As a doctor specializing in obesity and obesity, I see how drugs are loved Ozympic, WegsAnd their forefathers have completely changed the landscape for the struggling people Type-2 diabetes and obesity. Meanwhile, people still don’t really understand how it works and there are major misconceptions floating around; Especially on social media. All I know is that the drugs on the market right now are just the beginning – more alternatives will come soon and may be even more effective.
The one already prescribed is Mounjaro, although at this stage, it’s technically FDA-approved to treat type-2 diabetes, like Ozempic. By summer 2023, Mounjaro (commonly known as Tirzepatide) will probably be official. FDA approved for weight loss Also (seems to be one more major study on safety and efficacy).
Mounjaro, like Ozempic, is currently prescribed off-label. Obesity treatmentEspecially given the recent shortage of Wegovy, which is FDA approved for obesity. Wegovy and Ozempic are the same drug semaglutide—they’re just different doses. Wegovy has been shown to help people lose 15 percent of their body weight. At certain doses, Mounjaro can cause a 21 percent loss of body weight. These results are fast approaching Bariatric surgery You can do it.
The reason why Mounjaro is more powerful is probably because it employs more. Weight loss Methods from Wegovy. Ozympic and Wegovi belong to a class of drugs called glucagon-like peptide-1 (GLP-1) agonists. GLP-1 is produced naturally in the gut and sends satiety signals to the brain. These drugs work like GLP-1 in the body and can suppress appetite, so they lose weight (“agonist” means a drug that binds to a receptor in or on the cell and acts in the same way as a substance that normally binds to the receptor). These drugs help the pancreas to produce InsulinThis helps to lower blood sugar levels for people with diabetes.
Munjaro, on the other hand, is GLP-1/GIP agonist, which means that in addition to acting like GLP-1 in the body, it mimics the gastric inhibitory polypeptide (GIP) that causes insulin secretion. . Although there is a debate about how it works, in this case, the addition of GIP may increase the effectiveness of GLP-1, which creates an additional weight loss effect.
The future of obesity medicine is all about preparing compounds or combining compounds that are related to food cravings in the body and even possible. Metabolic ratenutrient partitioning (how your body chooses which fuel to store), and Lean muscle mass retention. There are many new compounds in the pipeline currently under research, with the goal that each new compound can produce significant weight loss with minimal side effects. Treatments that do not need to be taken frequently are also in the works.
CagriSema (combination of cagrilintide and semaglutide) It looks very promising. Cagrilintide also affects satiety by mimicking the hormone amylin from the pancreas.
Another is retatutride, which is a GLP-1/GIP/glucagon agonist. This compound is similar to tirzepatide, but it goes one step further by adding to the glucagon agonism. The added glucagon agonism helps with energy expenditure, which allows people to do so Burn more caloriesAppetite suppression.
In addition to the new compounds being investigated, there are ongoing studies to determine how high doses of the current GLP-1 agonists are tolerated. And as many of these compounds begin to be tested and approved for type-2 diabetes and later tested and approved specifically for obesity, this order may be changing. A compound called AMG-133Antibodies with a GLP-1 agonist, unlike tirzepatide, inhibit instead of increasing GIP, it seems to be happening. First studied obesity.
It may seem like it, but these drugs did not come out of nowhere. Ozimpic, Wegovi and Munjaro are the result of decades of research and development. The first GLP-1 agonist was Since its approval in 2005, a series of new compounds have been marketed every few years. First was exenatide (Baita), then liraglutide (Saxenda and Victoza), then dulaglutide (Trullity), then semaglutide (Ozimpic and Wegovi), and then tirzepatide (Mounjaro).
It’s important to set the record straight before the next generation of drugs comes along: this isn’t just an out-of-control pharmaceutical-industry weight-loss fad. Let me address a few of the many myths surrounding these new-of-the-zeitgeist-but-not-new drugs.
Myth 1: People should not use drugs like Ozempic and Mounjaro just for weight loss.
Obesity a Chronic disease. It’s been classified as such since the 1990s because the body fights it when people try to lose weight, and excess weight increases the risk of many health problems, including type-2 diabetes. Cardiovascular eventscovid-19 complications and more.
