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Ozempic, Wegovy, and Semaglutide - Some Honest Talk About Weight Loss Drugs

functional medicine functional nutrition information Jul 04, 2023

By Jennifer Engels, MD

By this time, most of us have seen television ads for Ozempic, the widely-prescribed drug used for the treatment of type 2 diabetes. And in a by-the-way sort of fashion, the commercials also mention that the drug may also help you lose weight.

By way of background, Ozempic and Wegovy are two names for the same generic drug, Semaglutide. The Federal Drug Administration approved Ozempic for the treatment of diabetes in 2017, and when the weight loss side effect of the drug became apparent, some physicians began prescribing it “off-label” for some of their obese patients.

Using a medication off-label means that it’s being prescribed for a use other than its original stated purpose, a practice that’s common in the medical profession. An example would be a provider prescribing an anti-seizure medication to help treat a patient’s migraine headaches.
Slightly later in 2021, the FDA approved prescribing Ozempic’s sister drug Wegovy for weight loss for obese individuals who had additional health problems such as high blood pressure or heart disease.

Of the three variants, Ozempic has gained the most notoriety. Various celebrities like billionaire Elon Musk have touted its use in helping them become “ripped and fit,” and on Tik Tok, the hashtag #Ozempic has been viewed over 273 million times, with many expressing their shock and surprise over their drug-induced weight loss.

Meanwhile, numerous online “clinics” have cropped up, making it incredibly easy to get Ozempic without ever setting foot in a doctor’s office and having an in-person consultation with a physician.

So, how do Ozempic and its variants work for weight loss, and are they really the “game changers” that their weight-loss proponents say they are?

Please read on, as I try to address these issues in this article.

How Does Ozempic Work?

Ozempic is in a class of medications known as GLP-1 receptor agonists, or for short, GLP-1 drugs. These medications mimic a hormone that is released in your digestive tract called glucagon-like peptide that lowers blood sugar and promotes a feeling of fullness. And that feeling of fullness can cause you to eat less.

But Ozempic and its variants do more than that. Ozempic changes the way your body responds to food and to weight loss.

As with other articles I’ve written, I don’t want to get too far into the scientific weeds, but think of this common scenario that you may have experienced.

You know you need to lose weight so you diet, increase your exercise, and gradually start shedding some pounds. Often, however, you reach a weight-loss plateau, what’s often called your “weight set point,” the threshold at which your weight loss stops. And no matter how hard you try, you just can’t seem to get beyond that plateau and lose more weight.

The simple explanation for this dilemma is that your weight set point is the weight your body thinks is good for you, and once you reach that weight-loss threshold, your body will fight tooth and nail against further weight loss. Instead, in its defense against additional loss of weight, your body will send in hunger hormones, while suppressing fullness hormones, to maintain the weight your body thinks is good for you, even if your body mass index (BMI) says otherwise!

So, in addition to curbing your appetite, weight-loss drugs like Ozempic change your body’s metabolic reaction to food to help you lose weight and keep it off. As Dr. Scott Butsch, the director of obesity medicine at the Cleveland Clinic explains, “These medications allow your body to seek a lower weight range, and that may not be solely related to reducing your food intake.”

As with many medications, weight loss drugs can produce temporary side effects including, nausea, diarrhea, constipation, dizziness, headaches, and fatigue. But according to Dr. Butsch, these side effects are no riskier than for other medications prescribed for conditions such as diabetes, hypertension, and high cholesterol.

How Effective Are Weight Loss Drugs?

Research has demonstrated that higher dosages of Ozempic - 2.4 milligrams of Semaglutide - can be very effective in helping obese individuals lose weight. In one recent study, obese individuals using the drug lost an average of 34 pounds over a 68-week period. In contrast, participants not taking the drug lost a mere six pounds on average.

There is, however, an important qualifier: If you’re taking Ozempic or its variants for weight loss and you’ve reached your desired weight, you can’t suddenly stop taking the drug. As with any drug, the condition you were treating is likely to recur. In the case of weight loss, suddenly stopping the use of Ozempic or its sister drugs, will in all probability produce a rebound effect causing you to regain the lost weight.

In short, using Ozempic, Wegovy, or Semaglutide to lose weight and keep it off is not a quick-fix, one-and-done thing but involves instead, a protracted, sustained effort.

My Approach at WeCare Frisco

In my practice at WeCare Frisco, I prescribe Semaglutide to my patients needing to lose weight. However, I insist that the use of this medication must be accompanied by a concerted and sustained commitment to lifestyle choices involving proper diet and appropriate levels of exercise. In particular, I encourage my patients to do at least two days a week of resistance training so they will maintain their muscle mass while losing weight.

Through this combination of approaches - medication, proper diet, and exercise - it is possible to confront obesity head-on, lose weight, keep the weight off, and over time very gradually withdraw from the use of the weight-loss medication.

If you’re struggling with weight-related issues and your earlier efforts at weight loss have not been successful, I would like to have the opportunity to work with you.

New patients are always welcome at WeCare Frisco, and I urge you to schedule a Discovery Call to discuss your weight loss goals and plan a path forward to promote your good health.

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“I was absolutely fascinated,” Engels says, “by this new style of medicine that saw the patient as a whole biological system rather focusing on only one organ system at a time, such as Cardiology. This was a complete paradigm shift from conventional medicine and how I was trained.”