By now you’re probably heard the names Wegovy or Ozempic talked about amongst your friends or family, at the hair salon and certainly in the news. The medications began by receiving a lot of positive press because they really work for achieving weight loss. I love understanding the mechanism of action for medications because then you never have to memorize anything and the downstream effects make sense! So let’s dive right in, these weight loss medications are in a class of medications called GLP-1, or glucagon-like peptide-1, medications. The active ingredient is a peptide called Semaglutide; semaglutide is an incretin, which is a hormone produced in the gut. It helps signal to your brain that you are full. It also helps regulate the transit time in your gut; if food passes more slowly through your body then you feel full longer. Hence some of the side effects from the medication which can include: nausea, early satiety, diarrhea and decreased appetite make sense.
For context, these GLP-1 medications have been used since 2005 to treat Type 2 Diabetes. They have been recognized by the medical community as safe and effective for treatment of diabetes and were noted to have a positive side effect of significant weight loss. Semeglutide was approved in 2021, under the brand name Wegovy, for weight loss. A myth that has been circulating around the internet is that Wegovy is more effective than Ozempic for weight loss. The truth is that they could be equally effective for weight loss at the same dosage. Until recently ozempic was typically prescribed at a lower dose when used for diabetes management. Wegovy, on the other hand, is prescribed with the intention of maximizing the dose to achieve optimal weight loss. With the increase in demand for these medications, Ozempic started to be prescribed for weight loss and not just diabetes management even though it’s technically only FDA approved for diabetes.
Studies show that these medications are very effective for weight loss. A recent study of 1,961 people showed that patients can lose up to 15% of their body weight on the medication. The medications are generally well tolerated but do require a weekly injection. So these medications certainly have a place in the weight management world and oral versions are already being studied. One of the potential complications of using these medications for weight loss is the loss of lean muscle mass. Lean muscle can be hard to gain back once lost, especially as people age. Even more concerning is the potential for loss of bone mass which is infinitely harder to regain. There isn’t a magic injection or pill for sustainable weight loss or weight management. Behavior change is hard and in order to achieve sustainable weight loss, which is the real goal, you need to have a comprehensive plan that combines: medicine, exercise and nutrition. And a plan that’s engaging and helps you achieve short term goals for the long term win. That’s why I created the HMW Method for weight management in collaboration with Troy Flanagan, Ph.D and Susie Parker-Simmons, RDN. Our method helps ensure that you lose weight with data driven metrics to maintain lean muscle, build strength and develop healthy eating patterns in order to feel your best. So the real deal is that medication for weight loss is only the beginning! Our program is designed to set you up for long term health and wellness.