Ozempic and Beyond: A Last Resort or Quick Fix?

Introduction:

In the quest for weight loss, society has witnessed a series of quick-fix solutions, extreme diets, and the allure of popping a pill to shed unwanted pounds. Today, I want to explore the history of these approaches, the impact on muscle mass, the evolving classification of obesity as a disease, and the role of the medical community and government in addressing this complex issue. Let’s delve into this topic with a critical lens and explore the underlying factors contributing to the obesity epidemic.

The Rise and Fall of Quick-Fix Solutions:

Over the years, numerous quick-fix solutions have emerged, promising miraculous weight loss results. One infamous example is Fen Phen, a combination of fenfluramine and phentermine, which was marketed as an effective appetite suppressant. However, it was later discovered to be associated with severe heart valve problems and was withdrawn from the market. This highlights the dangers of relying on shortcut solutions without fully understanding their long-term consequences.

Of course, Fen Phen hasn’t been the only quick fix scheme. Many diet programs, like Lindora, utilized extremely low-calorie diets, accompanied by energy shots, to promote rapid weight and muscle loss.

There are also the various cosmetic procedures and scams. These range from the never-ending string of liposuction, fat redistribution, and Cool Sculpting fat-freezing procedures…all the way to the “reposition your fat through massage” scams.

The weight loss industry cons billions of dollars out of people every year. Is the current trend to use diabetes and other weight loss obesity drugs any different than previous scams, offering a quick fix with no effort? Should these “miracle” drugs only be allowed for the morbidly obese, or should everyone be able to obtain? Do we know what the long-term effects of these medications are? These are some not so easy to answer questions.

Today, I want to discuss the growing trend of using drugs like Ozempic, not for its intended use for the health-compromised morbidly obese patient, but as a means of shedding pounds quickly for the average healthy person. While these drugs may show promise for the morbidly obese, I believe it’s important to consider them as a last resort rather than a go-to solution.

I also want to explore other major weight loss drugs currently in use or in review, like Wegovy, Mounjaro, Tesofensine, Orforglipron, and Retatrutide, and examine their mechanisms of action, the impact on muscle mass, and the pitfalls of relying on medication for weight loss. So, let’s dive in and explore this controversial topic!

Weight Loss Drugs:

Ozempic (generic name semaglutide): Ozempic is an FDA-approved medication developed to treat type 2 diabetes. However, it has gained attention for its potential to aid in weight loss and is used off-label to treat obesity. Ozempic works by mimicking a hormone called glucagon-like peptide-1 (GLP-1) that helps regulate blood sugar levels and appetite. GLP-1 receptor agonists work by increasing how much insulin your body releases after eating. By activating receptors in the brain, Ozempic promotes feelings of fullness and reduces hunger, leading to decreased calorie intake and subsequent weight loss.
Wegovy (generic name semaglutide): Wegovy is an obesity medication similar to Ozempic in its composition and mechanism of action. It is also a GLP-1 receptor agonist, designed to regulate blood sugar levels and appetite. Wegovy is administered as a high dose once-weekly 2.4 mg subcutaneous injection and has been approved by the FDA for chronic weight management in adults with obesity or those who are overweight and have at least one weight-related condition. Wegovy is a peptide which is expensive and labor-intensive to produce. Wegovy comes with warnings that it may cause serious side effects to include cancerous thyroid tumors, pancreatitis, kidney failure, and gallbladder problems.
Mounjaro (generic name Tirzepatide): Mounjaro is a glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist administered once weekly by subcutaneous injection. It is the first dual receptor agonist. It is FDA approved for adults who have type 2 diabetes to decrease blood glucose. Mounjaro reduces blood sugar by increasing your insulin production and lowering the amount of sugar your liver makes. It also slows digestion which makes you feel fuller longer. In clinical trials lasting 72 weeks, participants administered 3 dose levels, either 5mg, 10mg, or 15mg, lost -15%, -19.5%, and -20.9%. respectively.
Tesofensine: Tesofensine is an approved diabetes medication and investigational drug that has shown potential for weight loss. It is a serotonin-noradrenaline-dopamine reuptake inhibitor (SNDRI) SNDRI’s are a class of psychoactive antidepressants. It acts on the brain’s neurotransmitters, specifically targeting the receptors responsible for regulating appetite and metabolism. By increasing the levels of serotonin, dopamine, and norepinephrine, Tesofensine helps suppress appetite, leading to reduced calorie intake. Some studies find that Tesofensine may also to some extent stimulate thermogenesis. Other studied benefits of Tesofensine include: improves cognitive health, improves mood, improves blood sugar levels, increases energy levels, treats sexual dysfunction, treats eating disorders, treats ADHD, improves sleep quality, and fights alcohol addiction. Tesofensine is administered in 3 dosage levels. .25 mg, .5 mg, and 1.0 mg. Tesofensine is a synthetic peptide reported as expensive to produce. In some studies, Tesofensine was linked to an increased risk of cardiovascular events, such as hypertension and arrhythmias.
Orforglipron and Retatrutide: Both of these drugs mimic hormones produced by the gut in response to nutrients, resulting in a slower digestion and reduced appetite by acting on receptors in the brain. which ultimately leads to a decrease in appetite and weight loss. Orforglipron is a non-peptide molecule that is easier and cheaper to produce in pill form. Retatrutide is showing an unprecedented level of weight loss in study participants. At the maximum dose, participants lost on average 24.2% of their body weight over a 11-month period. Retatrutide reacts with 3 receptors that determine appetite which is why it seems to produce a higher weight loss (Wegovy reacts with one, and Mounjaro reacts with two.)

