Is Ozempic a Miracle Drug for Weight Loss? - Rhonda Patrick

okay so the next question is something we've not covered yet in any of our q&as so this will be fun it was submitted by Matthew Tanner who says how strong is the scientific evidence for or against the relatively new weight loss drugs like OIC that are in the headlines a lot okay so let's talk a little bit just about the background of these so so these so what these are okay we're going to start with it's it's kind of the basics so it's intin these intin our hormones um there's special chemicals in our body that come from our gut or our digestive system when we eat um they do help control blood sugar they signal to the body to release insulin after we eat foods containing sugar or fats or even to a lesser degree proteins there are two main types of these hormones one is known as Gip and the other one is known as glp1 so Gip is made in the upper part of our gut while glp1 is produced in the lower part so when we consume food foods like glucose or sucrose or starch um fats certain amino acids that are found in proteins our body will release both of these incretin hormones and this helps us manage our our blood sugar levels after we eat a meal right our postprandial blood sugar levels so that's kind of the background um OIC connects to enrtin hormones by mimicking the action of glp1 and it's one of the key incretin hormones involved in regulating insulin secretion and blood glucose levels post nutrient intake so it's a glp1 receptor Agonist so it's it's it's acting like glp1 and it's it's affecting the gp1 receptor so it basically um causes a natural like glp1 response to improve diabetes management right and it also has additional benefits related to weight loss control and reduced appetite okay so let's talk a little bit about gastric empty so both the Gip and gp1 are both types they're both types of hormones in our body that help control blood sugar levels after we eat right so we talked about that but they do have different effects on how quickly our stomach empties its contents into our intestines so giip doesn't really change the like the rate like how fast your stomach empties when Gip is working it doesn't affect the speed at which food moves in your stomach um to your intestines but glp1 on the other hand does so you know it's basically slowing down how quickly your stomach is emptying food into your intestines why does that matter so when your stomach empties more slowly because let's for example say there's gp1 or you're taking a glp1 receptor Agonist food takes longer to reach your intestines and so this means that the breakdown and absorption of nutrients into your bloodstream are going to be delayed as a result the increase in your blood sugar levels after eating a meal is going to be more gradual you're not going to get that really quick Spike you're going to get a slower steadier rise and this is beneficial for keeping your blood sh your blood um glucose levels stable it also impacts things like mental Clarity or commonly called brain fog um so having a really quick spike in your post print Ral blood glucose levels after a meal can cause problems with mental Clarity so having a more stable blood sugar levels makes it you know also affects your brain as well is what I'm trying to get at there's also an impact on triglycerides so triglycerides obviously this is a type of fat circulating your blood it also spikes after a meal so the triglycerides will be more gradual and so this is also it's really better to to not have a super high spike in triglycerides after a meal as well okay so the type 2 diabetes happens when your body doesn't use insulin properly so this could be insulin resistance and also the pancreas can't make enough insulin to meet the body's needs um another issue in type 2 diabetes is too much glucagon so this is a hormone that raises blood sugar which so it makes blood sugar control even harder right so the incretins are are lower helping lower the blood sugar and it's been shown to really help treat type 2 diabetes and these glp1 receptor agonists are a group of medications that do act like these natural hormones and they're really effective in helping manage people with diabetes so they're stimulating the re of in Rel insulin and they're also reducing the release of glucagon so those are two two separate ways that glp1 receptor agonists like OIC are working it's suggested as a first line of treatment for type two diabetes especially those who have heart disease and are at a high risk for um type diabetes as well and it's also commonly used in people that don't respond well to metform it and there are several different glp1 receptor agonists that are approved so there's a variety of them I'm not going to talk about all of them um but probably the most well known one is uh the the semaglutide which is known as OIC and I think that is probably the one that's again most welln but there are a variety of others and they all seem to end in glutide or Tide in general and I don't want to get into every single one of them but they're working in very similar ways they also affect appetite and food intake so gp1 I mentioned this it's a hormone it does play a role in controlling how much food we eat so um when when our bodies are making glp1 whether you know it's directly being administered to us uh through a medication or it's happening after we eat a meal um it it helps us F Fuller faster and eat l so what's happening is it it it's signaling and working on specific areas in our brain specifically the hypothalamus which is a a crucial part of the brain that is involved in appetite regulation so the ability of glp1 to make us F full and eat less and why medications that mimic it its action are able to do so um do help people lose weight because they are feeling satiated so separate from GP one there's gip1 we were talking about this you know at the at start of this this section um it's also it it wasn't originally known to help people with weight loss but um there's two there's new types of medications that are hybrid peptides so they're not only M mimicking gp1 but they're also mimicking gip1 and they're a hybrid between these two different types of medications so these new treatments are aiming to boost both weight loss more effectively than glp1 Alone um but also involved with blood glucose regulation as well so they're so they're further decreasing appetite they're increasing weight loss as well and so let's talk about some of these These are um there's there's some studies comparing just glp1 alone so semaglutide or OIC web Genny as well and um there's been a a lot of different studies done so there was a large study that combined the results from six different trials so there was a almost 4,000 different overweight or obese people in this trial that did not have diabetes and they were taking semaglutide sold as OIC it significantly reduced their body weight on average people taking the semaglutide lost about 11.8% of their body weight and about 12.2 kg or 20 26.9 lbs okay so that was compared to Placebo in one of these studies this was a popular trial it was called a step five trial it lasted for two years included about 300 different participants it showed that people taking semaglutide lost an average of 15.2% of their initial body weight compared to just 2.6% um in the placebo group and over 70% of the participants in the the treatment group um lost at least 5% of their body weight the study also found that the weight was the weight loss was um maintained um it levels off well it levels off at