Semaglutide, identified by the model names Ozempic, Wegovy, Rybelsus and others, is the newest weight-loss craze to hit Hollywood and past. The prescription drug, which is run through a weekly injection, is meant to deal with Type 2 diabetes, but it surely’s broadly used off-label for weight reduction.
For those that need to dive deeper into the science, the AMA video by Peter Attia does a pleasant job of offering the background of this very talked-about drug. You must be conscious, nonetheless, that though Peter is a superb doctor, he’s caught within the standard paradigm and we disagree on many facets of well being and longevity.
A 2021 research funded by Novo Nordisk, the drug’s maker, discovered utilizing semaglutide as soon as every week led to a 14.9% discount in physique weight amongst adults with weight problems.1 There’s been such a rush on the medicine that the U.S. Food and Drug Administration lists each Ozempic and Wegovy as “currently in shortage.” This, regardless of the drug’s hefty price ticket of about $1,400 a month.2
But fast fixes are hardly ever the reply in relation to higher well being, particularly within the case of advanced points like sustaining a wholesome weight, which has psychological, emotional and bodily components.
A weight reduction drug, even when it’s seemingly efficient, can not tackle the underlying emotional drivers which will result in overeating, for example, and it received’t save your well being if you happen to proceed to eat an unhealthy weight loss program — regardless of how skinny your outward look could also be.
By counting on remedy to get skinny, you rob your physique of the possibility to steadiness its weight naturally, in the way in which biologically meant, and expose your self to untold unwanted side effects within the course of.
Semaglutide Mimics GLP-1 in Your Body, Reducing Appetite
Semaglutide is a glucagon-like peptide 1 receptor agonists (GLP-1RAs). As a peptide hormone, GLP-1 is, amongst different issues, a part of a bunch of incretin hormones, that are launched while you eat to control insulin, together with many different capabilities.3
Along with affecting insulin, GLP-1 could affect the nervous system, resulting in an appetite-reducing response. Many taking semaglutide report that the drug makes them really feel full, quicker, so that they’re glad consuming smaller quantities. According to a scientist writing underneath the title Modern Discontent on Substack:4
“Although this impact of accelerating insulin excretion could assist help diabetics, what’s inquisitive about Semaglutide is its unusual affiliation with weight reduction, with many individuals reporting a scarcity of urge for food when on GLP-1RAs. Given that incretin hormones are launched when consuming meals, it’s doable {that a} signaling pathway involving incretin hormones might also be utilized to sign fullness.
Indeed, it seems that the mind and CNS additionally include GLP-1 receptors, which additionally reply to the GLP-1 launched after consuming. It additionally seems that some facets of the nervous system might also produce GLP-1 themselves
… In this case, the suggestions mechanism from GLP-1 produces an anorectic (appetite-reducing) response which might lower meals consumption. Thus, there’s an artificially induced impact of fullness produced by these GLP-1RAs.”
In brief, Dr. Robert Kushner of Northwestern University, who serves on Novo Nordisk’s advisory board, advised NPR, “This hormone is telling your brain, I’m full, I don’t need to eat anymore … What the pharmaceutical companies have done is taken this hormone that is naturally occurring and restructured it into a drug.”5
Weight Comes Right Back When Drug Is Stopped
Considering semaglutide doesn’t tackle the underlying drivers of weight achieve and weight problems, it’s not shocking that many individuals achieve again the burden they misplaced as quickly as they cease taking the drug. When one girl from South Holland, Illinois, who misplaced 60 kilos on Wegovy, may not entry it as a consequence of an insurance coverage change, she gained again 20 kilos inside a couple of months.6
The so-called “Ozempic rebound”7 has been making headlines within the media, after a research discovered that one yr after stopping semaglutide, individuals regained two-thirds of their prior weight reduction, and many of the adjustments in cardiometabolic variables additionally reverted again to pretreatment ranges.8
This, the researchers mentioned, highlights “the importance of maintaining long-term pharmacological treatment for weight management in people with obesity,”9 which, as Modern Discontent identified, is a “rather concerning remark to suggest that one solution to obesity is to continuously provide a pharmaceutical.”10
“Considering that GLP-1RAs seem to have precise neurological results (i.e. blocking starvation and mimicking satiation), there’s a critical psychological part that’s value contemplating with respect to those drugs and their influences on the connection folks have with meals.
That is, the lack of a “off” button in consuming signifies that weight achieve is presumably an inevitable end result if one didn’t get behavioral and life-style elements underneath full management (i.e. they return to the previous habits that contributed to their weight achieve).
This is a consequence of sacrificing long-term life-style adjustments that may result in higher well being for fast fixes the place the principle aim is simply to drop pounds. It’s additionally a rising signal of how out-of-touch many individuals are with what they put of their bodies- each food-wise and pharmaceutical-wise.”11
AAP Pushes Weight Loss Drugs for Children
Even youngsters are falling sufferer to the mentality that drugs are the reply for weight reduction. The American Academy of Pediatrics (AAP) up to date its steering on childhood weight problems, giving a wholehearted endorsement for weight reduction medicine and surgical procedure in youngsters as younger as 12 and 13, respectively.
The AAP steering recommends “comprehensive treatment,” which incorporates vitamin help, bodily exercise, behavioral remedy, drugs and metabolic and bariatric surgical procedure.
“There is no evidence to support either watchful waiting or unnecessary delay of appropriate treatment of children with obesity,” the steering explains, as an alternative setting the tone that early and aggressive drug and surgical therapy is warranted.12
Coauthor Dr. Sandra Hassink, medical director for the AAP Institute for Healthy Childhood Weight, advised The Associated Press that the rules are supposed to change the view that weight problems is “a personal problem, maybe a failure of the person’s diligence. This is not different than you have asthma and now we have an inhaler for you.”13 According to the rule’s government abstract:14
“Obesity has lengthy been stigmatized as a reversible consequence of non-public decisions however has, in actuality, advanced genetic, physiologic, socioeconomic, and environmental contributors.