Graphic showing the functions of Glucagon-like peptide-1 to various body organs and systems.

Celebrities and Weight Loss Drugs:

Hollywood celebrities always seem to be at the front of any weight loss controversy.

In recent times, weight loss drugs like Ozempic have gained popularity among celebrities as a shortcut to shedding a few pounds. Using the diabetes medication as a means to fit into a dress for an event or slip into that bikini on vacation goes way beyond the intended use, which is weight loss for the medically compromised morbidly obese. It seems like little thought is given to what is being promoted by giving out weight loss pills like candy, or what kind of detrimental long-term effects might occur.

Just in the context of creating false images, I liken the behavior to the over-use and abuse of fillers and plastic surgery procedures to give the impression that one never ages. At some point, people become unrecognizable. Likewise, sucking down potentially harmful diet pills to promote fast weight loss, because you don’t want to do the work, creates an illusion of “health & fitness” which is truly false.

It is unfortunate that many people look up to the rich & famous for guidance on life, and don’t hesitate to mimic their behavior. Usage of these drugs by ordinary people is so high, that there are shortages for those who are facing life threatening challenges because of obesity and diabetes.

The Impact on Muscle Mass:

Weight loss drugs, including GLP-1 receptor agonists, contribute to muscle mass loss alongside fat loss. Studies show 20-30% of weight loss achieved is lean muscle mass. During calorie restriction, the body utilizes muscle tissue for energy unless intense weight training is utilized as a prevention. This lean mass loss will negatively impact metabolism. Preserving muscle mass is crucial as it helps maintain a higher metabolic rate and promotes long-term weight management.

The Pitfalls of Quick-Fix Solutions:

While weight loss drugs may seem like a convenient option, it’s important to recognize that they do not teach individuals the necessary lifestyle changes for sustainable weight loss. Quick-fix schemes, such as fad diets or relying solely on medication, often neglect the importance of exercise, balanced nutrition, and overall well-being. Long-term weight management requires holistic changes that focus on both physical and mental health.

What Happens After Stopping Weight Loss Drugs?

One crucial aspect to consider is the outcome when individuals discontinue weight loss drugs. It’s inevitable that weight regain may occur as the human brain has a natural “set point” for storing fat. Weight loss drugs simply mask this set point, rather than permanently altering it.

When individuals rely solely on weight loss drugs and then stop taking them, they may experience the yo-yo effect. Weight loss drugs and extreme diets not focused on muscle mass retention lead to muscle mass loss and a slowed metabolism, ultimately fueling this yo-yo effect. This cycle involves losing weight, followed by a decrease in metabolism and eventual weight regain. However, the weight regained is often predominantly fat, leading to a higher body fat percentage. This potentially leaves individuals in a worse state than before. In the long run, repeats in the cycle leave the individual with a much higher bodyfat percentage, and very low lean mass and metabolic rate.

Behavior modification, exercise, and permanent lifestyle changes are the only way to sustain weight loss. However, even though drug trials and studies always add some level of diet and exercise modification, this is not how the drug is being used. I know several over-weight individuals currently using weight loss drugs. None of them are modifying their behavior or exercising and were not instructed to do so. Instead of a whole pizza, they eat one slice. Instead of 3 donuts, they eat one. So therefore, they are losing weight. This is the crux of the problem.

What could be the long-term effects?

I am not a doctor, nor a scientist. However, I do know the body’s mechanisms for fat loss and the processes that occur that cause difficulty in weight management and eventual obesity. Could a long-term effect of repeated usage of obesity weight loss drugs eventually cause a previously only slightly overweight person to become obese, and even diabetic?

Many of these new weight loss drugs stimulate the body to produce more insulin. What happens with a long-term high level of insulin production? Normally, insulin resistance and an eventual failure of the cells of the pancreas. This leads to weight gain, obesity, and diabetes. This is an obvious simplification of a very complex process which has many causes. However, it is a common result when an individual spends years consuming high carbohydrate high-glycemic foods and are in a constant state of insulin production.

Also, as mentioned above, the yo-yo diet effect causes massive lean mass loss and the accumulation of unhealthy levels of bodyfat. The high level of bodyfat and resulting metabolic changes can result in obesity and sometimes diabetes.

