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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 medicines like Wegovy, Mounjaro, Trulicity and Rybelsus are a scorching subject proper now.
Celebrities are publicly attributing their weight reduction to those medicines (Oprah being the newest one as I’m scripting this). Medical doctors are prescribing them left and proper for weight reduction (and every other ailment you may carry to the physician that they assume is correlated to your weight). Sufferers with diabetes (for whom these medicines have 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 ads to water cooler speak, Ozempic is all over the place. As a non-diet, weight-inclusive dietitian, I wish to ensure that I’m empowering my purchasers and my group with all of the evidence-based info we have now (and spotlight what we don’t have) so that you could make an knowledgeable choice on whether or not or to not take these medicines. It’s not my position to influence you (as a result of I consider in your company and physique autonomy) however it’s my position to teach and inform, which I hope to do right here.
I might by no means, ever disgrace or decide somebody who decides to take these medicines. It might make sense for those who select to take them or are fascinated by taking them given the anti-fat tradition we stay in and the stress from medical suppliers to “do one thing about your well being, aka your weight.”
So I compiled what I’ve realized about these medicines on this submit 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 may assume), what the identified negative effects are, and why you need to be cautious about the place you’re accessing these meds from.
What’s GLP-1?
These weight reduction medicines fall into a category of medicines known as GLP-1 agonists. GLP-1 is glucagon-like peptide, also referred to as 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 title for the lively ingredient in Ozempic and Wegovy. Ozempic and Wegovy are simply the model names. Ozempic is FDA-approved for the therapy of diabetes, and in 2021, Wegovy grew to become FDA-approved for the therapy of weight reduction. Each are basically 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 aside from what it’s FDA-approved for) for weight reduction. After which Ozempic shortages rapidly adopted go well with.
The issue with that is Ozempic and different GLP-1 and GIP agonists FDA-approved for diabetes therapy aren’t attending to the individuals who want them probably the most and might have critical well being ramifications for these with diabetes.
Semaglutide continues to be in scarcity as of scripting this weblog submit in December 2023.
How do GLP-1 agonists assist these with diabetes?
In of us with diabetes, incretin’s results are lowered (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 medicines can assist decrease A1c ranges by 1 – 2.4 share factors and might scale back the chance of cardiac occasions, no matter weight adjustments.
5 issues it’s best to learn about Ozempic and Wegovy (and different GLP-1 agonists)
1. You might or could not shed extra pounds with Ozempic and when you cease taking it, you’ll doubtless achieve the burden proper again.
Not everybody loses weight taking these medicines, which is essential to notice, in any other case individuals who don’t shed 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 trying solely on the STEP trials, outcomes present that 80% of individuals taking these medicines lose some quantity of weight. So about 20% of oldsters who take these meds gained’t lose any weight. For individuals who do shed 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 reasonable 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 fairly 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 medicines.
However let’s understand that these trials weren’t solely funded by the maker of the medicines but in addition had plenty of exclusion standards. Folks couldn’t be part of these research in the event that they have been depressed, had any present cardiovascular points, and in the event that they have been females of childbearing age with no extremely efficient contraception technique, simply to say a couple of.
Whenever you have a look at different trials on semaglutide, with out the pharma funding and in depth exclusion standards, the outcomes are much less spectacular. Solely 40% of oldsters are dropping at the very least 5% of physique weight. Taking a look at a meta-analysis (evaluate) of RCTs, most weight reduction totals hovered round a median of 8-10 lbs, with a couple of research displaying extra vital weight reduction, round 25-40 lbs.
In case your purpose is to lose about 5-10% of your physique weight then these medicines may enable you to get there however if you’re in search of extra dramatic weight reduction, these meds most likely gained’t enable you to meet your targets.
It’s additionally essential to acknowledge what occurs once you cease taking the medicines. As a result of possibly your insurance coverage will cease protecting it, or you’ll be able to not afford it, or there’s a scarcity, and so on.
Research have checked out what occurs once you take somebody off semaglutide and substitute it with a placebo and located that weight regain occurs in a short time. Inside a 12 months, folks regain virtually all of their weight misplaced, even whereas nonetheless doing behavioral interventions like diet, train, and cooking lessons.
Sounds similar to all of the analysis on what occurs to your weight when you cease doing a food regimen (you achieve 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 medicines will expertise some negative effects – the commonest being gastrointestinal misery. These negative effects could embrace nausea, vomiting, diarrhea, constipation, GERD, and belly ache. For most individuals, extreme GI signs ought to resolve inside a couple of days and extra gentle GI negative effects normally resolve inside 8-12 weeks.
These medicines additionally include a black field warning that they will improve the chance of thyroid tumors. That is primarily based purely on research carried out in rodents so we don’t understand how that extrapolates to people, but. There are human research being performed now however we gained’t know the outcomes till 2035 on the earliest. Due to this these medicines 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 just 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 possibly solely be handled with surgical procedure and might be deadly.
After which there’s the aesthetic reported facet impact individuals are speaking about, “Ozempic face”. Because of fast weight reduction (for some) and certain not getting enough diet, 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 accepted 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 will 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 medicines at a low value.
4. There’s no long-term information on Ozempic.
Let’s not overlook that we have now NO long run information on these medicine. Semaglutide was accepted by the FDA for diabetes therapy in 2017 and the longest research I discovered was follow-up with slightly over two years. We simply don’t know if there are any long-term negative effects. We additionally don’t know for those who preserve your weight reduction once you keep on this drug long-term.
It’s an eerily comparable image to previous weight reduction meds like Fen-Phen and Ephedra, each of which have been hailed as miracle weight reduction medicine with no long-term information and have been finally taken off the market due to irreversible critical hostile negative effects like deadly hypertension, coronary heart valve issues, coronary heart assault, stroke, and loss of life.
It’s essential 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 together 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 might 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 vital upswings in starvation, which can make you extra inclined to binges.
After which there’s the affect of weight adjustments in your psychological well being. For those who don’t shed extra pounds taking the treatment, chances are you’ll go to extremes to limit your meals consumption. Or shedding pounds could set off you to wish to lose much more, fueling extra restriction. Or for those who lose vital weight after which achieve 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 means I wouldn’t suggest a food regimen or intentional weight reduction to of us with an lively consuming dysfunction, a historical past of an consuming dysfunction, or disordered consuming, I wouldn’t suggest these weight reduction medicines both. It reinforces the concept that skinny is greatest and ends in insufficient nourishment and diet.
In case you are struggling to get enough diet whereas taking considered one of these medicines or are debating on taking considered one of these medicines and would really like extra individualized diet assist, our workforce would love that can assist you. E book a diet evaluation at the moment.
References:
https://pubmed.ncbi.nlm.nih.gov/32441473/
https://pubmed.ncbi.nlm.nih.gov/33567185/
https://maintenancephase.buzzsprout.com/1411126/13747346-ozempic
Consuming Problems & Diabetes: A Deal with Diabetes Drugs Webinar by Erin Phillips, MPH, RD, CDCES; hosted by EDRD Professional
For extra weblog posts like this take a look at:
How one can Set Sustainable Well being Targets For the New 12 months that Are Really Sustainable
Am I Consuming Sufficient? 8 Indicators You’re Undereating
Is Intuitive Fasting Actually Intuitive or Is It Simply One other Food regimen?
What Is Orthorexia? When Wholesome Consuming Turns into Obsessive
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