Over the last few decades there have been a ton of people looking to lose weight and improve their health.  It’s a noble goal for sure and one that myself and every other health practitioner has been talking about.  But the problem lies in all the misinformation out there.  The fad diets, the “experts” who are only really trying to sell a product and the lack of information or misinformation are all reasons why people fail.  These issues coupled with our extremely busy lifestyles and the need for instant results is why navigating the weight loss journey can be filled with land mines.

For those who are unfamiliar with the most recent weight loss trend, it involves the use of a prescription drug that goes by one of three brand names, Ozempic, Wegovy or Rybelsus, aka semaglutide.  This drug was developed to help treat people living with Type II Diabetes.  But because of the actions of the drug and the fact that so many people are being diagnosed with insulin resistance, the precursor to diabetes, this pharmaceutical is now being handed out like candy to help people lose weight.  It should be noted that both Ozempic and Rybelsus are specifically prescribed for people already afflicted with Type II Diabetes, while Wegovy is generally prescribed as a weight loss drug.  There is no chemical difference in the drug.  The difference is the dosage and the form.

Ozempic interacts with the body like glucagon-like peptide-1 (GLP-1), a hormone your body makes in response to eating. GLP-1 is known to have a variety of effects on appetite and weight.  Ozempic is usually taken once a week through a single-use injection pen, administered in a thin layer of fat on the arms, thighs or abdomen.  According to its pharmaceutical makers, Novo Nordisk, Ozempic improves blood sugar control in three important ways:

  1. Encouraging the pancreas to release more insulin when blood glucose levels are high.
  2. Preventing the liver from making and releasing too much glucose into the bloodstream.
  3. Slowing down the speed at which food leaves the stomach after a meal.

For somebody suffering with Type II Diabetes, this can be a game changer.  But for people not living with the disease, there are some potentially serious side effects.

Semaglutide side effects include decreased appetite, nausea, headaches, fatigue,vomiting, diarrhea, abdominal pain, constipation, heartburn and belching.  The more serious and potentially life-threatening side effects include thyroid cancer, rashes, itching / swelling of the eyes, face, mouth, tongue and throat, difficulty breathing, difficulty swallowing, decreased urination, lower leg edema, fainting, dizziness, vision changes, pancreatitis, kidney failure, tachycardia, severe abdominal pain, fever and / or jaundice.

The hype around semaglutide is two-fold.  First off, the makers, Novo Nordisk, sponsored and conducted the Semaglutide Treatment Effect in People with Obesity (STEP) program, which began in 2018.  Participants were overweight or obese but did not have diabetes. The 68 week, randomized, double-blind, placebo-controlled trial found that those who took semaglutide in combination with lifestyle modifications (like eating well and exercising) showed a weight loss of 14.9% from baseline.  These numbers are notable because they’re similar to outcomes in patients undergoing more invasive weight loss measures — like gastric sleeve surgery.  Secondly, it is trending on social media and many, many famous people and influencers have touted the drug, including Elon Musk.

And now, all the hype has led to shortages of the drug, which is impacting Type II diabetics that may need this drug to help them get to a healthier weight and control their insulin levels.  Semaglutide has proven to be very helpful for people afflicted with Type II Diabetes.  It can allow them to make significant strides in losing weight and being more active because of that weight loss.  But the drawback to this drug is that once you stop taking it, unless you maintain a healthy lifestyle, you will most likely end up back at square one.  And for many people, this is not what they want to hear.

Semaglutide causes the the body to lose weight and the remaining fat cells to shrink in size, while it is being used.  But once the drug is no longer being used, the fat cells swell up and the weight will most likely be gained back.  This makes those using this drug dependent on it for life, unless permanent lifestyle changes are made.

The simple answer to long term weight loss is not going to be found in a prescription drug.  It can only be found in lifestyle changes.  This isn’t specific to just eating better and exercising more.  Stress is one of the most significant factors to people gaining weight and not being able to lose it.  So when a healthcare practitioner recommends lifestyle changes, learning to cope with your daily stressors has to be considered too.

Instead of searching for a quick way to lose weight that could have unwanted side effects, there are more sustainable ways to shed a few extra pounds.  As much as you may want to dream about eating whatever you want and not gaining weight, a healthy diet, lifestyle, and exercise habits are all essential aspects of weight management and weight loss. Though early research shows evidence to support a potential therapeutic role for semaglutide outside the scope of managing type 2 diabetes, more long-term research is needed.  The drug has only been on the market for about 10 years and long term effects have not been evaluated yet.

If you are considering using this drug, please work with a professional who will do appropriate testing to determine if it is the right tool for you.  And also consider that once you decide to stop using this drug, if you have not made appropriate lifestyle changes, you will probably gain the weight back.  When it comes to weight loss, you have to be sure you’re approaching it in a healthy way.  If you are doing it for the wrong reasons or you are jumping on a trendy bandwagon, it might be safer to wait and research things a little more deeply.  You only have one body, so be cautious of things that seem too good to be true.

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