GLP-1 Agonists Ozempic, Wegovy, Mounjaro…What to Think?

Many of you are probably wondering what I think about the hype that has been spreading about the once per week injections that demonstrate remarkably better effectiveness in assisting with weight loss than any medicine that has ever come before them. This much does seem true, and we all know how significant extra weight can be on many short and long term health outcomes. So when a tool like this becomes available, it is worth taking a serious look at it.

The first of these medicines to be approved was exenatide (Byetta) in 2005, so while these medicines may seem new, that have been on the scene for almost 20 years now, though their use has been limited until recently to those with diabetes. Unlike certain medicines like insulin which can cause weight gain while lowering blood sugar, these medicines actually induce a weight loss.

In many ways, it makes sense that more widespread use is now being considered not just for diabetes, but for pre-diabetes and pre-diabetic conditions such as weight gain. After all, we must look at all of these as a spectrum. And we need to move away from the idea of treating illness only once it is already in its end stages. There are just too many problems that can be solved only if we are to actually transition to a system that puts resources into preventative and optimal health, rather than managing end stage disease. 

One does not get diabetes overnight- at least when it comes to Diabetes Type II which is close to 95% of the cases compared to Diabetes Type I. Also, it is not wrong to say that even Diabetes Type I has some potentially preventable causes, but certain Diabetes Type II is an eminently treatable condition- enormously responsive to relatively simple lifestyle changes such as nutrition and exercise. And considering the staggering statistics and alarmingly rising percentage of obesity and pre-diabetes, even in young children, we are definitely in a crisis.

Which brings us back to the GLP-1 Agonists. I recently had a patient send me a message saying “I just wanted to reach out and say thank you. I feel so much better already from the medication. It has literally almost eliminated my sugar cravings. I feel so much more balanced in my life. It’s a little overwhelming that I could feel this good. I just wanted to give you the feedback.”

This was a patient who had been sober from other drugs for decades and dedicates her life to helping others with addictions. Many of us at least pay lip service to how addictive sugar is. But really think about it. How can we know that on some deep level and yet still continue to indulge, or laugh it off, or reward a one year old at their first birthday party with a load of sugar, sealing in not only a physical but also an emotional connection with this drug before many of them have even learned to walk?

This leads us to the key point that I discuss with all my patients whenever we explore these medicines and begin to talk about the risks and benefits. There is something about the way these medicines work that may be able to help us break away from our addiction to the types of foods that are driving metabolic imbalance and the staggering financial and health consequences they bring.

That is the key. These medicines are a tool. They are an opportunity to free ourselves from the unhealthy, toxic foods that are ultimately what cause weight gain. They should not be looked at simply as a way to be able to eat less, but to eat the right foods, and to realize you enjoy the healthy foods more than the guilty “pleasures”. They are a chance to close the door on old patterns and embrace a new way. There is a growing industry of organic, regenerative farmers and food producers who are trying to do right for your body and for the planet by producing real food. This is a chance to invest your dollars in those foods, and help power this movement while doing right by yourself.

As always, we are here to help answer your questions and empower you to find clarity within a health and nutrition landscape that can be confusing and contradictory. If you are thinking that this might be an opportunity for you, of course we would be happy to discuss the potential risks and benefits and whether it could be appropriate based on your individual situation. If so, we can help you navigate the dosing and nutrition plan and the nuances and tricks that would help you have the most success with the minimal amounts necessary.

Posted by Dr. Rob

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