This article was originally published as an op-ed The Jerusalem Post on 13 June 2023: https://www.jpost.com/opinion/article-746056
“It’s déjà vu all over again”—Yogi Berra
This story seems to play itself out repeatedly. Will this have the same ending? Is this really the answer to the overweight and obesity epidemic? This time, it comes in the form an injectable drug called Ozempic, a semaglutide used to treat type 2 diabetes. Someone noticed that besides treating diabetes, it was bringing about significant weight loss. Many people have been able to lose 12-14% of their body weight by taking these injections.
So is this really it? The end of obesity and the solution to many chronic diseases, especially type 2 diabetes?
Weight loss pills and surgeries
On my desk is a long list of drugs. What do they all have in common? Over the last 40 years they were all approved by the FDA (Food and Drug Administration) in the United States as safe and effective for weight lost. Ultimately, all of these drugs were withdrawn from the market. Although they were effective for weight loss, they also harmed and killed people. (Yes, you read that correctly!)
We know about all of the various bariatric surgeries. Weight loss surgery such as gastric by-pass and sleeve gastrectomy have been far more effective than the band. Nevertheless, there are still bariatric surgeons using LAP banding. Regardless, those undergoing bariatric surgery who don’t learn how to change eating habits before the operation, might not see much success.
20% of those who have a bariatric procedure fail in just two years. Over time, that number rises. This does not take into account the amount of complications after the surgery of secondary infection and leakage. I believe we all know someone who had a bariatric procedure and ended up with little or no weight loss. Whether it’s drugs or surgery, there is no magic wand here.
Ozempic and other meds
Now, back to Ozempic. Business is business. Novo Nordisk petitioned the FDA to remarket Ozempic as a weight loss drug under a different name. They called it Wegovy. The same drug with a different name. Hhmm! Now, another drug called Mounjaro which is a Tirzepatide is about to be approved for weight loss. It is even more potent and can bring about 22% reduction in body weight. It all sounds good, but it isn’t.
The United States is one of two countries allowing advertising from prescription medication. Television commercials show luscious scenery and catchy music on their advertisements, and they literally seduce the consumer into thinking this is the answer. That decision should be made by a doctor and preferably without pressure from the patient who is still singing the jingle in his office. Saying things like, “We’ve found a solution” is misleading and just plain wrong. In the UK, these ads have led to an investigation by the association of the British Pharmaceutical Industry for deception and misleading the public.
Everyone seems to want the medicines. Sadly, no one wants the proven and tried way to good health—proper diet, exercise and activity, and a good night’s sleep.
Aside from the unsustainability of these drugs, these injections can have side effects, some of them serious. They can lead to pancreatitis, kidney problems, nausea, diarrhea, gallbladder disease, and may increase the risk of thyroid cancer.
No one seems to be concerned about an obvious long-term problem–malnutrition. As these drugs are appetite suppressants, inadequate food intake, potential for hair loss, and even crazy vivid dreams are risk factors. Dr. Adrane Berman and Judy Butler MS pointed all this out in a recent Medscape editorial. Besides all of this, a new phenomenon known as “Ozempic face” has emerged– sagging and aging of facial skin.
In addition, the World Health Organization has come out with a statement that Wegovy is not a “silver bullet” for the ever-worsening obesity crises. They also add that even those who might really need these drugs still need to incorporate a healthy diet and exercise.
Correction our approach
Part of our problem with obesity and overweight is approach. There are thin people with high blood pressure, type 2 diabetes, high cholesterol and heart disease. It’s isn’t the weight loss, it’s the health behaviors.
We take a different approach here at The Wellness Clinic. We attack disease. What do you need to do in order to prevent and reverse disease? This approach, in turn, will lead to real, sustained weight loss. The number on the scale is a good indicator or health, but it is one of many indicators. How many new healthy habits and behaviors one adopts is far more important. I tell my clients, to concentrate on their program and lifestyle measures, and the rest will follow.
When injections for weight loss are stopped, the weight comes back on almost immediately. This isn’t a cure for a health problem; it’s a temporary fix! It may be necessary in some cases, but we can’t look at the administration of these drugs as an end-game.
Avoiding negative side effects
As mentioned, Ozempic and Wegovy injections have negative side effects. How do the side effects of using lifestyle medicine, with a focus on eating whole-foods, mostly plants compare? Well, study after study show weight loss, higher energy, lower risk of most chronic diseases by about 80%, an increased immune system, less chance of infectious disease, and the list could go on and on. The bottom line is longer life and a much better quality of life even as we age.
The way semaglutide drugs works is to increase a hormone called GLP-1. This reduces appetite and then reduces insulin output. Is there another way to increase GLP-1? Yes, there is, explains Dr. Neal Barnard of The Physicians Committee for Responsible Medicine. Consuming whole-grain, complex carbohydrates full of fiber goes a long way to curbing your appetite and giving you a full feeling.
There are people for whom drug therapy is needed. No one can deny that. But drug companies and many doctors are over-promoting these pharmaceuticals. Ozempic, or other similar drugs, is not the answer to obesity. Weight loss is a complicated subject even though we try to simplify it for the public. It certainly is NOT just calories in and calories out. There are multiple factors involved.
The old adage of, “if it’s too good to be true, it’s too good to be true” is in play here. But let’s get an understanding as to the basics for seeing great results:
- focus on the type of food we eat
- Eat plant-predominant low fat (including oils) diet
- stop consuming ultra-processed food
As we have been discussing a diabetes drug, I can testify to the fact that I have seen the power of dietary changes alone to change fasting glucose. Some will even drop hundreds of points in a matter of a just few weeks. Add on activity, sleep, stress management, good social integration, not smoking or vaping, and you might just see a completely new life. Without the side effects of drugs and this will “add hours to your days, days to your years, and years to your life.”