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Townsend Letter for Doctors and Patients

Patients are increasingly looking for programs that combine affordability, physician guidance, convenience, and ongoing support rather than simply offering medication alone

Alternative medication classes should be considered if GLP-1 therapy proves intolerable: SGLT2 inhibitors (such as dapagliflozin, empagliflozin) for type 2 diabetes, which work via a completely different mechanism and rarely cause gastrointestinal side effects DPP-4 inhibitors (such as sitagliptin, linagliptin), which enhance endogenous GLP-1 activity more gently Metformin remains first-line for type 2 diabetes, though it can also cause gastrointestinal side effects Orlistat for weight management, though this also has gastrointestinal side effects of a different nature For weight management specifically, NICE recommends a comprehensive approach including dietary modification, increased physical activity, and behavioural interventions, with or without pharmacotherapy

This eligible population is approximately 8.5 million Canadian adults aged 18 to 64

Proc Natl Acad Sci U S A 1982;79:345-9.ArticlePubMedPMC 7