New Drugs — Does Lifestyle Intervention Still Count? Part 1

Today’s question is: Do the new, remarkably effective GLP-1 obesity medications eliminate the need for obesity interventions such as BrainWeighve? At this moment, it looks like the answer to that question is a resounding “No!”

First, a definition:

Lifestyle interventions can be defined as changes that patients can make to their lifestyles that improve these diseases in lieu of, or in addition to, clinical and pharmaceutical interventions, and often are prescribed as a first line of defense for patients showing diabetes and other symptoms of the metabolic syndrome.

An important reason why lifestyle intervention is vital is contained in a batch of recent news about those very drugs. One is the generic liraglutide (sold under the trade names of Saxenda and Victoza) that requires daily injections. It has been approved as an obesity treatment:

Liraglutide, used in conjunction with lifestyle changes, can help induce and maintain weight loss and improve insulin sensitivity. Liraglutide may be an especially attractive alternative in patients with severe obesity when lifestyle modification is unsuccessful or only partially effective…

At the very least, lifestyle intervention in the form of exercise has been shown to alleviate some of the side effects of liraglutide’s therapeutic use:

[The] combination of liraglutide and exercise can also bring benefits in weight loss. Furthermore, the combination of liraglutide and physical exercise can prevent adverse effects observed in the administration of liraglutide.

Apparently, exercise is especially useful in reducing adverse effects of the gastrointestinal kind, and also improves the patient’s resting heart rate.

Another generic

Next up is semaglutide, a weekly injection that might soon be available as an oral medication. It is sold under the proprietary names of Ozempic and Wegovy, which are both legitimately prescribed to fight obesity in the absence of diabetes.

Semaglutide has been described as “a new weight-loss drug that produced jaw-dropping clinical trial results in early 2021.” It was used in the highly publicized STEP trials conducted at many medical centers.

The results, released in February, were important enough to warrant prominent placement in the New England Journal of Medicine for the STEP 1 trial results and Journal of the American Medical Association for STEP 3 trial results, and a major feature in the New York Times.

Participants lost an average of 37 pounds through the combination of semaglutide and behavioral intervention in the STEP 3 trial.

There it is again, a reference to behavioral intervention, which means some exercise. Not much detail about the corporeal side of the intervention is to be found, except a mention of 150 minutes of physical activity per week, or two and a half hours, which is not a lot, but probably more than some of the participants were accustomed to.

(To be continued…)

Your responses and feedback are welcome!

Source: “Lifestyle Intervention,”, undated
Source: “Liraglutide with Lifestyle Intervention in Adolescents with Overweight/Obesity, Nonalcoholic Fatty Liver Disease, and Type II Diabetes Mellitus,”, 11/08/21
Source: “Liraglutide and Exercise: A Possible Treatment for Obesity?,”, 08/17/22
Source: “Who will benefit from new ‘game-changing’ weight-loss drug semaglutide?,”, 04/09/22
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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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