An elevated understanding of the affect of social determinants of well being (SDoHs) on the continual illness of weight problems — together with heightened appreciation of the affect of the chronicity and severity of obesity-related comorbidities — has enabled broader and deeper understanding of the complexity of each weight problems danger and therapy.”
Further, the rules particularly state:15
- Pediatricians and different main well being care suppliers ought to supply adolescents 12 years and older with weight problems (BMI ≥ninety fifth percentile) weight reduction pharmacotherapy … as an adjunct to well being conduct and life-style therapy
- Pediatricians and different main well being care suppliers ought to supply referral for adolescents 13 years and older with extreme weight problems (BMI ≥120% of the ninety fifth percentile for age and intercourse) for analysis for metabolic and bariatric surgical procedure
In December 2022, the FDA accepted using semaglutide to deal with weight problems in youngsters ages 12 and over.16 The approval got here following a 68-week research of 12- to 18-year-olds, which discovered these taking the drug had a 16.1% lower in BMI in comparison with 0.6% within the placebo group.17
Concern Over Cancer Risks, Long-Term Effects
The long-term dangers of semaglutide are unknown. The mostly reported unwanted side effects are gastrointestinal in nature, together with nausea and vomiting, however considerations of pancreatitis, pancreatic most cancers and retinopathy problems, together with hemorrhage and blindness, have been reported.18
The most cancers dangers are a pink flag, with one affected person within the Sustain 5 trial growing metastatic pancreatic carcinoma about 65 days post-treatment.19 A pharmacovigilance research utilizing the FDA Adverse Events Reporting System additionally seemed into “increasing data on the potential risk of pancreatic carcinoma associated” with GLP-1Ras, together with semaglutide, discovering a transparent affiliation.20
“Based on this pharmacovigilance study, GLP-1RAs, except albiglutide, are associated with pancreatic carcinoma,” the researchers famous, including, “Based on the bibliometric investigation, cAMP/protein-kinase, Ca2+ channel, endoplasmic-reticulum stress, and oxidative stress are potential pathogenesis of pancreatic carcinoma resulting from GLP-1RAs.”21
Already, the drug carries a black field warning as a result of rodent research discovered semaglutide causes thyroid C-cell tumors “at clinically relevant exposures.”22
Will Injectable Skinniness Ruin Exercise?
Another repercussion of fast weight reduction through injection is perhaps its affect on different wholesome life-style parameters, like train. While train is about excess of weight reduction — only one session results in adjustments in a exceptional 9,815 molecules in your blood23 — there are nonetheless many individuals who view it solely as a instrument to shed fats. “In the age of Ozempic, what’s the point of working out?” posits one article in The Atlantic.24
The author, Xochitl Gonzalez, was initially amongst those that solely labored up a sweat to see the numbers fall on her scale, however she ultimately got here to the conclusion that, much more importantly, train was important to her psychological well being and happiness.
Will a brand new technology of individuals, content material to shed kilos with a weekly injection, surrender train and the numerous helpful “side effects” that associate with it? Gonzalez writes:25
“[I]n the Age of Ozempic, the idea that we work out to get thin may be even more dangerous than ever, no matter your size. Ozempic now offers injectable skinniness to the same moneyed Alo- and Lululemon-wearing men and women who have been filling up fitness classes and gyms for years, all of them there to chase the elusive goal of “thinner,” or, in the event that they’ve caught it, to maintain that slim body of their clutches.
But on the similar time, all of them have been benefiting from the unwanted side effects of endorphins and rising coronary heart charges, the pleasure of experiencing the vitality of their very own blood-pumping our bodies.
If they will now keep skinny with simply an injection and some picked-over meals, will they abandon health? What is a life the place you don’t want to maneuver your physique and also you don’t have to eat, however you recognize you look good in designer garments? What is actual residing in case you are doing it for the ’gram?”
Keys to Maintain a Healthy Weight Naturally
Using drugs to drop pounds places your well being and danger and destines you to a lifetime of drug-taking, because you’re more likely to regain the burden when you cease taking the medicine. To drop pounds naturally, dietary adjustments are important. Collectively, consuming an excessive amount of linoleic acid (LA) is the first issue driving the chubby and weight problems epidemics.
LA is the commonest omega-6 fats present in seed oils like soybean, cottonseed, sunflower, rapeseed (canola), corn and safflower.26 Reducing your consumption of seed oils and all processed meals, whereas rising your consumption of wholesome fat is a strong method to help a wholesome weight.
Ideally, take into account chopping LA all the way down to under 7 grams per day, which is near what our ancestors used to get earlier than continual well being circumstances, together with weight problems, diabetes, coronary heart illness and most cancers, grew to become widespread.
To achieve this, you’ll have to keep away from almost all ultraprocessed meals, quick meals and restaurant meals, as nearly all of them include seed oils. The easiest method to do that is to arrange nearly all of your meals at house so you recognize what you’re consuming.
Then there’s the timing of your meals, or time restricted consuming (TRE) — one other necessary think about serving to to optimize weight. Our historic ancestors didn’t have entry to meals 24/7, so our genetics are optimized to having meals at variable intervals, not each few hours. When you eat each few hours for months, years or a long time, by no means lacking a meal, your physique forgets the way to burn fats as a gasoline.
In most instances, you may drop pounds by consuming actual meals — not ultraprocessed ones — and embracing TRE by limiting meals consumption to a sure variety of hours per day.27 Engaging in nonexercise motion all through the day, and getting common train, will present additional advantages, with no drugs required and radically enhancing your whole well being as a facet impact.