Anti-Obesity Medications and Functional Impairment

Over the past year or so, millions of words have been published about new products in the pharmaceutical industry. For a while, it seemed as if there might be no downside at all; that these awesome substances might be the first in the history of medicine to come unaccompanied by any ill effects. Then slowly, the miraculous illusion began to fade.

The honeymoon might be over, according to some signs, like for instance a University of North Carolina study that produced sentences like these:

Among individuals with obesity, participants using anti-obesity medications, compared with those not using said medications, were more likely to report physical function limitations… Older adults with obesity on [anti-obesity medications] had higher rates of self-reported limitations in function and were more likely to be treated.

In a piece by Jessica Nye, Ph.D., several drugs are mentioned by their generic names (liraglutide, naltrexone-bupropion, orlistat, phentermine-topiramate, semaglutide, and setmelanotide); none by commercial brand; but they include all the biggies. Dr. Nye writes,

Participants older than 60 years of age were evaluated for self-reported functioning and basic and instrumental activities of daily living… Older adults with a body mass index (BMI) greater than 30 kg/m2 are eligible to receive anti-obesity medications. However, this cohort of patients are also at an elevated risk for functional limitations and disability.

The report under discussion utilized data from the National Health and Nutrition Examination Surveys of 1999 to 2018. Included were very nearly 20,000 subjects, 55% female and 45% male, with a mean age of 70.3 years.

Some definitions

According to various authorities, physical function limitation includes “basic activities of daily living limitations,” “instrumental activities of daily living limitations,” and even “any impairment.” Knowledge of what is meant by these terms will come in handy, to understand the implications of these findings.

A different study in the same genre gives examples. Mobility limitations may include the inability to walk several blocks and/or climb a flight of stairs, the inability to get up from a sitting position or to stoop, crouch, or kneel. Similar limitations can affect the upper extremities, rendering the person unable to push or pull heavy objects or to lift more than a few pounds. In their studies of pre-diabetic patients, researchers assessed six geriatric conditions.

One would be cognitive impairment, ranging from mild and all the way to dementia. For individuals over 65, frequent or serious falls count. There is urinary incontinence serious enough to require the use of absorbent pads. Decreased hearing and/or vision that cannot be helped by the use of corrective technology, count as limitations; as does chronic pain.

(To be continued…)

Your responses and feedback are welcome!

Source: “Anti-Obesity Medications Increase Risk for Functional Impairment,”, 10/19/23
Source: “Physical Function Limitations Among Middle-Aged and Older Adults With Prediabetes,”, 09/14/13
Image by Quinn Dombrowski/CC BY-SA 2.0 DEED

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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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