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 unwanted effects truly are. We additionally cowl implications of the remedy 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 matter proper now.
Celebrities are publicly attributing their weight reduction to those medicines (Oprah being the most recent one as I’m scripting this). Medical doctors are prescribing them left and proper for weight reduction (and another ailment you would possibly carry to the physician that they assume 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 ads to water cooler discuss, Ozempic is in all places. As a non-diet, weight-inclusive dietitian, I wish to make it possible for I’m empowering my purchasers and my neighborhood with all of the evidence-based data we’ve (and spotlight what we don’t have) with the intention to make an knowledgeable resolution 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 could make sense for those who select to take them or are interested by taking them given the anti-fat tradition we stay in and the strain from medical suppliers to “do one thing about your well being, aka your weight.”
So I compiled what I’ve discovered about these medicines on this publish and am highlighting what the analysis exhibits 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 assume), what the identified unwanted 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 referred to as GLP-1 agonists. GLP-1 is glucagon-like peptide, often known 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 remedy is now getting used to manage 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 remedy 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 (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 therapy 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 publish 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 ends up 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 may scale back the chance of cardiac occasions, no matter weight modifications.
5 issues it’s best to find out about Ozempic and Wegovy (and different GLP-1 agonists)
1. You could or could not shed pounds with Ozempic and when you cease taking it, you’ll doubtless acquire the burden proper again.
Not everybody loses weight taking these medicines, which is vital to notice, in any other case individuals who don’t shed 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 parents who take these meds gained’t lose any weight. For individuals who do shed pounds, on the very least, they’re shedding 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 remedy 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 parents taking this remedy 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 after all what’s driving all of the hype and media protection on these medicines.
However let’s needless to say these trials weren’t solely funded by the maker of the medicines but in addition had a whole lot of exclusion standards. Folks couldn’t be a part of these research in the event that they had been depressed, had any present 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 just a few.
While you take 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 parents are shedding a minimum of 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 just a few research exhibiting extra important weight reduction, round 25-40 lbs.
In case your aim is to lose about 5-10% of your physique weight then these medicines would possibly provide help to get there however if you’re in search of extra dramatic weight reduction, these meds in all probability gained’t provide help to meet your targets.
It’s additionally vital to acknowledge what occurs while you cease taking the medicines. As a result of possibly your insurance coverage will cease overlaying it, or you possibly can now not afford it, or there’s a scarcity, and many others.
Research have checked out what occurs while you take somebody off semaglutide and substitute it with a placebo and located that weight regain occurs in a short time. Inside a yr, folks regain nearly 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 effects.
Research present {that a} vary of 60% as much as 93% of individuals taking these medicines will expertise some unwanted effects – the commonest being gastrointestinal misery. These unwanted effects could embrace nausea, vomiting, diarrhea, constipation, GERD, and stomach ache. For most individuals, extreme GI signs ought to resolve inside just a few days and extra delicate GI unwanted effects normally resolve inside 8-12 weeks.
These medicines additionally include a black field warning that they’ll enhance the chance of thyroid tumors. That is based mostly purely on research executed 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 medicines are contraindicated for these with a household historical past of thyroid tumors.
There are different very uncommon unwanted effects like pancreatitis, gallbladder illness, kidney harm, and suicidal ideation. The FDA additionally lately added ileus to the checklist of unwanted effects on the label, which is when your bowel stops functioning and you’ll’t take away waste – it may possibly solely be handled with surgical procedure and will be deadly.
After which there’s the aesthetic reported facet impact persons are speaking about, “Ozempic face”. On account of speedy weight reduction (for some) and certain not getting satisfactory diet, folks report having free pores and skin on their face and a hollowing beneath 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 permitted 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’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 far-off from wellness facilities, spas, or telehealth suppliers touting these medicines at a low value.
4. There’s no long-term knowledge on Ozempic.
Let’s not overlook that we’ve NO long run knowledge on these medication. Semaglutide was permitted by the FDA for diabetes therapy in 2017 and the longest research I discovered was follow-up with a little bit over two years. We simply don’t know if there are any long-term unwanted effects. We additionally don’t know for those who preserve 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 knowledge and had been ultimately taken off the market due to irreversible severe adversarial unwanted effects like deadly hypertension, coronary heart valve issues, coronary heart assault, stroke, and dying.
It’s vital to weigh this when deciding to take the remedy – 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 remedy finally places you out of contact along 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 battle 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 impression of weight modifications in your psychological well being. If you happen to don’t shed pounds taking the remedy, you could go to extremes to limit your meals consumption. Or shedding weight could set off you to wish to lose much more, fueling extra restriction. Or for those who 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 manner 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 medicines both. It reinforces the concept skinny is finest and ends in insufficient nourishment and diet.
If you’re struggling to get satisfactory diet whereas taking one in every of these medicines or are debating on taking one in every of these medicines and would really like extra individualized diet assist, our workforce would love that can assist you. E-book a diet evaluation right now.
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 Issues & 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:
Easy methods to Set Sustainable Well being Targets For the New 12 months that Are Truly 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
