The United States and much of the industrialized world has an obesity problem. The environment is obesogenic. The food is delicious and engineered by PhDs to target and titillate our brain reward systems. The portions are enormous. Half of our waking hours are devoted to sitting slumped over in a chair staring into an electronic device\u2014for work and for pleasure. We eat carbs we don\u2019t need, use seed oils in quantities our bodies haven\u2019t adapted to handling, and largely avoid the most important food our ancestors evolved consuming: animal protein. The cheapest food is the worst and the healthiest is the most expensive.<\/p>\n
It\u2019s a big mess, and many people resist the dietary and lifestyle changes required to fix the issue. It\u2019s no wonder many people have been hoping for a pill or medication that fixes the obesity problem.\u00a0<\/span><\/p>\n Over the last few years, scientists appear to have found a class of medications that can help: GLP-1 agonists like semaglutide (sold as Ozempic\u00ae and Wegovy\u00ae) and liraglutide (aka<\/em> Victoza\u00ae and Saxenda\u00ae)<\/strong>. Hollywood celebrities and fashion models are taking these drugs in vast quantities. Silicon Valley tech circles are taking them\u2014Elon Musk, most famously, is on semaglutide. In short, almost everyone with the money and access and weight to lose is using semaglutide and related drugs to stay thin. I know several docs who prescribe it for overweight patients.<\/p>\n Originally designed as diabetes drugs, these agents mimic the effects of glucagon-like peptide-1, an incretin hormone the body releases when you eat food. GLP-1 has two primary effects:<\/p>\n GLP-1 is a hormone that \u201csignals\u201d fullness. There are all sorts of positive downstream effects as well:<\/p>\n The new weight loss drugs bind to the receptors that normally interact with GLP-1 and elicit the same effect as the hormone itself.\u00a0<\/span><\/p>\n Yes. They work. Out of all the weight loss drugs the industry has pushed and tested and tried, the GLP-1 agonists actually help people lose weight.<\/p>\n A recent paper tested semaglutide for two years in obese people. The average starting body weight was 106 kilos, or 233 pounds. Average starting BMI was 38. Most were women. One group got the drug, the other got placebo. Both groups were counseled to follow a \u201cbehavioral intervention,\u201d which probably means exercise and other typical things.<\/p>\n By 104 weeks, the semaglutide group had lost an average of 15.2 percent of their bodyweight. The placebo group had lost an average of 2.6 percent.<\/p>\n Now, this didn\u2019t make them thin. At the end, most were still overweight or obese. 15 percent of 233 pounds is about 35 pounds. That\u2019s a great improvement, but it\u2019s not enough to get you to a normal body weight. Furthermore, there was a major plateau of weight loss in the semaglutide group around 68 weeks. They didn\u2019t really lose any more weight after that (as a group), and they even started to slightly gain by the end of the study. It was a very minor uptick, but an uptick nonetheless.<\/p>\n Semaglutide wasn\u2019t enough for them.<\/strong> They were still mostly overweight, and the weight wasn\u2019t continuing to come off\u2014and it may have been starting to come back on.<\/p>\n But these drugs aren\u2019t just about weight loss. There are other beneficial effects, too:<\/p>\n So these obesity drugs also improve other health markers. That\u2019s great and suggests that the effects while you\u2019re taking the drug are mostly positive.<\/p>\n \u00a0<\/p>\n I see some potential downsides, however.<\/p>\n It\u2019s not going to fix obesity. All the studies find that it helps users shed significant body weight but that there\u2019s a lull in the loss. It\u2019s not enough. It\u2019s doesn\u2019t get you past obesity and overweight into true leanness. To do that, you also have to address other aspects of your diet and lifestyle to really make the changes stick and extend them into perpetuity.<\/p>\n I do think it can help people stick to a better diet. While the fanfare focuses on the fact that you can \u201ceat whatever you want\u201d and still lose weight, it\u2019s also been shown to reduce cravings for junk food and starches. A smart use of this drug would be to pair it with a healthy low-carb diet based on whole food that emphasizes animal protein. Whole food so you\u2019re getting the micronutrients you need and protein so you\u2019re getting adequate protein to stave off muscle loss.<\/p>\n Ultimately, most people reading this don\u2019t need semaglutide injections. You\u2019re already willing to do the work and make permanent changes to your diet, lifestyle, and exercise habits that set you up for long term success. But millions of people aren\u2019t. While I have some major reservations about the long term effects of these drugs\u2014after all, I strongly suspect there\u2019s no free lunch when it comes to stuff like this\u2014they may be beneficial\u00a0on net<\/em> to people who\u2019d otherwise never consider changing their diet and lifestyle.<\/p>\n\n
\n
Do the obesity drugs work for losing weight?<\/h2>\n
\n
Potential Downsides of GLP-1 Agonists<\/h2>\n
\n
My Final Take on GLP-1 Agonists<\/h2>\n
![\"Olive_Oil_640x80\"](\"https:\/\/marksdailyapple.com\/uploads\/2019\/10\/PK_OliveOil_640x80.jpg\")
![\"\"](\"https:\/\/secure.gravatar.com\/avatar\/6f34056a4c522661afd98e6096a9dbae?s=96&r=g\")