clinics they are being prescribed without the patient in question meeting all the requirements. What could happen if a person who is not obese takes it? It is not indicated for that. No one can rule out that an eating disorder may not arise, for example. It could be effective, sure, but there are no studies that say so. It is a precision medicine for a specific disease, obesity. Like any drug, you have to stick to the indications, getting out of there is getting into a field where there is no data or scientific evidence and we cannot guarantee safety and efficacy. Q. Would it be like giving a heart drug without having heart disease? A. This medication really works very well, but always under the technical data sheet. You have to go to a serious center, the indications are very clear. It works well because it suppresses the appetite, but it must always be accompanied by a nutritional pattern and a change in lifestyle along with exercise. P. If these instructions are not followed, could it cause a rebound effect? If you use it in a timely manner, without medical supervision by a serious medical team, with the endorsement of the Spanish obesity society and outside medical indications, that is, for purely aesthetic reasons, you will lose weight very quickly but the danger is that you can’t sustain that weight loss and have the yo-yo effect. A rebound effect with which you gain a lot of fat, therefore you are doing your body a disservice, you are changing your body composition, and your proportion of adipocytes. P. These drugs, originally thought to treat type 2 diabetes, act by mimicking the hormone GLP-1, regulating the areas of the brain responsible for appetite and food intake. That is, what it does is trick the brain so that we are not hungry.R. It’s not a magic wand. It works well because it suppresses the appetite but it must always be accompanied by a nutritional pattern and a change in lifestyle along with exercise, I insist. Perhaps what is also important is that no serious contraindications have been observed in the patients to whom it has been prescribed and that the benefit does not only come from weight loss.R. The important thing is to maintain that weight loss. Let’s keep in mind that we are not talking about losing weight, we are talking about gaining health. What is also achieved is not having to reach a stomach reduction.R. Metabolic surgery is a failure of prevention, because we are already late. P. Thanks to these drugs that disease can remit, right? A. There are more than 200 complications associated with obesity so you have to take it seriously. It is a very complex disease, which has a lot of biology and genetics behind it. It is a long treatment, because you also have to change lifestyle, diet, and help the patient who in many cases has suffered a lot from social rejection. Q. How long does the treatment last? A. It is important to make it clear that there is not just one obesity, there are many different obesity phenotypes. There are people who achieve their weight goal earlier and others later. We have to flee from the term ideal weight because it does not exist. Each person is different, now yes, we are going to achieve weight loss with the new drugs of 15 percent of your body weight, which in health is a lot. But the time depends on each person. The person who has the thrifty body will always have to take care of himself, and he has to make more effort than another person with a different metabolism. Now it has just been shown that this type of drug can be administered in adolescents.R. It is very good news. Most of these patients have been bullied all their lives. If we can fight the disease soon, we tackle the problem sooner and they will improve their quality of life. P. Always under medical prescription.R. It can’t be done any other way. We advise a responsible use following the indications. These medications are prescribed, although they are not financed by Social Security. P. But if you don’t have to take them for many years, how can the patient afford them? A. That is why there is a social gap. The patients who need it most are usually those who have the least money, but the Public Health does not finance any treatment for obesity. P. That is indeed a problem because obesity already affects 25% of the population in our country according to the Spanish Society of Obesity Surgery.R. It would be necessary to analyze and look for ways on which patient profile benefits the most. But the first thing to keep in mind, I insist, is that obesity is a disease and as such must be treated. Saxenda, the most widely prescribed medicine, is priced at €283.05 for a box of 5 pre-filled pens.