The introduction of glucagon-like peptide-1 (GLP-1) receptor agonists, comparable to semaglutide (Ozempic and Wegovy) is a breakthrough within the administration of weight problems. These drugs have confirmed to be very efficient in selling weight reduction and enhancing blood sugar ranges.
Whereas lots of people might imagine that I’ve one thing towards GLP-1s – whether or not as a result of they’re ‘competitors’ for my observe (they aren’t), or that possibly I don’t agree with utilizing prescribed drugs over weight-reduction plan for weight reduction. I wrote all about that right here.
I consider the brand new class of weight reduction drugs are unbelievable instruments that can assist to vary individuals’s lives for the higher. However they aren’t your complete puzzle; they’re solely only a piece, and there are some very actual limitations to their use.
Latest analysis suggests that weight problems charges within the US have dropped very barely – from 46% in 2022 to 45.6% in 2023. There was a 700% improve in using GLP-1 agonist drugs between 2019 and 2023.
Though even a 0.04% change in weight problems charges might point out a common downward pattern which may be attributed partially to GLP-1 drugs, there are good causes to consider that these medicine won’t drastically scale back the prevalence of weight problems…a minimum of, not now. However why?
The reply to this query is multifaceted and complex.
Limitations of GLP-1 Medicines in Addressing Inhabitants-Large Epidemic
Price and Accessibility: These drugs are tremendous costly – as in, over $15,000 a yr in some instances. It is a large barrier for individuals who can’t afford to pay out of pocket, or who don’t have personal insurance coverage protection. Even for these with personal insurance coverage, firms usually cap spending or length for GLP-1 drugs. Whereas some individuals qualify for GLP-1 meds via Medicare or Medicaid, many don’t.
A current listening to of the US Senate Committee on Well being, Training, Labor, and Pensions revealed that Ozempic prices 15x extra in the US than in Germany. Information on affected person discontinuation of GLP-1 receptor agonist drugs is inconclusive, however numbers vary from round 50% inside 3 months to 75% by the two yr mark. The explanations for going off the meds embrace value, unintended effects, or sluggish weight reduction.
In different phrases, so many individuals who would probably profit enormously from these drugs, simply can’t entry them in any respect, or for lengthy sufficient. Entry is decrease for individuals in sure racial and ethnic teams, that are additionally the teams which have the very best charges of weight problems (and the bottom entry to healthcare total).
The patents for a number of of those drugs are up in March, 2026, that means that inexpensive generic variations of semaglutide will probably be available on the market shortly after that. Will they be way more inexpensive? Solely time will inform.
Sustainability of Results: Whereas GLP-1 drugs are efficient for weight reduction, analysis means that these drugs are in all probability a long-term dedication. For many individuals, their advantages are contingent on continued use. A examine from the STEP 1 trial highlighted that two-thirds of the load misplaced utilizing semaglutide was regained inside a yr after remedy discontinuation. Because the numbers point out, some weight regain is probably going, however that’s not essentially true for everybody.
Once I work with shoppers who’re on GLP-1 agonist drugs, we focus not solely on meals, but additionally on relationship with meals and with way of life adjustments comparable to rising bodily exercise.
Limitations on Efficacy of GLP-1 Agonist Medicines: Based on Dr. Spencer Nadolsky, D.O. and Weight problems and Lipid Specialist, these meds do have their limits.
Proper now, the common is round 20% weight reduction with Tizepatide (Mounjaro). For a 400 pound particular person, that may imply 80 kilos misplaced. That particular person nonetheless has weight problems.
Along with this, Dr. Nadolsky bolstered the truth that not everybody responds to those drugs.
Root Causes of Weight problems: Weight problems is pushed by complicated components, together with socioeconomic disparities, meals system points, and sedentary existence. Conversely, GLP-1 drugs primarily goal processes comparable to urge for food regulation and insulin sensitivity. These are clearly necessary, however to essentially impact change on weight problems charges, there needs to be a complete focus not solely on pharmacology, but additionally public well being interventions. A 2023 evaluation in Nature Drugs proposed that initiatives to handle this situation which have 4 elements: informing the general public about vitamin, enabling them to make health-promoting decisions, motivating them to make adjustments to their routines and habits, and influencing behaviour by way of social norms and different strategies.
