The best weight loss drugs: Just because they’re popular doesn’t mean they’ll work for you

Lauren, a New York middle school teacher and mom of four, started dieting when she was just 13. She went through cycles of short-lived success and regain. “I had done 100 other things to try and lose weight,” the 44-year-old says. “I had been offered medication before but with really bad side effects, and no backup support with the medication. So, it was like, ‘here, take this. It's going to work.’ But it made me feel really bad, and I didn't know how it was affecting my body. I didn't really understand what I was taking.”

Doctors have traditionally prescribed drugs for weight loss with a one-size-fits-all approach. Clinicians typically considered weight loss from the perspective that people who had problems managing weight just ate more calories than they burned. Today, experts know obesity is much more complex. Over the last 30 years, researchers have identified more than 400 genes linked to obesity and other contributors, including hormones and even the environment. Obesity is so complicated that organizations like the American Medical Association now say it deserves ongoing medical care with a range of interventions.

Even with those breakthroughs in understanding obesity’s complexity, only one percent of doctors in the United States are certified in obesity medicine. And not everyone who puts patients on medication for weight understands how to tailor treatment for each individual or help them through their journeys, which can lead to less-than-optimal patient experiences like Lauren’s.

“We're made up of millions of unique genes, so it makes sense that we wouldn't all use the same treatment for obesity,” says Rekha Kumar, MD, former medical director of the American Board of Obesity Medicine and chief medical officer at Found Health. “We need to individualize care.”

At Found, clinicians trained in obesity medicine use phenotypes to help predict a person’s specific type of obesity based on biological mechanisms and tailor care accordingly. 

What is a MetabolicPrint?

MetabolicPrint™ is a proprietary metabolic health assessment engine that Found-affiliated clinicians use to determine a personalized treatment plan, often with medication, to help people lose weight. It helps replicate the process that leading obesity medicine physicians use when treating patients.

“I usually ask people many questions, look at their biomarkers, their lab work,” says Dr. Kumar when discussing how she approaches caring for patients at her Manhattan-based endocrinology practice. “I ask a lot of questions about family history. I ask about people's weight journeys, when they started gaining weight. I actually need to know their birth weight to really understand their full metabolic profile. I ask about puberty development. I ask about family members who may have gained weight over their lifetime. Medicines, hormone changes, pregnancies, and based on all of this information, I choose a treatment plan.” 

The MetabolicPrint metabolic health assessment engine takes these factors into account to generate a unique MetabolicPrint for each individual. 

MetabolicPrint profiles 

There are four different MetabolicPrint profiles, and each person who takes the MetabolicPrint quiz has a unique mix, typically with one dominant profile. The profiles describe how many people experience weight struggles:

• Brain-Gut Disconnect,™ where the digestive system and brain are not in sync when it come to fullness, leading people to feel hungry frequently; 
• Constant Cravings,™ when you still want specific foods no matter how much you eat; 
• Mood Responses,™ which involves reaching for food as a response to emotional hunger and other factors; 
• and Slow Metabolism,™ when a sluggish metabolism means you burn calories at a slower rate, preventing you from losing weight even when you're eating right, exercising, and sleeping well.

These profiles, along with one-on-one consultations with patients, help Found’s clinicians tailor care and prescribe medicine responsibly. Not only does MetabolicPrint help Found-affilated providers make initial recommendations for treatment, but it also helps guide personalized care throughout a member’s weight journey.

A person’s MetabolicPrint can change over time and with life events. As Dr. Kumar explains, people may experience metabolic adaptation, where the body adapts to try to regain weight. When patients feel comfortable enough with their obesity medicine specialist to candidly share their experiences—including stalls and gains—the provider can adjust prescriptions and lifestyle habits to support weight loss and optimize care for long-term maintenance.   

How does Found use MetabolicPrint to aid in weight loss?

Found providers use MetabolicPrint profiles and one-on-one consultations with members to tailor comprehensive treatment plans to work with each person’s biology. 

MetabolicPrint helps clinicians recommend drugs and lifestyle changes

For example, someone with a dominant Mood Responses profile may benefit from a combination of medications that help manage cravings, along with practicing mindful eating to better address their hunger.  

Someone who has a dominant Brain-Gut Disconnect profile might be prescribed medicine that helps slow digestion and coached on how to eat foods in a specific order to feel full longer. 

The best weight loss drug for you makes lasting lifestyle changes possible

There are clear advantages to this kind of comprehensive care for weight management. One, it helps people get the medicine that will work for them, even if it’s not the most popular weight loss medication of the day. Slowing digestion in someone whose brain signals are sabotaging their progress doesn’t target the root cause of their weight gain.

A second advantage: The right medication makes lifestyle changes easier. Once someone with a dominant Constant Cravings profile can use medication to silence the food noise in their heads, it’s easier for them to identify actual hunger and stick to an eating plan that supports good health.  “I think Found gave me the permission to use medication as a tool, as part of the program, without feeling like I was cheating or I was doing something that was not healthy,” says Lauren. “Because it is healthy and combines with the other health changes I've made.”

Without such tailored pharmaceutical help, people are left to their own devices to fight their biology—often with little lasting success. 

Does this approach to finding the best weight loss drugs work?

Research shows that tailored treatment designed to help people lose weight is more effective than a traditional one-size-fits-all approach.  While results take time—with some medications, it can take two to three months before patients begin to see results on the scale—the health benefits are meaningful. 

In a study published in 2021 in the journal Obesity, researchers found that targeted therapy based on phenotypes led to almost two times more weight loss after a year than non-targeted obesity treatment. Participants in the phenotype-guided group in that study lost an average of about 16% of their original body weight, while those in the group not guided by phenotyping lost an average of  9% of their body weight.

Found members who received personalized prescriptions and coaching, a behavior change program, and an in-app support network have seen similar success. Since joining Found, personalized care has helped Lauren lose 25 pounds*. “I've had long-term success without major setbacks and without feeling like it's never going to happen. So, I think that was a big change,” she says. “And I'm really happy about that.”

Found is among the largest medically-supported telehealth weight care clinics in the country, having served more than 200,000 members to date. To discover your MetabolicPrint and start your journey with Found, take our quiz. *Individual results may vary.