I have been watching celebrities like Oprah, Jim Gaffigan, Kelly Clarkson, and Meghan Trainor shrink. At first, I wondered – what are they doing differently? Then, it became apparent that the sudden and persistent weight loss was due to something specific. And each celebrity eventually admitted to one thing – Ozempic (or its associated GLP-1’s or generics).
So, what exactly is Ozempic, or Mounjaro, or Trulicity, or Wegovy? Just to name a few hot labels. They are GLP-1 agonists. Which means “Glucagon-like peptide-1” for long hand. They are a class of injectable drugs (yes, that means needle injected under the skin typically into the belly, outer thighs, upper buttocks and the backs of arms daily or once a week). These medications treat type 2 diabetes and often obesity. Probably more often used for weight loss lately.
These medications were approved by the Food and Drug Administration (FDA) in 2005. It is important to note per the Cleveland Clinic “GLP-1 agonists alone can’t treat Type II Diabetes or obesity. Both conditions require other treatment strategies, like lifestyle and dietary changes.”
So how does it work? GLP-1 is a naturally occurring hormone located in the small intestine. It will:
- Trigger insulin release from the pancreas.
- This is a big method of action for type II diabetics (GLP-1’s have not been approved yet for type I diabetics yet). That being said – you should have tried metformin oral medication FIRST and it did not succeed before jumping to a GLP-1 if you are a type II diabetic.
- Blocks glucagon secretion, which is another hormone naturally occurring in the body that raises blood sugar levels when needed. So the GLP-1 will prevent more glucose from being released into the bloodstream.
- Slows stomach emptying. This will, in turn, slow digestion and release less sugar from food eaten and then released into the bloodstream.
- This effect may increase the likelihood of acid reflex and also issues with enamel degradation of the teeth and possible tooth decay.
- Increase the feeling of fullness after eating. GLP-1 affects the part of the brain affecting hunger and satiety (that feeling full feeling after eating).
- This is the big one for weight loss – it keeps you from eating, and affects appetite and hunger
Obesity is the big factor for GLP-1 prescription. This is a BMI of 30 or higher. Sometimes a provider may prescribe a GLP-1 for overweight (with a BMI of 25-29.9) WITH other comorbidities (or health conditions).
That being said, obesity cannot solely be addressed with a GLP-1. You cannot forget:
- Dietary changes (including eating more fruits and vegetables and eating a cleaner, healthier diet). Starving yourself with the use of a GLP-1 is NOT HEALTHY. Your body needs essential nutrients, vitamins, and minerals to survive. Starvation is not a healthy option for health especially in the long term.
- Exercise.
- Behavior modification programs
- Sometimes bariatric surgery.
Risks! There are potential side effects of a GLP-1. They can include:
- Loss of appetite, nausea, vomiting, diarrhea
- Low blood sugar events/hypoglycemia
- Dizziness
- Increased heart beat
- Infections
- Headaches
- Indigestion
- Pancreatitis
- Medullary thyroid cancer
- Acute/sudden injury to the kidneys
- Worsening diabetic retinopathy/eye disorder
- Allergic reaction
- Injection site reactions/itchiness
- Not safe during pregnancy
My take:
If you are a type II diabetic and obese, and nothing has worked for you, and your doctor has recommended the use of a GLP-1, it is worth a shot. But, if you are just a little overweight, and want to lose a few pounds, I don’t think this is a healthy option. Everyone, forever, has been looking for quick fixes to lose weight. How did amphetamines work in the 80s? And crash dieting since kingdom come? If you are looking for a quick fix to lose weight, this is not the best, healthiest, or long term option you should look for. An active lifestyle, coupled with a healthy, well balanced diet of a variety of fruits, vegetables, lean meats and diary, etc are the way to go! Anything, in moderation, is fine. And that even includes occasional (and I mean occasional) sweets, alcohol, and greasy burgers. Make good choices!!!!!!!!!
Heal today, transform tomorrow. Unlock your potential to heal, learn and grow. – Dr. Barb Wally, LLC
References:
- GLP-1 Agonists. Cleveland Clinic. (n.d.) https://my.clevelandclinic.org/health/treatments/13901-glp-1-agonists
Note: These blog articles are not in exchange for a one on one Physical Therapy visit. Please contact me if you are interested in receiving a Physical Therapy visit!
*This content is original and copyright Dr Barb Wally, LLC*
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