The evaluation recommended rising lively transport, rising healthcare payor incentives, enhancing entry to and affordability of wholesome meals, limiting availability and media advertising of high-calorie meals, enhancing meals labeling, reformulating meals merchandise to be extra healthful, and rising entry to weight administration applications and bariatric surgical procedure.
Facet Results and Contraindications: Frequent unintended effects of GLP-1 drugs, comparable to nausea, vomiting, and gastrointestinal discomfort, can deter adherence. Moreover, these medicine are contraindicated for people with sure situations, comparable to kidney illness, sure cancers, and a historical past of pancreatitis.
The Function of Dietary Interventions
GLP-1 drugs are efficient for most individuals, however adjustments in weight-reduction plan do must be a part of their use. Dietary methods can improve the efficacy of remedy whereas supporting long-term well being.
Listed below are some ideas for consuming whereas on a GLP-1 drugs:
Prioritize Protein and Fiber: GLP-1 drugs sluggish gastric emptying, selling early satiety. Which means most meals and snacks needs to be nutrient-dense to keep away from nutrient deficiencies and promote total well being. A weight-reduction plan wealthy in lean proteins (e.g., meat and fish, tofu, eggs, Greek yogurt and ricotta, beans and lentils) helps to keep up muscle mass. Getting ~25+ grams of fiber per day from greens, complete grains, and fruits, helps maintain fullness and helps blood sugar management. Don’t sleep on beans or soy meals as a strategy to get high-quality protein and fibre in a single place!
Reduce Extremely-Processed Meals: Processed meals excessive in refined carbohydrates, added sugars, and unhealthy fat can counteract the advantages of GLP-1 drugs. I like to recommend specializing in complete, minimally processed meals to enhance total metabolic well being. That additionally means minimizing alcohol and different lower-quality meals to assist maximize vitamins in your weight-reduction plan.
Hydration and Small, Frequent Meals: Individuals on GLP-1 drugs usually expertise nausea, which might be mitigated by staying hydrated and consuming smaller, extra frequent meals. On nauseous days, incorporating meals which might be light on the abdomen, comparable to soups and smoothies, might help.
Aware Consuming Practices: GLP-1 drugs scale back urge for food, creating a possibility to observe conscious consuming. Slowing down throughout meals, savoring meals, and listening to starvation cues might help reinforce wholesome consuming behaviors.
Rising Weight Loss Medicines
Along with current GLP-1 receptor agonists, a number of promising weight reduction drugs are below improvement or awaiting approval:
- Orforglipron Eli Lilly is growing Orforglipron, an oral GLP-1 receptor agonist. This treatment may present an alternate for sufferers preferring to not use injectables.
- CagriSema (Cagrilintide/Semaglutide Mixture) Novo Nordisk is advancing this mix remedy, exhibiting vital weight reduction results in early trials.
- Retatrutide Retatrutide is a triple-hormone receptor agonist, with early research reporting substantial weight discount.
- VK2735 Viking Therapeutics is exploring VK2735, an oral remedy with promising preliminary outcomes.
Conclusion
GLP-1 drugs provide vital advantages for people fighting weight problems, however they don’t seem to be a panacea for the broader epidemics. Addressing these complicated, multifactorial challenges requires a complete method that mixes medical innovation with sturdy public well being efforts. By integrating dietary methods, selling equitable entry to care, and tackling systemic points, we are able to make significant progress towards reversing the tendencies in weight problems.
Are you on the lookout for assist together with your vitamin? I’m taking new shoppers in my 1:1 observe. Get extra info and e-book a session right here.
Do you know? I even have an internet course for vitamin in perimenopause and menopause known as Don’t Sweat It. Get extra info and enroll right here.