Weight loss medication: What's all the scepticism about?

Since the revelation that there are certain medications available that can deliver impressive weight loss results, patients and health providers alike have been scrambling to get their hands on them — so much so, that Australians now face a supply shortage for the next few months. 

But many people demanding the drug may not be eligible for it. To access it, a doctor must first assess each patient, and when clinically indicated, provide them with a prescription.  

What several influential commentators are concerned about is the medium through which an increasing number of these assessments are conducted in contemporary healthcare.

Specifically, they fear that text-based telehealth consultations fail to meet minimum clinical quality standards to assess patients and safely prescribe medications, such as those used for weight loss.

And while we agree that any provider of these medications needs to adhere to high-quality care and safety criteria, we argue that our asynchronous model of care surpasses current standards.

That’s what we strive to provide at Juniper — let’s dive into why and how.

Is it too good to be true?

When it comes to weight loss drugs, a lot of the scepticism centres around the approach’s simplicity, with many wondering how something so simple can address a condition as complex as obesity — and that’s a valid question.

Although this class of medications has been proven to suppress appetite, viewing them as a ‘tick and flick’ cure for weight loss is irresponsible.

For one, patients need to take these medications for a long period, which considering the potential side effects, cannot be done safely without ongoing support from clinicians.

Plus — and as effective as the drug itself is for weight loss — it simply shouldn’t be promoted as an alternative to a good diet and regular exercise. 

Sceptics believe that this is exactly the culture that online weight loss medication providers are fostering, and we completely agree that such a mindset is dangerous. 

These medications should form part of a holistic weight loss program, along with a guided nutrition and exercise routine to maximise results and create a more sustainable weight regulation culture across the population.

How Juniper optimises the efficacy and safety of medication

Juniper’s Weight Reset Program combines medication, health tracking, a supportive community, and health coaching that looks at stress levels, sleep, nutrition, and exercise — all to help Australian women reach their weight loss goals and become their most confident selves.

This program has achieved unprecedented outcomes (which we’ll get to shortly), which are largely thanks to our holistic, data-centred approach.

From the moment a prospective patient starts our initial questionnaire, every single touchpoint is stored in our database. Not only does this enhance data quality by removing time pressures but it also safeguards each patient’s data.

Considering that Australia’s (overworked) GP workforce cites their administrative burden as a key concern, the benefits of having a database like Juniper's are clear [1]:

• Our doctors have a significantly reduced administrative load because everything is done online. This not only renders them less susceptible to human errors but they are also alerted by our database safeguards whenever they make a mistake, such as overlooking contraindications or medication interactions.

• Our dietitians and health coaches are also connected to the same patient database, which relieves them of typical care coordination inefficiencies, such as chasing up notes from another specialist involved in a patient’s care journey. The database will also alert our dietitians and health coaches if they make ill-advised decisions.

• In rare cases where warnings are missed, our support staff is alerted and reviews are held with the responsible clinicians.

Although in-person GPs should in theory be protected by similar safeguards, the reality is that very few of them enter patient data into the Government’s My Health Record, so the system simply doesn’t have the information or technical capabilities it needs to create these alerts and safeguards.

The failure to store data in a central network becomes equally problematic when patients have to be referred to specialists, who end up having to spend a disproportionate amount of time retrieving (often incomplete) patient data from GPs.

This can make it extremely difficult to coordinate continuous care with GPs and other specialists, which for complex, chronic conditions like obesity, is essential. 

So, how effective is Juniper’s Weight Reset Program?

By now, you understand how our model of care exceeds the minimum safety threshold required by the Australian healthcare standards.

What you may still be wondering is how effective our program actually is.

To answer this question, let’s compare our efficacy data with the results from a 2015 GLP-1 RA clinical trial [2]. 

The magnitude of this discrepancy may astound you at first, but when you think about it, it makes sense.

We’ve known for decades that a good diet and exercise are 2 of the most significant factors in weight regulation, and we’ve recently discovered that a certain drug is comparably effective. Juniper’s Weight Reset Program simply combines the forces of these interventions to deliver highly effective care without compromising patient safety.

It’s important to disclose that our data was taken from a sample of ‘ideal path users’, meaning it excluded data from patients who deviated significantly from their treatment plans. This was done to remove confounding variables that would make results difficult to interpret and is common practice when reporting scientific results.

Moreover, ‘ideal path’ manipulation tends to have a smaller positive effect on overall results than the manipulation applied in most clinical trials. 

In the cited 2015 study, for example, researchers imputed results from the patients’ last observed inputs, rather than discarding data from non-compliant or discontinued patients. And as patients lose a disproportionate amount of weight in the first 2 months, the results skew in an upward direction. 

Plus, the level of guidance patients receive in clinical trials doesn’t accurately reflect the experience they would have if they were to access standalone weight loss treatment in a traditional care setting. Juniper’s ‘ideal path user’ data, on the other hand, is a replica of what a compliant patient would receive. 

As you can see, we don’t have any secrets and we’re not doing anything novel or controversial. We’ve simply leveraged the advantages of digitisation and holistic care models to deliver safe, high-quality healthcare services at scale.

Photo credit: Getty Images