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Is GLP-1 Medication the Right Solution for Long Term Weight Loss and Better Health in the Fight Against Obesity?


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"...so many people I know are turning to the medication and losing weight fast. I know most quick fixes don't last but I am conflicted about whether I should take it too..."

GLP-1 is everywhere! No matter where you turn, you can not escape the marketing, messaging, availability, or distinct results of GLP-1 medications for weight loss. A quick Google search yields numerous results, including links, directing you to sites allowing you to purchase them directly.


With so much marketing noise, accessibility (not affordability), and profitability around this new medication, how do you know if it is the right LIFEstyle tool to address your weight loss and health needs and personal goals?


To answer this question, it is important to first identify and understand the root problem to solve.


Oftentimes, when we attempt to address a specific problem, especially those related to weight loss and health outcomes, we find ourselves looking at the problem's surface instead of examining the root.


What do we mean by that?


The surface of the problem is what the problem or situation "appears to be." In the context of obesity and being overweight, the surface problem appears to be losing weight. At the rate of sales and profits for products like GLP-1s, it is quite evident a lot of people want to lose weight.


But remember, weight loss is at the surface. If we are only dealing with the surface of the problem, the root causes remain. If the root remains, the problem still exists. Which means surface solutions only mask the surface.


What about the root problem? Let's discuss further...

Obesity is an epidemic in the United States and around the world. Most recent research conducted by the Centers for Disease Control and Prevention suggests that “more than one-third (36.5%) of U.S. adults are obese.” By the year 2030, growth trends project 85% of the adult population in the United States will be overweight or obese.


For African Americans, the statistics are even more staggering. We have the highest level of adult obesity at 49.9 percent and black women (4 out of 5) have the highest rates of obesity or being overweight compared to other groups.


Obesity, defined as a complex, multifactorial disease, is a major risk factor for chronic conditions like cardiovascular disease, type 2 diabetes, cancers, and death. As a result, black women experience a higher prevalence of obesity related chronic disease conditions such as heart disease, stroke, cancers, hypertension, diabetes, maternal morbidities, anxiety, hormonal imbalances, and stress.


What is most dynamic about obesity is its association with modifiable lifestyle risk factors. In other words, obesity is a lifestyle-related, preventable disease. If the condition is preventable, why is the obesity prevalence continuing to rise?


In response to the rise in obesity, the business of weight loss and weight loss products has grown into a $250 billion dollar industry. Industry forecasters predict the market will grow to $377 billion by 2026. Insert Ozempic, Wegovy, and other GLP-1 medications.


Glucagon-like peptides (GLP-1) analog, like Semaglutide, is approved for type 2 diabetes treatment and for reducing the risk of cardiovascular events in individuals with type 2 diabetes and cardiovascular disease. Subcutaneous semaglutide is approved for the treatment of type 2 diabetes at a dose of 1.0mg or less once a week. For weight loss, the medication dosage is increased to 2.4mg once a week. This medication is believed to improve appetite, slow stomach emptying, improve satiety, reduce food noise, silence hunger signals, and facilitate weight loss. But at what direct and indirect cost to you...or your health?


GLP-1 medications are positioned as the "perfect weight loss" solution. As a result, Novo Nordisk's market value exceeds $500 billion. The company posted a net profit of $12 billion for 2023, a growth of 51% over previous earnings. For U.S. health insurers, this massive demand for "weight loss" drugs translates to bigger profits. In 2022, prescriptions for these medications reached 9 million in just 3 months, translating to a 300% increase in healthcare spending.


While the health and wellness industry is primed with ample opportunities for these weight-loss medications, the obesity crisis and preventable chronic conditions continue to plague children and adults at an exponential rate.


What is the tipping point?


Evidence-based research studies reveal knowledge is the greatest gap in producing consistent shifts in this growing obesity trend. (read that again)

The STEP trials are currently testing semaglutide at the higher dose of 2.4 mg/week SPECIFICALLY for promoting weight loss regardless of type 2 diabetes. Additional trials will explore a higher dose of 7.2 mg/week. The trials are researching the outcomes of this medication on weight loss in obese individuals with and without co-morbidities. While these trials are seeing weight loss reductions, concerns exist about the adverse reactions and long-term health implications.


It is important to note some facts about the STEP trials and health implications of Semaglutide:

  1. Conflict of Interest Disclosure: The authors of the study report receiving grants and personal fees from Novo Nordisk for service and WW International (Weight Watchers) for service on the scientific advisory board.

  2. The trial is funded by Novo Nordisk A/S.

  3. Adverse reactions include gastrointestinal disorders, nausea, vomiting, diarrhea, constipation, abdominal pain, headache, fatigue, indigestion, dizziness, bloating, excessive gas; 

  4. More severe risks and side effects: pancreatitis, gastroparesis, harmful effects on bone density and muscles, liver and kidney function, and thyroid issues (reported in animal studies) 

  5.  Current studies have a very low inclusion of minority study participants.

  6. Long-term weight loss success facilitated by the use of weight loss medication drugs REQUIRE patients to remain on the drug. Patients report gaining all the weight back once they stop taking the medication.


Individual health behaviors, like dietary patterns, physical activity, physical inactivity, nutrition education, health awareness, and lifestyle skills are modifiable risk factors that can shift the trajectory of your obesity status, health, physical fitness, mental health, and work/life balance.


The STEP trials reaffirm this position in its study stating "Behavioral intervention incorporating modifications in diet and physical activity remains the foundation of treatment for overweight and obesity."


So, if the foundation or "root" is addressing behavioral interventions that incorporate diet and physical activity, how does medication correct behavior? How does a medication solution for weight loss solve the problem of consistent nutritional imbalances, lack of physical activity, and reliance on highly processed and convenient foods associated with the Standard American Diet (SAD)?


Here's The Reality:

You can not medicate your way out of something that you are eating yourself into. This is not a concept about gluttony but rather a consistent practice of nutritional imbalances, multiple nutrient deficiencies, and physical inactivity. Medication is not the cause; therefore it can not become the lifestyle (long-term) solution, especially if the solution you seek is SUSTAINABILITY of both your health and weight. 


Here’s The Truth:

You can not change your age, genetics, or environmental factors. These are considered nonmodifiable lifestyle factors. These are things BEYOND your control.


What is within your control? 


The two most significant factors that directly impact your health and weight…positively or negatively:


  1. Diet (daily foods & beverages consumed)

  2. Physical Activity 


Life balance, better health, and sustainable weight loss require consistent shifts in both. These are two sustaining lifestyle factors medication can’t produce or alter. 


Remember, medications simply treat the symptoms and offset the negative lifestyle behaviors. (read THAT again.)


What can you do today? Focus on your daily nutrition. Let’s start there.



What types of foods naturally increase GLP-1 levels?


Foods high in fiber, healthy fats, and protein can trigger the release of GLP-1. GLP-1 is a hormone that helps regulate blood sugar levels and promotes feelings of satiety.


Healthy Fats

Monounsaturated fatty acids (MUFA) Omega 3 fatty acids

Fish

Avocado or avocado oil

Olives or olive oil

Flaxseed or flaxseed oil

Various nuts

Lean Proteins

Soluble Fiber


References

1. Katie Kerwin McCrimmon Uch. Wegovy vs. Ozempic: The truth about new “weight-loss” drugs. UCHealth Today. November 18, 2023. Accessed April 3, 2024. https://www.uchealth.org/today/wegovy-vs-ozempic-the-truth-about-new-weight-loss-drugs/.


2. Livingston S. