The USA and most industrialized countries have an obesity problem. The environment is conducive to obesity. The food is delicious and formulated by doctors to channel and excite our brain reward systems. The portions are huge. We spend half of our time sitting hunched over in a chair observing an electronic device, each for work and for pleasure. We eat carbohydrates we do not need, use seed oils in amounts our bodies aren’t designed for, and largely avoid a very powerful food our ancestors ate during evolution: animal protein. The most affordable food is the worst and the healthiest is the most costly.
It’s an enormous mess, and lots of people resist the dietary and lifestyle changes required to unravel the issue. No wonder many persons are hoping for a pill or drug that may solve the issue of obesity.
In the previous few years, scientists appear to have discovered a category of drugs that will help: GLP-1 agonists similar to semaglutide (marketed as Ozempic® and Wegovy®) and liraglutide (often known as Victoza® and Saxenda®). Hollywood stars and models take these drugs in huge quantities. They’re taken by tech circles from Silicon Valley – most famously Elon Musk, is on semaglutide. In brief, almost everyone with money, access, and weight to lose uses semaglutide and related drugs to remain slim. I do know several doctors who prescribe it to chubby patients.
Originally designed as diabetes medications, these agents mimic the consequences of glucagon-like peptide-1, the hormone incretin that the body releases whenever you eat. GLP-1 has two primary effects:
- It stimulates the discharge of insulin and inhibits the discharge of glucagon.
- It slows down the motility of the stomach and the passage of food through the intestines, because of which it maintains the sensation of satiety for longer.
GLP-1 is a hormone that “signals” the sensation of satiety. There are also every kind of positive unintended effects:
- Lower glucose production
- Greater glucose uptake by muscles
- Increased insulin sensitivity
- Lower blood pressure
- Improved endothelial function
New slimming drugs bind to receptors that normally interact with GLP-1 and produce the identical effect because the hormone itself.
Do obesity drugs work for weight loss?
Yes. They’re working. Out of all of the weight loss drugs the industry has promoted, tested and tried, GLP-1 agonists actually help people lose weight.
A recent article tested semaglutide for 2 years in obese people. The typical starting body weight was 106 kilograms, or 233 kilos. The typical initial BMI was 38. The bulk were women. One group got the drug, the opposite a placebo. Each groups were advised to follow a “behavioral intervention,” which probably means exercise and other typical things.
By week 104, the semaglutide group had lost a median of 15.2 percent of their body weight. The placebo group lost a median of two.6 percent.
It didn’t make them skinny. Ultimately, most were still chubby or obese. 15 percent of £233 is about £35. It is a big improvement, but not enough to attain a traditional body weight. As well as, there was a major weight loss plateau around 68 weeks within the semaglutide group. They didn’t really lose any more weight after that (as a gaggle) and even began to achieve slightly weight towards the top of the study. It was a really small increase, but a rise nonetheless.
Semaglutide wasn’t enough for them. They were still mostly chubby, and the weight was not coming off – and maybe starting to return back on.
But these drugs aren’t only for weight loss. There are also other helpful effects:
- Decreased blood pressure.
- Less cravings for junk food.
- Reduced major cardiovascular events (heart attacks, strokes, etc.).
- Higher glucose tolerance.
- Reduced visceral fat.
So these obesity drugs also improve other indicators of health. That is great and suggests that the consequences while taking the drug are mostly positive.
Nonetheless, I can see some potential downsides.
Potential Drawbacks of GLP-1 Agonists
- You most likely must take it for the remainder of your life. A recent article checked out a gaggle of people that took semaglutide for over a yr and lost lots of weight. Half of them continued taking the drug and the opposite half received placebo injections. This lasted for 48 weeks. Those still on the sauce retained most of their weight. Those that went off the drug quickly regained most of their weight and lost just about all other health advantages (blood sugar, blood lipids, blood pressure, etc.).
- It is dear. No less than for now, the monthly cost of a GLP-1 agonist subscription is $1,500. Insurance can cover lots of this, but you will have to be severely chubby or wait until these drugs are prescribed so that you can be barely chubby – but even then, assuming you will have insurance, someone pays.
- Liraglutide has been shown to extend adipogenesis, the formation of new fat cells, at the very least in mice. Even when the rodents lost weight, they increased the variety of fat cells of their bodies. It is a process that sometimes occurs in childhood. That is one in every of the the reason why childhood obesity is so difficult to beat and so often results in adult obesity. You might have loads of “extra” fat cells from whenever you were obese as a toddler, so filling them up becomes easier and easier. If liraglutide or semaglutide also increase the formation of new fat cells, what happens whenever you stop taking them? What’s going to or not it’s in five, ten years? Do these “empty” fat cells refill quickly? That is an interesting query that we just do not know the reply to. Already.
- GLP-1 agonists increase the resting heart rate, with longer-acting versions similar to injectable semaglutide (mostly used for weight loss), resulting in sustained and long-lasting increases in resting heart rate. Whether this portends a rise in health problems in the longer term stays to be seen, but it surely is mostly accepted that a better resting heart rate is a nasty thing.
- GLP-1 agonists cause nausea and diarrhea. The truth is, these are essentially the most common unintended effects people complain about and should even contribute to a scarcity of interest in food. It’s hard to be hungry when you would like to throw up.
- GLP-1 agonists cause a loss of lean body mass. This will not be unique to GLP-1 agonist related weight loss; that is typical whenever you lose weight, but anecdotally it doesn’t appear to occur when people lose weight following the unique way of eating and exercising. This could potentially be avoided by simply emphasizing protein and ensuring we lift heavy stuff moderately than counting on semaglutide to do all of the work.
- The advantages wear off after about 68 weeks. They could be continued in the event you increase the dose, but it is going to also increase the chance of unintended effects similar to nausea, diarrhea and any problems related to increased adipogenesis.
- We do not know what we do not know. These are fairly new drugs and we have no good long-term data (10 to twenty years).
My final tackle GLP-1 agonists
It will not solve the obesity problem. All studies have shown that it helps users shed significant body weight, but there may be a lull within the loss. Not enough. It doesn’t permit you to undergo obesity and chubby to true thinness. To do that, you furthermore mght need to deal with other points of your weight loss plan and lifestyle to actually make changes and lengthen them perpetually.
I feel it will probably help people stick with a greater weight loss plan. While the fanfare focuses on the actual fact which you could “eat what you would like” and still lose weight, it has also been shown to scale back cravings for junk food and starchy foods. A clever use of this drug could be to mix it with a healthy low-carb weight loss plan based on whole foods that emphasizes animal protein. Complete nutrition so that you get the micronutrients and protein you would like so that you get the fitting amount of protein to stop muscle loss.
Ultimately, most individuals reading this don’t need semaglutide injections. You are actually able to get the job done and make lasting changes to your weight loss plan, lifestyle and exercise habits that may ensure your long-term success. But tens of millions of individuals don’t. While I even have some serious reservations about the long-term effects of those drugs – in spite of everything, I strongly suspect there is no such thing as a free lunch on the subject of such things – they could be helpful on the Web individuals who would otherwise never consider changing their weight loss plan and lifestyle.
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