Weight Loss Medication: Wading Through the Confusion
Why the recent explosion in media coverage?
During this summer, it feels as though we cannot open a newspaper or read an app without some form of opinion on weight loss medication, “fat jabs”, the pros, cons, extreme symptoms, best diets and coming off, staying on or “microdosing” somewhere in between. If we as nutritional experts and doctors are confused, it must be worrying for others.
So how do we wade through all the information that is currently being presented? Are these medications safe? Are they the miracle cure? Are people gaining weight once stopping the medication? Is this a medication that you can stay on forever?
Here at Hormone Health, we aim to offer practical, sensible, long term safe advice and a dietary programme that can help to achieve weight loss without medication, as well helping those who would like to come off their weight loss medication but not regain the weight.
At present, we do not offer weight loss medication as we believe that further research needs to be carried out and the long-term implications should be fully understood. Our Hormone Health nutrition and lifestyle department always advocate natural assistance through diet, exercise and lifestyle changes, whilst also realising that many of our patients might have been on the medication and possibly be seeking further assistance. Prevention is key, whilst understanding that many people will have struggled to lose weight over a number of years, and for them, this medication acts as a silver bullet.
What does the weight loss medication entail?
There are various forms in the pharmaceutical market that cover specific assistance for Type 2 Diabetes (T2D) known as Ozempic, as well as two weight loss medications; Wegovy and Mounjaro. Companies are currently looking at even more sophisticated medication which will become multi-faceted in the quest for better health and faster results, by helping to keep patients feeling fuller for even longer after eating, and a tablet form could well be on the way as an alternative to weekly or monthly injections.
How does the medication work?
We all have a certain amount of GLP-1 in our bodies naturally, the substance that forms the bulk of the medications, but it is broken down so rapidly that it does not always maintain the opportunity to do its job. This is called glucagon like peptide 1, and this works by helping to manage blood glucose levels to an optimum amount, leading to a reduced appetite and a slowing down of the digestive tract. It can also lead to an increase in insulin production and function which in turn helps to ensure that any excess sugar in the blood is removed and used as energy or stored as fat for future use. This upturn in metabolic health can also lead to improvements in certain areas such as cardiovascular health and inflammation.
The various forms also appear to reduce or even silence the recently coined term “food noise”, whereby many people talk of a protruding, persistent voice in their head telling them to eat, eat more, and often eat foods that they are craving such as processed, fast food, regardless of whether they are hungry or not. All of these aspects mentioned lead to an increased feeling of fullness (satiety), a reduction in focus on food in general, and therefore a big reduction in food intake altogether. Reports suggest it can even reduce cravings for other substances such as nicotine, alcohol and incessant mobile phone usage.
What are the advantages?
To name a few:
- Weight loss.
- Lack of food noise.
- Reduction in obesity leading to less depression, anxiety and “fear” around food.
- Reduced risk of cardiovascular disease such as heart attacks and strokes (up to 20% in some cases).
- Reduced risk of non-alcoholic fatty liver disease, kidney disease, certain cancers such as colon, and possible certain illnesses such as Alzheimer’s and Parkinson’s.
- Possibility of less hip/knee replacement due to less weight pressure on joints and bones.
What are the disadvantages?
- Nausea/vomiting – up to 40% of those on medication experience nausea whilst up to 25% suffer from vomiting.
- Many people experience eructation (burping!) with a distinct sulphur odour.
- Ongoing diarrhoea.
- Constipation.
- Gaunt appearance known as “Ozempic face”, now also Ozempic bottom
- Hair loss and thinning.
- Changes in libido.
- Weight loss addiction and disordered eating during and on completion of treatment, “fear” of eating “normally”.
- Extreme muscle loss in some cases, most people experience some muscle loss if not eating sufficient protein or exercising.
- Lack of pleasure in eating and changes in relationships with partners, children, friends and affected social life.
- Huge weight loss can be achieved, on average over 21% of the original total body weight, but 14% of that is muscle. However, if there is no dietary and lifestyle habit changes, a lot of people can regain the weight when reverting to previous habits, and in general that ends up consisting of more fat than muscle, resulting in a worse body composition than in the first instance.
- Resurgence of food noise after medication has stopped.
- Nutrient deficiency resulting in immune, hormone, digestive and bone health issues.
- More serious – gut/bowel blockage, pancreatitis, gallstones and possible increase in thyroid cancer, but more research is required.
Perhaps the most worrying aspect is that these medications seem to have seeped into everyday life, Ozempic was only ever intended to help those already experiencing T2D, whilst other forms should only be prescribed if a patient has a BMI of 27 or above and a health condition, or a BMI of 30 and above.
A normal range of BMI is considered to be between 18.5 and 25, and many people within those parameters are able to order these medications online without proper supervision and certainly no support on long term changes of habits, looking at hunger and satiety patterns, recognising different forms of hunger and triggers, exercise input and a healthy, sustainable eating plan.
At Hormone Health, our experts we are here to help; whether that be in approaching longevity and long-term health plans with a sustainable, preventable, Mediterranean style way of eating, or for those currently on medication or attempting to come off, to find a healthy, achievable way of life incorporating the enjoyment of food and an active life.
Antonia de Gier is a Hormone Health Associate and highly experienced Registered Nutritional Therapist and trained at the Institute of Optimum Nutrition (ION). Arrange a consultation with Antonia.