Over the past two years, starting with the FDA’s approval of Wegovy for weight loss in June 2021, our team at Structure House has been keeping a close eye on the clinical trials that — again and again — suggest that these medications (in the class of GLP-1 agonists) are gaining attention for good reason. Aside from the significant weight losses that are observed in these trials (on the order of 15% of one’s initial body weight), it is the effect this medication seems to have on one’s psychology around food that has been most compelling to our team at Structure House. We understand the prison of being bombarded by thoughts about eating, and these medications appear to quiet that noise. We have been hearing our participants, who have tried these medications over the past few years, say, “For the first time in my life, I feel normal around food.” For this reason, in September 2023, Structure House launched its medication track — to be used in tandem with the lifestyle interventions taught on campus that have been central to Structure House’s teachings and success over the past 46 years. To date, Structure House remains the only residential weight management program to be able to support its participants with both medication and behavior modification simultaneously.
Structure House firmly believes that weight loss medication is neither necessary nor sufficient for the long-term treatment of obesity. For decades, the team at Structure House has successfully supported thousands of individuals to win the battle of obesity via implementing sound nutrition practices, a regular program of physical activity, and the emotional and psychological exploration of one’s relationship with food. Weight loss medication can, for some, be one additional tool in this already extensive toolbox of life skills and strategies we have been teaching all along. It seems that these medications may make it easier for some to adhere to the dietary changes required for weight loss (in terms of reducing hunger, increasing satiety, and reducing cravings for food). However, with or without medication, the foundational education and support around the behavioral and emotional shifts will always be necessary — especially if one does not desire to stay on these medications indefinitely.
Structure House’s four-week medication track was carefully designed to address some of the potential challenges and pitfalls individuals face when taking weight loss medication in the absence of additional supports (as is typical for many people who are receiving just a prescription from their primary care doctor and left to go the journey alone). Specifically, individuals taking weight loss medications in the general public — due to their significantly reduced interest in food — oftentimes are lacking in adequate nutrition, in terms of both micronutrients and macronutrients, because they are experiencing such a reduction in hunger. To combat this, Structure House participants enrolled in our medication track receive individualized guidance (for while they are on campus and when they transition home) around how to maximize nutrition when consuming so many fewer calories. They attend a biweekly seminar addressing this and also can develop a game plan for home in individual sessions while on campus. Furthermore, individuals losing weight with the assistance of medication are more likely to lose lean muscle mass, which puts them at greater risk for sarcopenia and reduces their basal metabolic rate. It is well-known that following a routine of regular strength training can help to offset potential muscle loss, and so participants in the medication track meet weekly with an exercise physiologist to learn strength training routines so that they are prepared to continue these at home to optimize their success. Finally, because individuals report that they no longer get the same pleasure from food (while taking the medications), it is imperative that they receive behavioral and psychological coaching to determine other ways they can get their needs met — needs for comfort, for pleasure, for fulfillment, for distraction, and for soothing. Our life coaching team meets with these participants every other week to discuss these challenges and come up with strategies to fill in the gap that food no longer fills.
Finally, even Oprah has commented on how taking weight loss medications can be a lonely journey, as there can be some shame associated with utilizing this extra support. The general public lags behind in their understanding of the complexity of these issues, and so individuals also feel as though their friends and family members can’t understand what they are going through. Thus, individuals enrolled in the medication track at Structure House have the added benefit of a supportive community who can identify with the challenges, issues, roadblocks, and feelings that are inherent in this problem and the various treatments of it. Our participants form lifelong friendships that persist well beyond their time on campus, so they leave with a support system that can continue with them on their journey at home.
Structure House has helped thousands of individuals lose weight and keep it off for decades — without any kind of medication in the mix. For some, medication will be an additional support, and for those who choose to take advantage, they will be able to optimize the effectiveness of this tool with the nutrition, fitness, and psychological support for which Structure House already has an established reputation. Please feel free to call us if you have any questions or would like to receive additional information.
