A registered dietitian’s deep dive into the reality about Ozempic. Let’s dive into the science to take a look at how efficient at weight reduction it truly is and simply how unhealthy the negative effects truly are. We additionally cowl implications of the treatment scarcity and issues for these with a historical past of an consuming dysfunction or disordered consuming. Set off warning: discussions of weight reduction numbers, consuming dysfunction behaviors
Ozempic and different weight reduction drugs like Wegovy, Mounjaro, Trulicity and Rybelsus are a sizzling subject proper now.
Celebrities are publicly attributing their weight reduction to those drugs (Oprah being the newest one as I’m penning this). Medical doctors are prescribing them left and proper for weight reduction (and some other ailment you would possibly deliver to the physician that they assume is correlated to your weight). Sufferers with diabetes (for whom these drugs had been initially developed) can’t entry these meds as a result of there are shortages throughout the nation and their well being is struggling consequently.
From information headlines to TV commercials to water cooler discuss, Ozempic is all over the place. As a non-diet, weight-inclusive dietitian, I need to ensure that I’m empowering my purchasers and my neighborhood with all of the evidence-based data we’ve got (and spotlight what we don’t have) so as to make an knowledgeable choice on whether or not or to not take these drugs. It’s not my function to influence you (as a result of I consider in your company and physique autonomy) however it’s my function to coach and inform, which I hope to do right here.
I might by no means, ever disgrace or choose somebody who decides to take these drugs. It might make sense when you select to take them or are fascinated about taking them given the anti-fat tradition we dwell in and the stress from medical suppliers to “do one thing about your well being, aka your weight.”
So I compiled what I’ve discovered about these drugs on this put up and am highlighting what the analysis reveals us on weight reduction (how a lot weight you’re truly more likely to lose – trace: it’s not as a lot as you would possibly assume), what the recognized negative effects are, and why you have to be cautious about the place you’re accessing these meds from.
What’s GLP-1?
These weight reduction drugs fall into a category of medicines known as GLP-1 agonists. GLP-1 is glucagon-like peptide, also called an incretin. Incretins are secreted within the small gut and assist to extend insulin, lower glucagon and decelerate gastric emptying (i.e. digestion), all of which assist to handle blood sugar. With incretin, glucose can slowly enter the bloodstream as a substitute of being flooded with it.
It additionally stimulates satiety and fullness and helps you keep full longer, which is why the treatment is now getting used to regulate urge for food and produce weight reduction.
What’s semaglutide?
Semaglutide is the generic identify for the lively ingredient in Ozempic and Wegovy. Ozempic and Wegovy are simply the model names. Ozempic is FDA-approved for the remedy of diabetes, and in 2021, Wegovy grew to become FDA-approved for the remedy of weight reduction. Each are primarily the identical treatment solely Wegovy has increased doses of semaglutide.
As soon as Wegovy grew to become FDA-approved for weight reduction, it rapidly went into scarcity after which medical doctors started prescribing Ozempic off-label (which means prescribing it for one thing apart from what it’s FDA-approved for) for weight reduction. After which Ozempic shortages rapidly adopted swimsuit.
The issue with that is Ozempic and different GLP-1 and GIP agonists FDA-approved for diabetes remedy aren’t attending to the individuals who want them probably the most and may have severe well being ramifications for these with diabetes.
Semaglutide remains to be in scarcity as of penning this weblog put up in December 2023.
How do GLP-1 agonists assist these with diabetes?
In people with diabetes, incretin’s results are decreased (by about 30%), which results in increased blood sugars and poorer blood sugar management. GLP-1 agonists assist management blood sugar and decrease A1c ranges, which measure your common blood sugar ranges during the last three months. Research present these drugs may help decrease A1c ranges by 1 – 2.4 proportion factors and may scale back the chance of cardiac occasions, no matter weight adjustments.
5 issues it is best to find out about Ozempic and Wegovy (and different GLP-1 agonists)
1. You could or could not drop extra pounds with Ozempic and when you cease taking it, you’ll possible acquire the load proper again.
