By now, most of you acknowledge that typical weight reduction recommendation—lower your energy; transfer extra, eat much less; every thing carefully; eat many small meals each two hours all through the day, and many others.—is ineffective and doesn’t result in long-term weight reduction success. In truth, it’s effectively established that such recommendation doesn’t work and causes well being to deteriorate, to not point out it makes you depressing, combating towards the incessant starvation it creates. Ineffective recommendation from healthcare suppliers subsequently opened the door to pharmaceutical brokers and bariatric procedures for weight reduction, incentivizing healthcare suppliers to the movement of revenues into their pockets.
The brand new class of GLP-1 agonist medicine, equivalent to Ozempic, Wegovy, Rybelsus, and Mounjaro, are skyrocketing in recognition resulting from their weight reduction results. Persons are scrambling to acquire these medicine, anticipated to be a $19 billion/12 months alternative for the pharmaceutical business in brief order. Regardless of their recognition, I query whether or not these medicine ought to have been accredited by the FDA within the first place, given their long-term potential for damaging well being results. So let’s take into account this wildly in style class of medicine and the consequences they wreak on well being.
Initially supposed to cut back blood glucose in sort 2 diabetics, it was famous that substantial weight reduction additionally happens. In a single current scientific trial, for instance, as soon as weekly injections (solely Rybelsus is oral; all others are injectable) led to 52 kilos misplaced over a 12 months and a half. This ignited wild and unprecedented demand for these medicine, a lot in order that many weight reduction packages like Weight Watchers, Noom, and Calibrate embraced the medicine, including them to their packages (making you surprise, if all these packages should depend on a drug, what’s the aim of this system when you’ll be able to simply go to your main care physician and get a prescription?). Three medicine on this class, Wegovy, Saxenda, and Mounjaro, have been FDA-approved for a weight reduction indication, whereas the others are used off-label, that means that healthcare insurers might want to resolve whether or not they may cowl the prices of the medicine accredited for weight reduction, spreading out the prices to you and me as payers of healthcare insurance coverage premiums.
Let’s put apart the side-effects (nausea, vomiting, diarrhea, pancreatitis) and absurd prices (sometimes $1000 to $1500 monthly). Let’s take into account the long-term penalties of taking these medicine.
Say you spent round $15,000 over one 12 months by injecting one among these medicine and misplaced 30 kilos. Of that 30 kilos, about 50% of misplaced fats is subcutaneous (buttocks, thighs, arms, chest, and many others.), 50% is belly visceral fats, the fats chargeable for a lot of the issues related to extra weight (insulin resistance, sort 2 diabetes, cardiovascular threat, fatty liver, elevated threat for Alzheimer’s dementia, breast most cancers, stroke, and many others.). In different phrases, the medicine will not be selective for essentially the most problematic type of fats, belly visceral fats. Metabolic advantages on blood glucose, blood strain, and many others. are subsequently restricted. Recall that belly visceral fats, not subcutaneous fats, is chargeable for producing insulin resistance that causes weight acquire, blocks weight reduction from fats shops. Preferentially shedding belly visceral fats that results in lowered insulin resistance would subsequently speed up weight reduction; the GLP-1 agonists will not be selective for belly visceral fats.
One other problematic difficulty: Of the 30 kilos misplaced, roughly 10 kilos is muscle—that’s a whole lot of muscle. Take into consideration 10 kilos of beef and shedding that quantity out of your arms, chest, again, thighs, face. Not solely are you weaker, much less assured in navigating stairs, climbing, finishing up garden work, and many others., you might be additionally extra vulnerable to falls, fractures, and frailty over time. Muscle mass is the first determinant of basal metabolic price (BMR), i.e., the speed at which your physique “burns” energy to maintain the work of respiration, gastrointestinal digestion, upkeep of physique temperature, and many others., physique actions which might be ongoing and beneath aware path. Lack of muscle subsequently sometimes results in 15-27% discount in BMR, an impact that persists for a lot of years after muscle loss. It’s a survival mechanism: a discount in calorie consumption is perceived by your physique as a scarcity of assets, hunger, and metabolic price is lowered to make sure your survival. But it surely additionally ensures weight regain—even when you keep a low-calorie life-style. Dropping muscle mass with weight reduction is subsequently a pivotal and crippling growth of any methodology of decreasing energy, whether or not it’s a GLP-1 agonist, a bariatric process, or calorie restriction. You will regain the load.
Worse: If you regain the load, it’s largely fats. Of the ten kilos of muscle you misplaced, you’ll regain, at finest, 5 kilos of muscle together with round 25 kilos of fats. You’re subsequently in worse form metabolically after the drug than you had been earlier than taking it. Your threat for circumstances equivalent to coronary coronary heart illness and coronary heart assault, sort 2 diabetes, cognitive impairment and dementia, breast most cancers, hypertension and others is elevated. Had the FDA required long-term follow-up proof for the consequences of those medicine, they’d have seemingly acknowledged that these medicine enhance mortality, i.e., they enhance potential for quite a few ailments and shorten your life.
With GLP-1 agonists, you subsequently have a selection: Cease the drug after spending hundreds of {dollars} and regain the load or keep on the drug ceaselessly, paying the pharmaceutical business a whole bunch of hundreds of {dollars} over time to keep up your extra slender weight. Think about a most cancers chemotherapy drug that doesn’t remedy the most cancers, however retains it from rising and metastasizing. Cease the drug and the most cancers grows and spreads, finally killing you. Keep on the drug at the price of many hundreds of {dollars} and it retains the most cancers managed. You’re, in impact, held hostage by the drug and the pharmaceutical firm. That is how it’s with the GLP-1 agonists.
And wait till all these Hollywood varieties who inject GLP-1 medicine to drop some weight acknowledge what occurs to your look while you lose subcutaneous fats and muscle from the face and elsewhere: You look 10-20 years older.
But strategies to particularly goal lack of belly visceral fats can be found. Methods to extend lean muscle mass with out train can be found. Briefly, you’ll be able to obtain slenderness, restore youthful muscularity, take pleasure in regular wholesome physique composition. But it surely received’t contain medicine, procedures, or the misguided recommendation of your physician. Return via the various discussions I’ve posted on this weblog and elsewhere and it can save you your $15,000 and keep away from hostile well being results whereas having fun with youthful slenderness. The concepts I initially articulated in my Wheat Stomach books are a begin. However, since then, the methods we use to regain youthful physique composition—increase oxytocin with restoration of L. reuteri, push again SIBO by restoring microbes that colonize the small gut and produce bacteriocins, add the body-shape modifying results of collagen peptides and hyaluronic acid absent from trendy life, and others, all pure however missing in most individuals’s lives—can be found, efficient, secure, and restore a number of elements of well being and youthfulness.
