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 side effects truly are. We additionally cowl implications of the medicine 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 medicines like Wegovy, Mounjaro, Trulicity and Rybelsus are a sizzling matter proper now.
Celebrities are publicly attributing their weight reduction to those medicines (Oprah being the most recent one as I’m penning this). Docs are prescribing them left and proper for weight reduction (and some other ailment you may convey to the physician that they suppose is correlated to your weight). Sufferers with diabetes (for whom these medicines have been initially developed) can’t entry these meds as a result of there are shortages throughout the nation and their well being is struggling because of this.
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 guarantee that I’m empowering my purchasers and my group with all of the evidence-based data we have now (and spotlight what we don’t have) with the intention to make an knowledgeable determination on whether or not or to not take these medicines. It’s not my function to steer you (as a result of I imagine in your company and physique autonomy) however it’s my function to coach and inform, which I hope to do right here.
I’d by no means, ever disgrace or choose somebody who decides to take these medicines. It could make sense when you select to take them or are eager about 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 medicines on this submit 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 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 known 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 an alternative of being flooded with it.
It additionally stimulates satiety and fullness and helps you keep full longer, which is why the medicine is now getting used to regulate urge for food and produce weight reduction.
What’s semaglutide?
Semaglutide is the generic identify 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 basically the identical medicine solely Wegovy has greater 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 (which means prescribing it for one thing aside from what it’s FDA-approved for) for weight reduction. After which Ozempic shortages rapidly adopted go well with.
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 might have severe well being ramifications for these with diabetes.
Semaglutide continues to be in scarcity as of penning this weblog submit 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 greater 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 might help decrease A1c ranges by 1 – 2.4 proportion factors and might cut back the danger of cardiac occasions, no matter weight adjustments.
5 issues you must learn about Ozempic and Wegovy (and different GLP-1 agonists)
1. Chances are you’ll or could not drop pounds with Ozempic and when you cease taking it, you’ll possible acquire the load proper again.
Not everybody loses weight taking these medicines, which is essential to notice, in any other case individuals who don’t drop 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 medicines lose some quantity of weight. So about 20% of parents who take these meds received’t lose any weight. For many who do drop 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 parents who took this medicine 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 medicine 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 loads of exclusion standards. Folks couldn’t be a part of these research in the event that they have been depressed, had any present cardiovascular points, and in the event that they have been females of childbearing age with out a extremely efficient contraception methodology, simply to say just a few.
Once you have 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 parents are shedding at the very least 5% of physique weight. a meta-analysis (evaluation) of RCTs, most weight reduction totals hovered round a median of 8-10 lbs, with just a few research exhibiting extra important weight reduction, round 25-40 lbs.
In case your purpose is to lose about 5-10% of your physique weight then these medicines may assist you to get there however in case you are on the lookout for extra dramatic weight reduction, these meds most likely received’t assist you to meet your objectives.
It’s additionally essential to acknowledge what occurs whenever you cease taking the medicines. As a result of possibly your insurance coverage will cease protecting it, or you’ll be able to now not afford it, or there’s a scarcity, and so forth.
Research have checked out what occurs whenever 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 courses.
Sounds similar to all of the analysis on what occurs to your weight when you cease doing a food 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 medicines will expertise some unwanted side effects – the most typical 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 just a few days and extra gentle GI unwanted side effects normally resolve inside 8-12 weeks.
These medicines additionally include a black field warning that they will enhance the danger of thyroid tumors. That is primarily based purely on research executed in rodents so we don’t know the way that extrapolates to people, but. There are human research being carried out now however we received’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 side effects like pancreatitis, gallbladder illness, kidney harm, and suicidal ideation. The FDA additionally not too long ago 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 will possibly solely be handled with surgical procedure and may be deadly.
After which there’s the aesthetic reported facet impact persons are speaking about, “Ozempic face”. Because of speedy weight reduction (for some) and certain not getting satisfactory diet, folks 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 authorized 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 will produce it till 2032 so compounding pharmacies don’t have entry to this lively ingredient.
If you wish to take a weight reduction medicine, 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 price.
4. There’s no long-term knowledge on Ozempic.
Let’s not neglect that we have now NO long run knowledge on these medication. Semaglutide was authorized by the FDA for diabetes remedy in 2017 and the longest research I discovered was follow-up with slightly 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 whenever 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 have been hailed as miracle weight reduction medication with no long-term knowledge and have 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 dying.
It’s essential to weigh this when deciding to take the medicine – 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 may be harmful for these with a historical past of an consuming dysfunction or disordered consuming.
This medicine in the end 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 battle with episodes of binging, coming off the medicine may end up in important upswings in starvation, which can make you extra vulnerable to binges.
After which there’s the impression of weight adjustments in your psychological well being. If you happen to don’t drop pounds taking the medicine, you might 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 medicine, that change in physique look could trigger emotional misery and result in disordered consuming.
In the identical approach I wouldn’t suggest a food 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 suggest these weight reduction medicines both. It reinforces the concept that skinny is greatest and ends in insufficient nourishment and diet.
If you’re struggling to get satisfactory diet whereas taking one among these medicines or are debating on taking one among these medicines and would love extra individualized diet assist, our staff would love that can assist you. Ebook a diet evaluation in the present day.
References:
https://pubmed.ncbi.nlm.nih.gov/32441473/
https://pubmed.ncbi.nlm.nih.gov/33567185/
https://maintenancephase.buzzsprout.com/1411126/13747346-ozempic
Consuming Problems & Diabetes: A Give attention to Diabetes Drugs Webinar by Erin Phillips, MPH, RD, CDCES; hosted by EDRD Professional
For extra weblog posts like this try:
The right way 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 Food regimen?
What Is Orthorexia? When Wholesome Consuming Turns into Obsessive
