Anti-Obesity Medications and Functional Impairment, Continued

This is the continuation of an exploration of the possible negative effects of the new wave of weight-loss drugs, which began with a recent post.

Physical function limitations affect the activities of daily living (ADLs) such as bathing, dressing, eating, transferring, and toileting. Then there are instrumental ADLs, which include such survival skills as meal preparation, shopping for groceries, taking medications properly, making telephone calls, and managing finances. The activity categories are further sorted into more specific tasks, like raising the arms above shoulder level, climbing one flight of stairs without resting, and picking up a dime from a flat surface.

The viewpoint of another bureaucracy, the Social Security Administration, is somewhat slanted because its main concern is an individual’s capacity for gainful employment. The SSA is not very concerned about limitations that only affect one’s personal life, but in millions of cases it makes judgment calls about the ability to work, so its definitions carry a lot of weight.

The main work-related disabilities have to do with: “climbing and balancing; fine manual dexterity; hearing; kneeling and crawling, using an upper extremity, alternately sitting and standing; reaching and handling; stooping and crouching; seeing.”

Mental limitations encompass the ability to understand, remember, and carry out simple instructions. A person also needs to make work-related decisions, including appropriate responses to people and situations, and to be capable of dealing with change. Another category of limitations has to do with environmental conditions. For various reasons, it might be very dangerous for someone to work around moving machinery or certain chemicals, in an excessively dusty or noisy environment, or extreme cold or heat.

Impairment claims and refutations

We have listed the broad categories of possible functional limitations upon the activities of daily existence, which may be physical, mental, or environmental. Other problems can affect a person’s ability to earn a living, depending on the field in which one has been trained and has successfully supported oneself. There are subtleties, less obvious skills — like the ability to hold onto and manipulate a small object, and to feel sizes, shapes, and textures — that might not affect a farm laborer but that would ruin the prospects of a surgeon.

All these many skills and abilities, it now appears, could potentially be affected by the new weight-loss drugs, in ways that will become increasingly apparent as time passes. A person’s RFC, or residual functional capacity, could be negatively impacted by these pharmaceuticals in ways that researchers are now only beginning to imagine.

When claims are made, one very problematic area is pain. Is it disabling, or merely unpleasant and inconvenient? Should people be permitted to collect Social Security just because they say they are in pain?

What if their pain, or any other physical function limitation, can be proven to result from using liraglutide, naltrexone-bupropion, orlistat, phentermine-topiramate, semaglutide, or setmelanotide electively, in a voluntary manner that is not medically necessary, but for cosmetic purposes — for instance, because they want to lose a non-life-threatening amount of weight? Such a development could provide numerous job opportunities for attorneys, and a whole new realm of problems for doctors and patients.

Your responses and feedback are welcome!

Source: “What Are Functional Limitations & How Do They Affect Disability Benefits?,” DSSMD, undated
Source: “How Do Physical Limitations in Disability Claims Affect Disability Benefits?,”, undated
Image by Stephen Cherniske/Public Domain

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Profiles: Kids Struggling with Weight

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The Book

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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