DEAR DR. ROACH: In a recent column, you answered a question regarding weight loss. You stated that you do not recommend weight-loss drugs unless the person is very overweight or has medical complications. I’m curious to know your reasoning behind this. Can you please elaborate on your answer?

— J.S.

ANSWER: In my opinion, being overweight is not a medical diagnosis and does not have a large effect on a person’s quality or length of life. Being obese puts a person at a much higher risk of medical complications such as sleep apnea, arthritis, high blood pressure, and diabetes. When a person does have a complication tied to being obese, then a weight-loss drug can be considered.

I still don’t rush to prescribe them as many people can lose weight by changing their diet and exercise. When these aren’t enough to control whatever medical complication is associated with their weight, then it’s time to consider medications.

Although the data so far suggest that these are pretty safe drugs, there are possible side effects. People tend to not only lose fat but lean body mass. There are rare reports of serious kidney and pancreas complications with GLP-1 drugs. A rare eye disease (non-arteritic ischemic optic neuropathy) is associated with GLP-1 use, so vision changes should be promptly evaluated.

Since these drugs have the potential for harm, they should only be used when the benefit outweighs the risks.

DEAR DR. ROACH: I am someone who opted for a minimally invasive knee replacement surgery. It was a botched, failed operation. A revision orthopedic surgeon said that my knee could be fixed with another surgery, but at my age (I’m 88)), he doesn’t advise it. He suggested that if I can live with it the way it is, I should do so. So, I can never walk again without a walker, which I use even around the house.

Your recent column mentioned that sometimes the “easier” surgery can leave nerve damage, which is also what happened to me. I have nerve damage in my left leg and foot, and I never had nerve problems like neuropathy before the surgery.

My regular orthopedic surgeon had tried to keep me from having the knee surgery. I sure wish I had listened to him. This is being written to support the people who fall for the marketing scam of no pain, walking and dancing and golfing the next day, and no therapy.

— Anon.

ANSWER: I’ve heard from people who have done extremely well with the minimally invasive procedure, but your letter points out what the data show, which is that not everybody does well with it.