While watching the baseball World Series the other night (what an incredible game 7, by the way! I’m not the kind of person who typically gets that drawn into watching sports, but that really was a game for the ages!), I saw a commercial that got my attention: Serena Williams, the legendary Tennis player, was advertising GLP1 agonist medication (translation: weight loss jabs such as Ozempic or Wegovy) for a company named “Ro.”
I’ve said this many times before, but I will say it again. Exercise is terrifically good for your health, and just about everyone should be doing more of it. But IT DOES NOT lead to much weight loss. This is borne out by numerous studies, as well as by the experience that I (and just about every other doctor) has had of more patients than I can count telling me “Doc, I don’t understand why I’m not losing weight. I’m going to the gym every day.” This commercial ought to really drive this point home. If Serena Williams – one of the greatest tennis players ever, and a woman who presumably spends hours per day working on tennis drills, stretching, lifting weights, running, etc. in order to maintain the level of elite fitness needed to compete in professional tennis – can’t lose weight via exercise, then neither can you. Which doesn’t mean you shouldn’t exercise. You should, as it will make you stronger, healthier, and in every other way more awesome, not to mention extending your life expectancy significantly. But if you want to lose weight and are starting the conversation with your fitness plan, not your diet (or in Serena’s case, a weight loss medication), then you’ve already lost the game.
It says a lot about our society that, increasingly, medications are being hawked directly to the consumer rather than being dispensed by a trusted doctor. Companies like Ro – which as I gather gives you a quick telehealth visit and then, for a direct cash fee, will send you “lifestyle medications” for things like weight loss or erectile dysfunction in the mail – are increasingly popular.
I have reservations about this kind of business model. If a company stands to make money by dispensing you a medication, can you really trust it to be objective in warning you about the possible downsides and side effects? Can a nurse practitioner who has spent 15 minutes on the phone with you really know the intricacies of your medical needs in the same way as a physician who has cared for you over a period of many years?
But on the flip side, it’s hard to argue with the logic of Ro’s business model. Americans are tired of not being able to find a doctor, or to not be able to get attention from the doctor they do have, or having to wade through weeks of interminable appeals to find out if their insurance company will pay for a treatment they need. My own practice in fact essentially caters to these very frustrations by providing an alternative to corporate-dispensed, insurance-driven, care and restoring the old-fashioned touch of the small town family doctor. Regardless of whether companies like Ro are a benefit, a danger, or (as I believe) a bit of both, look for services like this to thrive unless and until a more sane healthcare system is restored to the American public.