Not everybody loses weight taking these drugs, which is vital to notice, in any other case individuals who don’t drop extra pounds on these meds are left feeling like failures.
The analysis on semaglutide for weight reduction largely comes from the STEP trials, randomized managed trials (RCTs) that are funded by, you guessed it, the pharmaceutical firm that makes this drug, Novo Nordisk.
When wanting solely on the STEP trials, outcomes present that 80% of individuals taking these drugs lose some quantity of weight. So about 20% of oldsters who take these meds received’t lose any weight. For many who do drop extra pounds, on the very least, they’re dropping about 5% of their physique weight (that’s about 10 lbs for somebody who weighs 200 lbs).
Roughly half of the parents who took this treatment noticed a extra average weight reduction, about 10-15% of physique weight (about 20-30 lbs for somebody weighing 200 lbs) and roughly one third of oldsters taking this treatment noticed a reasonably substantial weight lack of 20% or extra physique weight (about 40 lbs weight reduction for somebody weighing 200 lbs). This extra substantial weight reduction is in fact what’s driving all of the hype and media protection on these drugs.
However let’s remember the fact that these trials weren’t solely funded by the maker of the drugs but in addition had loads of exclusion standards. Individuals couldn’t be part of these research in the event that they had been depressed, had any present cardiovascular points, and in the event that they had been females of childbearing age with no extremely efficient contraception technique, simply to say just a few.
While you have a look at different trials on semaglutide, with out the pharma funding and intensive exclusion standards, the outcomes are much less spectacular. Solely 40% of oldsters are dropping no less than 5% of physique weight. Taking a look at a meta-analysis (evaluate) of RCTs, most weight reduction totals hovered round a mean of 8-10 lbs, with just a few research displaying extra important weight reduction, round 25-40 lbs.
In case your purpose is to lose about 5-10% of your physique weight then these drugs would possibly make it easier to get there however in case you are in search of extra dramatic weight reduction, these meds most likely received’t make it easier to meet your targets.
It’s additionally vital to acknowledge what occurs whenever you cease taking the drugs. As a result of possibly your insurance coverage will cease protecting it, or you possibly can now not afford it, or there’s a scarcity, and so forth.
Research have checked out what occurs whenever you take somebody off semaglutide and change it with a placebo and located that weight regain occurs in a short time. Inside a yr, folks regain nearly all of their weight misplaced, even whereas nonetheless doing behavioral interventions like vitamin, train, and cooking courses.
Sounds similar to all of the analysis on what occurs to your weight when you cease doing a food regimen (you acquire it again).
2. Ozempic comes with very disagreeable negative effects.
Research present {that a} vary of 60% as much as 93% of individuals taking these drugs will expertise some negative effects – the commonest being gastrointestinal misery. These negative effects could embody nausea, vomiting, diarrhea, constipation, GERD, and belly ache. For most individuals, extreme GI signs ought to resolve inside just a few days and extra delicate GI negative effects often resolve inside 8-12 weeks.
These drugs additionally include a black field warning that they’ll enhance the chance of thyroid tumors. That is primarily based purely on research completed in rodents so we don’t understand how that extrapolates to people, but. There are human research being carried out now however we received’t know the outcomes till 2035 on the earliest. Due to this these drugs are contraindicated for these with a household historical past of thyroid tumors.
There are different very uncommon negative effects like pancreatitis, gallbladder illness, kidney harm, and suicidal ideation. The FDA additionally lately added ileus to the checklist of negative effects on the label, which is when your bowel stops functioning and you may’t take away waste – it could solely be handled with surgical procedure and might be deadly.
After which there’s the aesthetic reported aspect impact persons are speaking about, “Ozempic face”. Because of fast weight reduction (for some) and certain not getting sufficient vitamin, folks report having unfastened pores and skin on their face and a hollowing beneath the eyes and close to the temples. This look can be seen in these affected by malnutrition.
