You may have heard the buzz about diabetes drugs Ozempic, Wegovy, and Mounjaro being used for weight loss. Whether called the “game-changer” for weight loss or the “Hollywood drug,” chances are the topic has popped up in your social media feed or conversations.
What’s the real story? Are these medications something celebrities take just to fit into their designer clothes? Or are they a valid medical treatment that helps reduce the risk of metabolic diseases like heart disease, diabetes, and other preventable causes of death? (Emphasis on preventable.)
Start with the Definition: What Are These Drugs?
These medications are GLP-1 agonists, which are a class of type 2 diabetes drugs that improve blood sugar and aid weight loss.*
What does that mean? GLP agonists mimic the hormones that regulate appetite and increase satiety. GIP agonists act like another naturally occurring hormone and not only reduce appetite but spur insulin production to control blood sugar.
When taking these medications, people report feeling full after eating even small amounts of food. The cravings that drive constant grazing between meals vanish. (Anecdotally, patients also tell us they don’t have as much of an appetite for sweets or alcohol.)
Insulin: The Delivery Service That Never Quits
Many modern diseases are dietary diseases. Why is that?
The body produces the hormone insulin to help us process the glucose that we consume. Think of insulin as a messenger service, carrying glucose around the body to deliver it for energy. When we consume too much glucose or too many carbs (which turn into glucose), it leads to two negatives:
- We throw insulin into a state of flux. Insulin drives hunger. Eating sugar makes you want to eat more sugar. It’s an unending loop.
- Insulin spurs fat storage. And this is not just fat that shows up on your arms or thighs. It can also turn into visceral fat around your body organs. This is the most dangerous kind of fat because it causes inflammation and increases the risk of heart disease and diabetes, just to name a few issues.
We know that if we can control insulin, we can control our fat stores. GLP-1 agonists offer that control.
Why These Meds Are So Popular
These medications are generating buzz because they’re extremely effective at helping people lose weight. According to a study published in The New England Journal of Medicine in 2021, participants who took semaglutide and made lifestyle changes lost 33.7 pounds compared to those making healthier changes without semaglutide – those people only lost 5.7 pounds.
For those who suffer from what feels like uncontrollable weight struggles, GLP-1 agonists provide hope. That’s because, for many, weight gain and the inability to lose weight are out of their control. For them, managing a healthy weight is not as simple as being disciplined or maintaining motivation. Genetics and biology inform hormone regulation, and obesity is a legitimate disease state for many.
What’s more, losing and keeping weight off is difficult. Humans are biologically wired to maintain their weight, even in excess. Normally, as we actively shed weight (without this type of drug intervention), cutting back on calories and increasing physical activity make us feel hungrier. It’s no wonder so many people give up and start eating more again. But, when taking GLP-1 agonists, people lose weight without being hungry – a win-win.
Another reason these medications give people a real shot at weight loss is because they finally allow them the mental and emotional space to stick with behavior modifications to maintain the weight loss once they discontinue the medications. Patients often know what to do to lose weight, but they just could not do it before trying a medication like Ozempic, Wegovy, or Mounjaro. The compulsion to eat is too strong. These medications challenge food addiction.
Benefits That Go Beyond Numbers on the Scale
The health benefits of GLP-1 agonists go beyond weight loss. People in clinical trials also saw a reduction in blood pressure, cholesterol, and inflammation. This is because the same hormones that lead to weight gain also contribute to high blood pressure, abnormal cholesterol, and inflammation. It’s no wonder then that these medications have also been shown to protect against heart disease. (And we should note that scientists are also researching GLP-1 agonists for possible treatment of Parkinson’s and Alzheimer’s diseases.)
How to Evaluate Downsides
As with any medication, these drugs may have side effects (and not everyone should take them, for example, those who have had thyroid cancer). The most common side effects are nausea, bloating, diarrhea, and constipation. They usually happen early and subside over time, though we want our patients to contact us for strategic help managing side effects. Less commonly, some of our patients have noticed hair loss, which might be related to significant weight loss.
One common criticism you’ll hear is that the weight will come right back after someone stops taking the medication. True, a rebound could happen if someone resumes bad eating habits and a sedentary lifestyle. But a potential rebound doesn’t mean we should ignore the preventative benefits of losing weight. And for some, experiencing successful weight loss could be the catalyst for long-term success through healthier eating habits and physical activity.
Another downside is the high cost. That’s why we work with compounding pharmacies and try to find cost savings for members of our practice.
An Ounce of Prevention….
At Griffin Concierge Medical, we prescribe Ozempic, Wegovy, and Mounjaro to diabetics as well as those who are overweight and, therefore, at higher risk for other conditions.
The biological reality is that sometimes you can’t diet and exercise your way out of hormone dysregulation or being overweight. It’s not always about willpower. We don’t view GLP-1 agonists as a fad or a quick fix. We view them as effective tools for controlling hormones and helping to prevent diabetes and heart disease.
* Semaglutide is branded as Ozempic and Wegovy and has both diabetes- and weight-loss indications. Tirzepatide is branded as Mounjaro, and it has a diabetes indication. Mounjaro is largely preferred because studies show it to be more effective than semaglutide when it comes to weight loss as it’s both a GLP agonist and a GIP agonist. (Semaglutide is FDA-approved for weight loss while Mounjaro is currently pending FDA approval.)