GLP-1 Weight Loss Drugs - What To Consider
Unless you are one of those rare smart people who has eschewed all forms of media, social and otherwise, you have probably heard a lot of buzz about weight loss drugs like Ozempic® and Wegovy®.
And with all of the glitter and pixie dust that is being thrown our way about how these drugs are changing lives, I wouldn’t blame anyone for giving them a strong look and so I want to give you some things to consider when making decisions for yourself about these drugs from a registered dietitian nutritionist who has a unique point of view on these medications.
Interestingly enough, in my previous life, I worked for a big pharma company and I promoted a drug that treated type 2 diabetes that worked on a similar pathway but in a different way than drugs like Ozempic® and Wegovy®, which are a class of drugs called GLP-1 analogues.
Please know that in this newsletter, I’m referring to GLP-1 analogues that are being promoted for weight loss in general, and I am talking about the use of these drugs for weight loss alone. These drugs can be used to manage type 2 diabetes very well, and I will make a statement about that later* - but this is not what this blog is about.
The first thing I think is important to understand when considering these medications is HOW they CAN lead to weight loss. There is actually nothing about this drug that directly is doing anything to body fat. It is not “melting fat away.” This drug works by mimicking a hormone (GLP-1) that your body already makes, and gives you a super big dose of it.
GLP-1 delays gastric emptying, which means it slows down the rate food leaves your stomach, thus leaving you feeling fuller longer.
This is also why the drug makes many people feel nauseated and can even lead to vomiting.
So the weight loss is likely coming from people not feeling like eating.
Now, in the meantime, has anything happened to the amount or types of energy your body needs?
Nope.
So depending on the person, this drug may put them in a forced state of malnutrition. And I have seen this happen in clients who started exhibiting symptoms of malnutrition while using the medication.
This is also one of the reasons why these medications have what is called a high discontinuation rate, meaning most people who start them do not stay on the medication for longer than a year. I have had clients describe this feeling as reminiscent of persistent pregnancy nausea.
The other thing that I think is important to think about is how long you plan to stay on the medication.
There seems to be people that think “I will do this to lose weight and then I will go off the drug and maintain my weight loss.”
Studies are showing that weight regain is common in individuals who stop the medication, and as we already established, a lot of people are stopping the medication.
Like any other method used to lose weight where intake is restricted (forced or otherwise), the expected response is to eat a lot when the restriction is over. The body is desperate for food, the brain is desperate for food, often satisfaction has been missing. When the desire to eat returns, it does not surprise me that it is difficult to maintain the weight lost.
It is similar to what we see with other restrictive diets. If you have tried a lot of things to lose weight in the past and have regained the weight lost, please know that it is not you, you don’t have a lack of willpower or self control, the long term “success” rate of weight loss attempts is very low for most people.
*Now for that statement about people with type 2 diabetes and blood sugar management, these drugs can be helpful because in people with type 2 diabetes the action or the amount of GLP-1 can be lower. At the right dose that balances side effects so the patient can still nourish themselves adequately, these drugs can be a very useful tool for blood sugar management in people who have type 2 diabetes.