3. There’s a scarcity of those weight reduction medicine, which is main compounding pharmacies to create variations that aren’t authorized or regulated.
When a drug goes on the FDA drug scarcity checklist, the FDA permits compounding pharmacies to combine up their very own model of the drug with none FDA approval or screening.
However, right here’s the catch. Novo Nordisk has a has a patent on the semaglutide molecule and solely they’ll produce it till 2032 so compounding pharmacies don’t have entry to this lively ingredient.
If you wish to take a weight reduction treatment, get a prescription out of your physician and safe it from a licensed pharmacy. Keep far-off from wellness facilities, spas, or telehealth suppliers touting these drugs at a low price.
4. There’s no long-term information on Ozempic.
Let’s not neglect that we’ve got NO long run information on these medicine. Semaglutide was authorized by the FDA for diabetes remedy in 2017 and the longest examine I discovered was follow-up with a little bit over two years. We simply don’t know if there are any long-term negative effects. We additionally don’t know when you keep your weight reduction whenever you keep on this drug long-term.
It’s an eerily related image to previous weight reduction meds like Fen-Phen and Ephedra, each of which had been hailed as miracle weight reduction medicine with no long-term information and had been ultimately taken off the market due to irreversible severe hostile negative effects like deadly hypertension, coronary heart valve issues, coronary heart assault, stroke, and loss of life.
It’s vital to weigh this when deciding to take the treatment – you merely can’t know what the security or efficacy is of taking Ozempic long-term. What we do know is that if you wish to have a shot at sustaining your weight reduction, you’ll have to keep on it long-term.
5. Ozempic might be harmful for these with a historical past of an consuming dysfunction or disordered consuming.
This treatment finally places you out of contact along with your physique’s pure starvation and fullness cues, which is counterproductive to consuming dysfunction restoration and the intuitive consuming framework. It causes you to eat much less, which may exacerbate and gasoline already restrictive consuming patterns, and result in potential nutrient deficiencies.
For these with binge consuming dysfunction or who wrestle with episodes of binging, coming off the treatment may end up in important upswings in starvation, which can make you extra prone to binges.
After which there’s the impression of weight adjustments in your psychological well being. In the event you don’t drop extra pounds taking the treatment, you could go to extremes to limit your meals consumption. Or reducing weight could set off you to need to lose much more, fueling extra restriction. Or when you lose important weight after which acquire all of it again when you come off the treatment, that change in physique look could trigger emotional misery and result in disordered consuming.
In the identical method I wouldn’t suggest a food regimen or intentional weight reduction to people with an lively consuming dysfunction, a historical past of an consuming dysfunction, or disordered consuming, I wouldn’t suggest these weight reduction drugs both. It reinforces the concept skinny is finest and leads to insufficient nourishment and vitamin.
In case you are struggling to get sufficient vitamin whereas taking one among these drugs or are debating on taking one among these drugs and would really like extra individualized vitamin help, our group would love that will help you. Guide a vitamin evaluation as we speak.
References:
https://pubmed.ncbi.nlm.nih.gov/32441473/
https://pubmed.ncbi.nlm.nih.gov/33567185/
https://dom-pubs.onlinelibrary.wiley.com/doi/pdfdirect/10.1111/dom.14863
https://pubmed.ncbi.nlm.nih.gov/35441470/
https://maintenancephase.buzzsprout.com/1411126/13747346-ozempic
https://www.frontiersin.org/articles/10.3389/fendo.2021.645563/full
Consuming Problems & Diabetes: A Give attention to Diabetes Drugs Webinar by Erin Phillips, MPH, RD, CDCES; hosted by EDRD Professional
For extra weblog posts like this try:
Tips on how to Set Sustainable Well being Objectives For the New Yr that Are Truly Sustainable
Am I Consuming Sufficient? 8 Indicators You’re Undereating
Is Intuitive Fasting Actually Intuitive or Is It Simply One other Food plan?
What Is Orthorexia? When Wholesome Consuming Turns into Obsessive
#Ozempic #dietitian
