By now, most of you acknowledge that typical weight reduction recommendation—minimize your energy; transfer extra, eat much less; all the things sparsely; eat many small meals each two hours all through the day, and so on.—is ineffective and doesn’t result in long-term weight reduction success. In reality, it’s properly established that such recommendation doesn’t work and causes well being to deteriorate, to not point out it makes you depressing, preventing towards the incessant starvation it creates. Ineffective recommendation from healthcare suppliers due to this fact 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, resembling Ozempic, Wegovy, Rybelsus, and Mounjaro, are skyrocketing in recognition as a consequence of their weight reduction results. Persons are scrambling to acquire these medicine, anticipated to be a $19 billion/12 months alternative for the pharmaceutical trade briefly order. Regardless of their recognition, I query whether or not these medicine ought to have been authorized by the FDA within the first place, given their long-term potential for harmful well being results. So let’s take into account this wildly standard class of medication and the consequences they wreak on well being.
Initially meant to scale back blood glucose in sort 2 diabetics, it was famous that substantial weight reduction additionally happens. In a single current medical 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 applications like Weight Watchers, Noom, and Calibrate embraced the medicine, including them to their applications (making you surprise, if all these applications need to depend on a drug, what’s the aim of this system when you may 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’ll cowl the prices of the medicine authorized 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 per thirty days). 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 so on.), 50% is stomach visceral fats, the fats answerable for many 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 so on.). In different phrases, the medicine are usually not selective for essentially the most problematic type of fats, stomach visceral fats. Metabolic advantages on blood glucose, blood strain, and so on. are due to this fact restricted. Recall that stomach visceral fats, not subcutaneous fats, is answerable for producing insulin resistance that causes weight achieve, blocks weight reduction from fats shops. Preferentially dropping stomach visceral fats that results in diminished insulin resistance would due to this fact speed up weight reduction; the GLP-1 agonists are usually not selective for stomach visceral fats.
One other problematic subject: Of the 30 kilos misplaced, roughly 10 kilos is muscle—that’s numerous muscle. Take into consideration 10 kilos of beef and dropping that quantity out of your arms, chest, again, thighs, face. Not solely are you weaker, much less assured in navigating stairs, mountaineering, finishing up garden work, and so on., you’re additionally extra liable 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 respiratory, gastrointestinal digestion, upkeep of physique temperature, and so on., physique actions which can be ongoing and beneath aware path. Lack of muscle due to this fact 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 an absence of sources, hunger, and metabolic price is diminished to make sure your survival. Nevertheless it additionally ensures weight regain—even when you keep a low-calorie life-style. Shedding muscle mass with weight reduction is due to this fact a pivotal and crippling growth of any technique of lowering energy, whether or not it’s a GLP-1 agonist, a bariatric process, or calorie restriction. You will regain the burden.
Worse: While you regain the burden, it’s principally 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 due to this fact in worse form metabolically after the drug than you have been earlier than taking it. Your threat for situations resembling 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 might have doubtless 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 due to this fact have a selection: Cease the drug after spending hundreds of {dollars} and regain the burden or keep on the drug eternally, paying the pharmaceutical trade lots of of hundreds of {dollars} over time to take care of your extra slender weight. Think about a most cancers chemotherapy drug that doesn’t treatment 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 reduce weight acknowledge what occurs to your look once you lose subcutaneous fats and muscle from the face and elsewhere: You look 10-20 years older.
But strategies to particularly goal lack of stomach visceral fats can be found. Methods to extend lean muscle mass with out train can be found. In brief, you’ll be able to obtain slenderness, restore youthful muscularity, get pleasure from regular wholesome physique composition. Nevertheless it received’t contain medicine, procedures, or the misguided recommendation of your physician. Return by way of the various discussions I’ve posted on this weblog and elsewhere and it can save you your $15,000 and keep away from antagonistic 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 fashionable life, and others, all pure however missing in most individuals’s lives—can be found, efficient, secure, and restore a number of facets of well being and youthfulness.