A registered dietitian’s deep dive into the reality about Ozempic. Let’s dive into the science to have a look at how efficient at weight reduction it truly is and simply how unhealthy the uncomfortable side effects truly are. We additionally cowl implications of the treatment scarcity and concerns 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 sizzling subject proper now.
Celebrities are publicly attributing their weight reduction to those medicines (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 carry to the physician that they suppose is correlated to your weight). Sufferers with diabetes (for whom these medicines 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 in consequence.
From information headlines to TV commercials to water cooler speak, Ozempic is in every single place. As a non-diet, weight-inclusive dietitian, I wish to guarantee that I’m empowering my shoppers and my neighborhood with all of the evidence-based info we now have (and spotlight what we don’t have) in an effort to make an knowledgeable determination on whether or not or to not take these medicines. It’s not my function to steer you (as a result of I imagine 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 medicines. It might make sense if you happen to select to take them or are interested by 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 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 would possibly suppose), what the identified uncomfortable side 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 medicines 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 an alternative 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 energetic 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 larger doses of semaglutide.
As soon as Wegovy grew to become FDA-approved for weight reduction, it shortly went into scarcity after which docs 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 shortly 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 severe well being ramifications for these with diabetes.
Semaglutide continues to be in scarcity as of penning this weblog submit in December 2023.
How do GLP-1 agonists assist these with diabetes?
In of us with diabetes, incretin’s results are decreased (by about 30%), which results in larger 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 will help decrease A1c ranges by 1 – 2.4 proportion factors and might scale back the danger of cardiac occasions, no matter weight modifications.
5 issues it is best to learn about Ozempic and Wegovy (and different GLP-1 agonists)
1. You could or might not shed some pounds with Ozempic and when you cease taking it, you’ll probably achieve the burden proper again.
Not everybody loses weight taking these medicines, which is necessary to notice, in any other case individuals who don’t shed some 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 85% of individuals taking these medicines lose some quantity of weight. So about 15% of oldsters who take these meds received’t lose any weight. For individuals who do shed some 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 oldsters 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 medicines.
However let’s take into account that these trials weren’t solely funded by the maker of the medicines but additionally had quite a lot of exclusion standards. Folks couldn’t be part of these research in the event that they had been depressed, had any current cardiovascular points, and in the event that they had been females of childbearing age and not using a extremely efficient contraception methodology, simply to say a couple of.
If 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 least 5% of physique weight. Taking a look at a meta-analysis (assessment) of RCTs, most weight reduction totals hovered round a mean 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 would possibly assist you get there however if you’re on the lookout for extra dramatic weight reduction, these meds in all probability received’t assist you meet your objectives.
It’s additionally necessary to acknowledge what occurs if you cease taking the medicines. As a result of possibly your insurance coverage will cease protecting it, or you possibly can not afford it, or there’s a scarcity, and so forth.
Research have checked out what occurs if you take somebody off semaglutide and change it with a placebo and located that weight regain occurs in a short time. Inside a yr, individuals regain virtually all of their weight misplaced, even whereas nonetheless doing behavioral interventions like vitamin, train, and cooking lessons.
Sounds similar to all of the analysis on what occurs to your weight when you cease doing a eating regimen (you achieve it again).
2. Ozempic comes with very disagreeable uncomfortable side effects.
Research present {that a} vary of 60% as much as 93% of individuals taking these medicines will expertise some uncomfortable side effects – the most typical being gastrointestinal misery. These uncomfortable side effects might embody nausea, vomiting, diarrhea, constipation, GERD, and belly ache. For most individuals, extreme GI signs ought to resolve inside a couple of days and extra delicate GI uncomfortable side effects normally resolve inside 8-12 weeks.
These medicines additionally include a black field warning that they’ll improve the danger of thyroid tumors. That is based mostly 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 medicines are contraindicated for these with a household historical past of thyroid tumors.
There are different very uncommon uncomfortable side effects like pancreatitis, gallbladder illness, kidney damage, and suicidal ideation. The FDA additionally lately added ileus to the listing of uncomfortable side effects on the label, which is when your bowel stops functioning and you may’t take away waste – it may possibly solely be handled with surgical procedure and will be deadly.
After which there’s the aesthetic reported aspect impact individuals are speaking about, “Ozempic face”. On account of speedy weight reduction (for some) and certain not getting satisfactory vitamin, individuals report having unfastened pores and skin on their face and a hollowing underneath 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 medication, which is main compounding pharmacies to create variations that aren’t authorised or regulated.
When a drug goes on the FDA drug scarcity listing, 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 energetic 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 price.
4. There’s no long-term information on Ozempic.
Let’s not overlook that we now have NO long run information on these medication. Semaglutide was authorised by the FDA for diabetes therapy in 2017 and the longest examine I discovered was follow-up with a bit over two years. We simply don’t know if there are any long-term uncomfortable side effects. We additionally don’t know if you happen to preserve your weight reduction if 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 medication with no long-term information and had been ultimately taken off the market due to irreversible severe hostile uncomfortable side effects like deadly hypertension, coronary heart valve issues, coronary heart assault, stroke, and loss of life.
It’s necessary 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 will 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 battle with episodes of binging, coming off the treatment can lead to vital upswings in starvation, which can make you extra prone to binges.
After which there’s the impression of weight modifications in your psychological well being. When you don’t shed some pounds taking the treatment, you could go to extremes to limit your meals consumption. Or dropping pounds might set off you to wish to lose much more, fueling extra restriction. Or if you happen to lose vital weight after which achieve all of it again when you come off the treatment, that change in physique look might trigger emotional misery and result in disordered consuming.
In the identical means I wouldn’t suggest a eating regimen or intentional weight reduction to of us with an energetic 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 finest and ends in insufficient nourishment and vitamin.
In case you are struggling to get satisfactory vitamin whereas taking certainly one of these medicines or are debating on taking certainly one of these medicines and would love extra individualized vitamin assist, our staff would love that will help you. E book a vitamin evaluation in the present day.
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 Medicines Webinar by Erin Phillips, MPH, RD, CDCES; hosted by EDRD Professional
For extra weblog posts like this take a look at:
Methods 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 regimen?
What Is Orthorexia? When Wholesome Consuming Turns into Obsessive