about 60 to 68 weeks but the weight the reduced weight was maintained for several months as long as the medication was continued um so the medication need to be continued uh there wasn't but there wasn't such a dramatic loss in weight after about 60 to 68 weeks it was just sort of maintained after that level after that time so there's these large studies that have really significantly shown reductions in body weight with semaglutide um it's thought that the the reductions in body weight are largely contributed to a loss in fat Mass but not all studies were you know directly measuring changes in muscle mass so you know there are some studies use dexas scans which do um dexas scans are s sort of a widely used method for assessing body composition they include bone mineral density fat Mass lean body mass muscle which includes muscle mass um it's considered a reliable and valuable tool clinical research but it does not directly it's not directly you know an accurately measuring muscle mass so it is an indirect measurement and so for that reason you know de doing lean body MKS you know it's people are saying oh lean body mass and saying yes this this means muscle mass but it doesn't necess it's they're not necessarily the same thing so lean body mass includes muscle but it also has other non fat tissues like organs it has connective tissues and it can be influenced by the hydration status of the individual so lean mass measurements are affected by water content in the body and so dexa assumes a constant hydration level of lean tissue um but you know there's there's there's there's a lot of you could you could point out a lot of flaws with dexa measurements as a actual measurement of muscle mass I don't want to turn this into a podcast about dexa the point I'm I'm trying to make is that the gp1 receptor antagonists sorry agonists um the semaglutide drugs do reduce appetite and if you are reducing appetite you are going to decrease your overall food intake which is what happens and that includes protein so there could be some implications for reductions in muscle mass as part of that weight loss particularly in people that are not taking in enough protein and are not engaging in resistance training and resistance exercise and that is a consideration you know for people that are taking these drugs um the semaglutide drugs because they likely are reducing their overall protein intake and I don't know what percentage of people are not engaged in resistance training but there's a large percentage of the population in general that does not engage in resistance training so these are important considerations um particularly when people are are taking any kind of drug that is in some ways sort of increasing a fasting state right by by reducing appetite and reducing food intake now there's also some data on these dual Gip and gp1 receptor agonists and um these are called uh tyep zppa zepeti and so monjaro or zppa pound I guess is what is what they're they're called sorry if I I butchered their names but um there was one large study that looked to see how well people um lost weight and manag that weight loss and this included over 4,000 people some people did have type 2 diabetes some people did not that were part of the trial and these these combination drugs were really good at helping people lose weight compared to a placebo um depending on the dose people lost between 7.7 kg to almost 12 kg more than people who did not take the medication so this is anywhere between 8.1% to 12.4% of their their total body weight in another part of the study called the surmount 3 trial people who are already lost 5% of their their weight through diet and exercise were also given the the the tire Zep zepeti or Placebo and those in the treatment group lost an additional 18.4% of their body weight while those on the placebo actually gained back 2.5% so it really um shows that these these drugs are effective at weight loss and um the weight loss did level off a little bit later than the semaglutide so they it leveled off about 68 to 72 weeks um and the study didn't last long enough to see if the weight loss would stay off in the long term there wasn't a head-to-head comparison of the semaglutide to the tyep zepeti but when those trials were sort of just looked at separately um it was found that the combination the tyros uptide was actually more effective than the semaglutide with respect to weight loss so um what about after discontinuing treatment there was one there was a um one year after withdrawal of once weekly subcutaneous semaglutide treatment that found um people did regain 2third of their weight after they had had prior weight loss after discontinuing discontinuing the this the semaglutide and um and I think I think it's pretty I think it's pretty clear now from a variety of studies that in order to maintain the weight loss those drugs need to be continued and so that's a major obviously a major drawback with um with some of these drugs now the combination drug the tyr zepeti it seems as though those uh weight was also gained back but um to a lesser degree I think both those medic medications are effective for weight loss um when they're combined it's more effective however stopping the medication leads to weight regain so there are some adverse effects um as well in addition to obviously stopping the medication and regaining back the weight um there's some stomach related side effects like nausea diarrhea constipation vomiting all those sorts of things burning in the stomach and um generally speaking the side effects seem to be um more common obviously in people that are taking the the the actual drug versus the placebo for the semi glutide the chances of experiencing these were 2.6 times higher than those taking a placebo for the combination drug the tyr eptide it was up to 4.6 Times Higher so it seems as if some of the side effects were even higher with the combination drugs um some some of the studies suggest that these negative side effects the stomach related ones actually don't last that long and they generally improve in l than two months so it's like the first couple of months are the hardest with respect to some of those side effects and then some people have um more serious side effects like a really RIS a risk of very low blood sugar um acute pancreatitis which is inflammation of the pancreas is another another one and then some people can experience some psych psychiatric disorders um but those are more rare than the more common stomach related issues so generally speaking I think that you know these medications can be very helpful for um people that are overweight and obese um to you know to get to lose a healthy amount of of weight and and control their blood sugar levels um particularly if they're doing resistance training and trying to take in enough protein as well to make sure they're not losing a lot of muscle um the problem then becomes okay is this going to be a lifelong medication or can you keep that weight off by um dietary and lifestyle changes probably you will regain some of that weight back because just simply you're going to not be as satiated so you will calories in calories out will calories will be be coming in more readily when you when you stop the drug and so um that is something to consider we don't really know what the long-term effects of these drugs are um over the case of like you know two three four decades right so um that's a whole other question

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Length: 16min 57sec (1017 seconds)

Published: Thu May 09 2024