The latest pharmaceuticals transcend the old-school weight loss algorithm of “Calories In” versus “Calories Out” that failed to produce lasting weight loss for so many overweight or obese individuals. Unless you’ve been living off the grid, you have likely read or heard about the use of diabetes drugs like Ozempic for achieving weight loss by increasing feelings of fullness, reducing food cravings, and boosting fat oxidation.
In a recent study of obese adults, food scientists focused on comparing results of adults who followed an approach that included a semaglutide weight loss drug combined with diet and exercise to those who only made lifestyle changes without taking the drug. The group of semaglutide users lost six times the body weight by taking a medication originally developed to treat type 2 diabetes.
One Drug to Target One Disease
The goal for pharmacology had long focused on improving patient health by targeting a single disease to alleviate symptoms or provide a permanent cure. This is how research and development within the industry traditionally looked at designing a new drug. Today, there has been a major shift as many new medications have been found effective at treating more than one disease process. An example would be prednisone, which was developed to reduce inflammation but holds promise as a treatment for Parkinson’s disease.
In recent years, the opioid crisis forced doctors prescribing the oldest recorded medication to find alternative solutions for managing chronic pain. Gabapentin, which was originally developed for treating epilepsy, is now prescribed to manage pain and discomfort. Similarly, the little blue pill that has become so popular in recent years for treating erectile dysfunction in men was originally developed as a treatment regimen for high blood pressure. The toxicology of Ozempic supports multitargeted use of the medication due to its side effects that can include weight loss.
Although many health experts continue to say that the obesity epidemic cannot be overcome solely with drugs and will eventually require systemic changes across the food industry, the demand for the latest medications has soared in recent months. This is due in part to the influence of social media platforms like Tik Tok, which feature celebrity testimonials about amazing weight loss results, and telehealth companies who advertise on sites like Instagram. However, maintaining poor eating habits can exacerbate the drug’s side effects like.
How Weight Loss Drugs Work
Semaglutide medications have produced jaw-dropping results in treating obesity by mimicking the release natural appetite hormones that stimulate feelings of fullness. Chemical messengers like GLP-1 (glucagon-like peptide-1) and PYY (pancreatic peptide YY) hormone signal the brain, gut and other digestive organs to trigger an array of important bodily functions related to weight control, such as:
- Reduces Food Noise – Among the beneficial side effects of GLP-1 when using semaglutide weight loss drugs is the reduction of so-called food noise or chatter that refers to intrusive and constant thoughts or preoccupation with food cravings.
- Signals You’ve Eaten – GLP-1 is one of about twenty satiation hormones that help suppress hunger signals. The brain signals the body to begin the absorption process, by slowing consumption, and eventually stop eating due to feelings of fullness.
- Improves Insulin Resistance – One of the observed cellular effects of GLP-1 hormone is the inhibition of channels resulting in membrane depolarization that stimulates insulin secretion, inhibits glucagon secretion and reduces insulin resistance.
- Slows Food Movement – To slow down food’s journey through the gastrointestinal tract, GLP-1 hormone inhibits peristalsis and intestinal motility by affecting both peripheral and central nervous system mechanisms.
- Delays Gastric Emptying – Glucagon-like peptide 1 delays gastric emptying by relaxing the gastric fundus, increasing gastric compliance, inhibiting antral motility and increasing pyloric tone. GLP-1 also slows the absorption of glucose in the bloodstream.
- Boosts Lipid Metabolism – Due to semaglutide’s mechanism of action as a GLP-1 receptor agonist, gastric emptying is delayed reducing hepatic TG content, improving cholesterol homeostasis and lipid metabolism for modulating inflammation.
- Stimulates Fat Oxidation – By activating genes involved in fatty acid oxidation and insulin sensitivity, GLP-1 has a direct effect on hepatocytes and can lead to significant reductions in visceral adipose tissue (body fat) and subcutaneous fat.
Some clinical studies have shown GLP-1 levels are lower in people with obesity, particularly after meals. This could be the result of less production of GLP-1, or an increased breakdown of the hormone. In addition, the receptors that detect GLP-1 may be less sensitive or there could be fewer receptors present in obese adults. Semaglutide may even close the gap with bariatric surgery as a go-to treatment for people who are dangerously overweight.
Wholesome Foods Also Release Appetite Hormone
Macronutrients like monosaccharides (simple sugars), peptides and amino acids from proteins as well as short-chain fatty acids can all trigger the natural secretion of appetite hormones. Consuming food high in these nutrients tells your brain that you are no longer hungry and produces numerous other benefits for healthy living. A key food that many Americans struggle to eat in sufficient quantities is fiber. Increasing consumption of fermentable fiber is known to help control appetite and weight by triggering activities in the blood and brain.
Protein not only provides essential amino acids to promote muscle growth and repair, high-quality sources like lean meats, fish, plant-based tofu, and legumes help stimulate the release of GLP-1 in the intestines. High-fiber whole grains, nuts, seeds, avocados and eggs can also support weight loss in people with various metabolic disturbances by stimulating the natural secretion of GLP-1 hormone. Most patients almost immediately notice a change in food preferences along with fewer cravings when taking Ozempic-like medications.
New Habits May Drive Systemic Change
In a recent Bloomberg article, officials at Walmart reported it is already experiencing the impact of people taking the latest weight loss drugs. The retailing giant reported a decrease in purchases of less healthy meals and snacks by customers who picked up a prescription for a semaglutide appetite-suppressing medication. Overall, the food retailer concluded consumers were spending less on food by purchasing fresh foods instead of highly-processed food options. This could be a major step toward systemic changes within the food industry.
Although some sectors may not be excited about the potential changes to the American Diet, it is a fact that Americans could be spending less money on high-calorie snacks, fast food, overly processed foods, and foods containing added sugars and less-healthy fats. Other companies like Kellogg and Proctor & Gamble have suggested the potential changes in buying trends is being carefully studied. So, the popularity of drugs that reduce food cravings could influence the packaged-food industry to provide products that support healthy living.
Where studies have shown combining the new weight loss medications with healthy eating works best, it is also important to note that people using semaglutide without dietary changes more often report problems with digestive discomfort like nausea, diarrhea and vomiting. The use of semagultide medications is contraindicated in people with inherited disorders like multiple endocrine neoplasisa (MEN) or medullary thyroid cancer (MTC) as well as patients with a history of gallbladder disease or pancreatitis.
Photo credit pexels.com
Dr. Hans Wolf devoted decades to developing WOLFPACC’s Methodology for helping medical students understand how to apply the basic sciences that they learned in medical school to the practice of medicine. If you’re ready to be the best physician you can be, contact us today to schedule a USMLE or COMLEX review program.