Yet for decades our society has shamed people who are overweight. Their weight is said to be a reflection of not eating healthy foods and not exercising. This is mostly due to Weight discrimination It covers every aspect of our culture, from television shows to health care.
Weight stigma affects people with large bodies in many ways. Studies have shown that people classified as obese are more likely to be exposed. Discrimination in the workplace and rejection in health care facilities. But another way weight stigma hurts plus-sized people is the judgment associated with getting obesity treatment — whatever it is. Bariatric surgery Or now, using an FDA approved weight loss drug. It is seen as a “crutch” or “easy way out” when it couldn’t be further from the truth. Just as you wouldn’t tell a person with type-2 diabetes that they should feel bad about injecting insulin, you shouldn’t tell an obese person that they should feel bad about using drugs to treat obesity.
It’s true that most of the GLP-1 agonists on the market are approved as type-2 diabetes drugs, and not all of them are approved for obesity yet—but it’s a big misconception that people shouldn’t take them. Weight loss Alone. We know semaglutide is FDA approved (in Wegovy form) in 2021. Ozympic (The same compound) is safe and works for weight loss.
In Wegovy shortages, people can work with their doctor to see if an off-label prescription is right for them. Obesity should be taken as seriously as any other disease, and people struggling with it have the same right to medicine as anyone else.
Myth 2: You can take these drugs to lose weight, then quit.
Another big misunderstanding about these drugs is that they are a “quick fix”, you can use them to lose weight and then stop taking them. In fact, they only work if you take them consistently, similar to a blood pressure medicine or other Chronic disease Medicines. They are meant to be taken indefinitely, and going on and off these medications can have a yo-yo effect on appetite and weight. There may be some people who are able to wean themselves off of these drugs, but most need to stay on a very small dose.
By addressing one of the keys to long-term weight loss—controlling appetite—these drugs allow people to follow the lifestyle they already know to lose weight. Most people know Eating apples instead of chips It’s probably a good idea if you’re trying to lose weight. But even if they have the knowledge, why can’t they do it? It’s because the mind is so powerful that it touches people to eat them. Large rooms And high-calorie foods, especially a Genetic predisposition to obesity. Some people can. Practice moderation with these foods. Some people can abstain. No matter how hard they try, they cannot.
When people who struggle with obesity—despite the best training and advice—try these drugs, they feel what it must be like to not struggle with appetite and weight. They say they feel “normal”. They still have to do it Healthy lifestyle choices And work hard to lose weight. But you can do it without starting at a loss.
Obesity medicine can go a long way toward improving the lives of people with obesity-related health problems—but only if we let it. Currently, only 30 percent of insurance covers these drugs, another misconception is weight stigma and obesity. Just a matter of lifestyle He continues to hurt people.
Myth 3: These drugs are great if you’re trying to lose 15 pounds or 100 pounds.
People without a diagnosis of type-2 diabetes or obesity These drugs should not be sought. Not only does it exacerbate supply issues for people with real medical conditions who are dependent on these drugs, there are also risks. If a person who wants to lose a few pounds takes on more than just excess fat, they may be underweight and have less bone and muscle mass. Although the drugs are relatively safe, there can be unpleasant side effects—mainly nausea.
The use of these drugs requires the supervision of a qualified physician. I don’t trust a doctor to help you get a drug you don’t need, especially if you order it from a compounding pharmacy (which not only dispenses the drugs, but manufactures them, which poses a risk of contamination).
It is true. Diet and exercise They only work for a minority of obese patients who want to lose weight, because they are incredibly difficult to stick with. With these new devices, there’s now another option—relatively safe, non-invasive, effective—to help people lose weight and keep fighting.
At the end of the day, everyone should have full autonomy over their own bodies. A person classified as overweight, but healthy and happy You should not feel pressured to lose weight Or they are discriminated against because of their size. At the same time, people who are suffering and need change should not feel ashamed or hindered from accessing tools that can help.
Spencer Nadolsky, DO, is a board-certified obesity and lipid specialist. He is the medical director. Join Sequence.com, which helps deliver holistic obesity treatment accessible online. You can follow him on Instagram. @drnadolsky.