Are Weight Loss Medications Really Miracle Drugs?
According to the CDC the prevalence of obesity was 41.9% from 2017-March 2020. Since obesity can lead to a variety of health problems including heart disease, type 2 diabetes, and impaired mobility drugs like Ozempic, Wegovy, and Mounjaro which have shown to promote significant weight loss seem like miracle drugs since typical diet and exercise regimens haven’t shown to be successful. The rate of obesity continues to increase and the World Obesity Federation states over 4 billion people, more than half the world’s population will be obese in 2035.
In 2012 a team of researchers at Norvo Nordisk developed semaglutide, a once-a-week diabetes treatment and named it Ozempic. The FDA approved Ozempic in 2017 for treating type 2 diabetes. Four years later the FDA approved Norvo Nordisk’s drug Wegovy to treat obesity which has the same active ingredient as Ozempic. In 2022, the FDA approved another medication developed by Eli Lilly called Mounjaro who’s active ingredient is Tirzepatide, to treat type 2 diabetes but is also being used off label to treat obesity like Ozempic.
So how do these drugs work? They are given as an injection that contain semaglutide or tirepatide and mimic a hormone which suppresses appetite to help reduce and regulate hunger, so you eat fewer calories. They help lower blood sugar by assisting the pancreas in making more insulin and slow digestion by increasing the time it takes food to leave the stomach. In one cohort study of 175 patients taking semaglutide the total weight loss percentage was 5.9% at 3 months and 10.9% at 6 months. In another study patients with obesity taking Mounjaro experienced a 26.6% weight loss in 84 weeks.
The significant weight loss seen in these studies is promising in the fight against obesity, but before you go running to your medical provider for a prescription there are side effects (as with all medications) that everyone should be aware of. Mild side effects include nausea, constipation, diarrhea, and vomiting. More severe side effects are stomach paralysis, pancreatitis, bowel obstruction, dehydration, and malnutrition. Although severe side effects are considered rare, they must be considered before starting treatment and as more people take these medications the rate of the more severe side effects occurring may increase. In a recent study people taking Ozempic had a higher risk of developing pancreatitis, bowel obstruction, and stomach paralysis. It is also thought that once these medications are stopped people will regain the weight. In one study when the medication was stopped, people regained two-thirds of the weight that was lost in a year.
So, what’s the answer? Unfortunately, there is no easy answer. Before starting any weight loss medication, it is important to discuss the pros and cons with your medical provider. If you do decide to take the newest weight loss medications it’s important to incorporate lifestyle changes including eating minimally processed foods, exercising, stress management, and getting proper sleep. It is uncertain if taking these medications will work long-term or if they need to be stopped due to side effects or other complications such as pancreatitis. Currently these medications are very expensive and sometimes hard to get due to shortages unlike lifestyle changes which have no side effects, aren’t expensive, or hard to get. Just like being told these medications may need to be taken for a lifetime so are life-style changes without the worry of some very severe side effects and this is where we at Gut Instinct can help.
References
2. (2022) Review for ‘weight regain and cardiometabolic effects after withdrawal of semaglutide: The step 1 trial extension’ [Preprint]. doi:10.1111/dom.14725/v1/review2.
3. Ghusn W, De la Rosa A, Sacoto D, Cifuentes L, Campos A, Feris F, Hurtado MD, Acosta A. Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity. JAMA Netw Open. 2022 Sep 1;5(9):e2231982. doi: 10.1001/jamanetworkopen.2022.31982. PMID: 36121652; PMCID: PMC9486455.
4. Sodhi M, Rezaeianzadeh R, Kezouh A, Etminan M. Risk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss. JAMA. Published online October 05, 2023. doi:10.1001/jama.2023.19574
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