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The truth is, weight loss is more complex than willpower alone
When initial therapy proves insufficient, treatment escalation includes: Biologic DMARDs targeting specific inflammatory pathways (TNF inhibitors, IL-6 inhibitors, T-cell costimulation blockers, B-cell depleting agents) Targeted synthetic DMARDs such as JAK inhibitors (tofacitinib, baricitinib, upadacitinib), which carry FDA boxed warnings for serious cardiovascular events, malignancy, and thrombosis [24] [25] Combination DMARD therapy Short-term glucocorticoids for symptom control during treatment initiation Before starting biologic or targeted synthetic DMARDs, screening for tuberculosis and hepatitis B is recommended, along with appropriate vaccinations according to ACR guidelines
Though we always stress diet and exercise, surgery remains a more sustainable method of losing weight and ultimately leads to a higher weight loss compared to other modalities. There are different types of bariatric surgeries, but they all work by reducing the size of the stomach
Importantly, Wegovy should not be used during pregnancy or breastfeeding
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