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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 dangerous the unwanted side effects truly are. We additionally cowl implications of the remedy 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 drugs like Wegovy, Mounjaro, Trulicity and Rybelsus are a scorching matter proper now.
Celebrities are publicly attributing their weight reduction to those drugs (Oprah being the most recent one as I’m scripting this). Docs are prescribing them left and proper for weight reduction (and every other ailment you may carry to the physician that they suppose 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 in every single 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) in an effort to make an knowledgeable determination on whether or not or to not take these drugs. It’s not my position to influence you (as a result of I imagine 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 drugs. It might make sense when you 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 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 may suppose), what the recognized unwanted 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 drugs fall into a category of medicines referred to 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 an alternative of being flooded with it.
It additionally stimulates satiety and fullness and helps you keep full longer, which is why the remedy 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 remedy of diabetes, and in 2021, Wegovy turned FDA-approved for the remedy of weight reduction. Each are primarily the identical remedy solely Wegovy has increased doses of semaglutide.
As soon as Wegovy turned FDA-approved for weight reduction, it rapidly went into scarcity after which medical doctors started prescribing Ozempic off-label (that 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 essentially the most and may have severe well being ramifications for these with diabetes.
Semaglutide continues to be in scarcity as of scripting this weblog put up in December 2023.
How do GLP-1 agonists assist these with diabetes?
In people with diabetes, incretin’s results are diminished (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 will 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 you need to find out about Ozempic and Wegovy (and different GLP-1 agonists)
1. You could or could not drop some 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 necessary to notice, in any other case individuals who don’t drop 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 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 gained’t lose any weight. For individuals who do drop 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 parents who took this remedy 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 remedy 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 after all what’s driving all of the hype and media protection on these drugs.
However let’s understand that these trials weren’t solely funded by the maker of the drugs but additionally had numerous exclusion standards. Folks couldn’t be a 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 number of.
Whenever you take 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 not less than 5% of physique weight. a meta-analysis (overview) of RCTs, most weight reduction totals hovered round a mean of 8-10 lbs, with a number of research exhibiting extra important weight reduction, round 25-40 lbs.
In case your objective is to lose about 5-10% of your physique weight then these drugs may assist you to get there however in case you are in search of extra dramatic weight reduction, these meds most likely gained’t assist you to meet your objectives.
It’s additionally necessary to acknowledge what occurs while you cease taking the drugs. As a result of possibly your insurance coverage will cease protecting it, or you may not afford it, or there’s a scarcity, and so on.
Research have checked out what occurs while you take somebody off semaglutide and exchange 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 diet, train, and cooking lessons.
Sounds similar to all of the analysis on what occurs to your weight when you cease doing a weight loss plan (you acquire it again).
2. Ozempic comes with very disagreeable unwanted side effects.
Research present {that a} vary of 60% as much as 93% of individuals taking these drugs will expertise some unwanted side effects – the commonest being gastrointestinal misery. These unwanted side effects could embrace nausea, vomiting, diarrhea, constipation, GERD, and stomach ache. For most individuals, extreme GI signs ought to resolve inside a number of days and extra delicate GI unwanted side effects normally 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 carried out in rodents so we don’t understand how that extrapolates to people, but. There are human research being carried out now however we gained’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 unwanted side effects like pancreatitis, gallbladder illness, kidney harm, and suicidal ideation. The FDA additionally lately added ileus to the listing of unwanted side effects on the label, which is when your bowel stops functioning and you may’t take away waste – it may solely be handled with surgical procedure and could be deadly.
After which there’s the aesthetic reported aspect impact persons are speaking about, “Ozempic face”. Because of speedy weight reduction (for some) and sure not getting satisfactory diet, individuals report having unfastened pores and skin on their face and a hollowing below the eyes and close to the temples. This look can also 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 accredited 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 lively ingredient.
If you wish to take a weight reduction remedy, get a prescription out of your physician and safe it from a licensed pharmacy. Keep distant 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 have now NO long run information on these medication. Semaglutide was accredited by the FDA for diabetes remedy in 2017 and the longest examine I discovered was follow-up with somewhat over two years. We simply don’t know if there are any long-term unwanted side effects. We additionally don’t know when you keep your weight reduction while 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 finally taken off the market due to irreversible severe hostile unwanted 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 remedy – you merely can’t know what the protection 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 could be harmful for these with a historical past of an consuming dysfunction or disordered consuming.
This remedy 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 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 remedy can lead to important upswings in starvation, which can make you extra prone to binges.
After which there’s the influence of weight adjustments in your psychological well being. For those who don’t drop some pounds taking the remedy, chances are you’ll go to extremes to limit your meals consumption. Or reducing weight could set off you to wish 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 remedy, that change in physique look could trigger emotional misery and result in disordered consuming.
In the identical method I wouldn’t advocate a weight loss plan or intentional weight reduction to people with an lively consuming dysfunction, a historical past of an consuming dysfunction, or disordered consuming, I wouldn’t advocate these weight reduction drugs both. It reinforces the concept that skinny is greatest and leads to insufficient nourishment and diet.
In case you are struggling to get satisfactory diet whereas taking one in all these drugs or are debating on taking one in all these drugs and would love extra individualized diet assist, our workforce would love that will help 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 Issues & Diabetes: A Concentrate on Diabetes Drugs Webinar by Erin Phillips, MPH, RD, CDCES; hosted by EDRD Professional
For extra weblog posts like this take a look at:
Learn how to 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 Weight loss program?
What Is Orthorexia? When Wholesome Consuming Turns into Obsessive
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