So, it is logical, if one is not already obese, abuse of these drugs can possibly cause what they are designed to treat.

When you take the above information, and combine it with the already known possible side effects, what does it leave you? It leaves a very risky proposal in my view.

Another question raised recently outlines what effect these drugs might have when combined with other health issues. Even smaller side effects can have enormous consequences. Take a look at the following video link featuring Dr. Terry Dubrow, discussing the death of Lisa Marie and her complications from bariatric surgery that ultimately took her life.

https://www.tmz.com/watch/2023-07-14-071423-dr-terry-dubrow-1649473-617/

The Historical Context and Medical Assumptions:

The medical community has historically struggled to address the complex issue of obesity, often assuming that individuals cannot make lasting lifestyle changes. Many doctors have limited knowledge of the anti-aging and anti-fat benefits of intense weight training, which can lead to a pessimistic outlook regarding weight loss. This systemic failure, coupled with an agenda that promotes high-carb fake food diets, has contributed to the increasing incidence of obesity.

And let’s face it, the majority of people are a bit on the lazy side and cringe when you talk to them about exercise. I’ve been told by various doctor’s that they don’t expect people can make lifestyle changes, and it is a waste of time. They believe it is just too hard. Since most people wouldn’t follow their recommendations, they don’t waste their time talking about it. Even the doctors that believe lifestyle changes can help, don’t have the real background to instruct a person how to manage their weight and prevent obesity.

It is too easy to jump onboard with the latest quick fix scheme that involves no effort. To deal with pending bone loss, doctors prescribe osteoporosis medicine and hormones instead of resistance training. To deal with fat loss, they prescribe stimulants, appetite suppressants, and other pills.

Obesity as a Disease and Beyond:

In recent years, obesity has been recognized as a disease rather than the result of poor lifestyle choices, primarily due to the changes it induces in the body’s functioning and energy production. Obesity involves complex hormonal and metabolic imbalances that contribute to weight gain and difficulties in sustaining weight loss.

However, before this recognition as a disease, the medical community often dismissed the possibility of lasting lifestyle changes and the idea of prevention. The belief that lifestyle changes are impossible has led to the ballooning obesity epidemic. It’s important to address the root causes of obesity and challenge societal norms that perpetuate unhealthy food choices and discourage physical activity.

I understand that at a certain point obesity is a disease because of the extreme metabolic changes that happen. But before this point, there are often many years where lifestyle changes and exercise can provide a solution. It has become so ingrained in our society that “healthy at any size” exists we’ve lost sight of reality. Talking about the need to manage weight and have a healthy body fat percentage is not fat shaming or hate speech, yet this is what it has become in the minds of many.

Illustration in blue and yellow showing a hand writing complications of obesity in circles to include Type 2 Diabetes, liver disease, asthma, high cholesterol, emotional & mental health problems, high blood pressure, sleep apnea, and foot problems.

Government’s Role:

Our society’s approach to nutrition and health has been heavily influenced by government guidelines and medical recommendations. Unfortunately, historically, these guidelines have often advocated for high-carb diets, processed foods, soy, and other hormone disrupters. This approach has had severe consequences on our health and metabolism, contributing to the rise in obesity rates. Recognizing the detrimental effects of this agenda is essential in shaping policies and practices that promote healthier lifestyles.

Government “guidance” over the years has resulted in a food pyramid, produced by the Dept. of Agriculture to promote grain sales, skyrocketing our consumption of insulin-producing carbohydrates. It has led school lunch programs to classify catsup and tater tots as vegetables. Now, government guidance is promoting fake foods and lab produced biomass 3-D printed in the shape of real food…to save the planet. It seems like government guidance is actually doing more to eliminate us than help us lead a long and healthy life.

Challenging the Status Quo:

It is crucial to stop pretending that obesity cannot be prevented or that it is healthy at any size. The obesity epidemic demands a shift towards promoting preventive measures, educating individuals on the importance of balanced nutrition, physical activity, and sustainable lifestyle changes. Empowering people with the knowledge and tools to make informed and wise decisions about their lifestyle choices is key to combating obesity and its associated health risks. While weight loss drugs may offer a temporary solution for extreme cases, a comprehensive approach of major lifestyle changes is the only component that offers a lasting solution. And yes, any lifestyle changes can be tough. But focusing on prevention, healthy habits for living lean, and an inclusive understanding of well-being is the only real solution.

Conclusion:

Weight loss drugs like Ozempic can be useful tools in specific cases, but they should be reserved for individuals who have exhausted other options and implemented comprehensive lifestyle changes. Rather than relying solely on medication, we should prioritize sustainable lifestyle modifications, including exercise, balanced nutrition, and mental well-being. By addressing the root causes of obesity and promoting healthy habits, we can create a society that prioritizes long-term health and well-being over quick fixes.