Viewpoint: Antidepressants and obesity medications work — but we don’t know why. Here’s why that’s a problem

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Credit: Michael Clesle/Flickr (CC BY-NC-SA 2.5)

We like to think we understand the drugs we take, especially after rigorous trials have proved their efficacy and safety. But sometimes, we know only that medications work; we just don’t know why.

Recently, I’ve faced this conundrum regarding drugs for mental health conditions and obesity, two heavily stigmatized health issues with causes and treatments that science doesn’t fully comprehend.

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Mental health disorders and obesity fall into a bucket of diagnoses that, amid a lack of complete knowledge of their causes, are subject to societal moralizing and stigma. We make assumptions that people with depression aren’t trying hard enough, that people with obesity lack willpower. These stigmas are then compounded by a limited understanding of how their treatments work, leading to further judgments of people who seek them.

This is especially true if there’s no clear endpoint for treatment. I’ve heard so many thoughtful people argue against using these injectable drugs for weight loss because “people often regain the weight if they stop taking them.” Of course they do. Something is off balance with them that these drugs are correcting. We don’t know what it is, but the drugs are compensating for it, not curing people permanently.

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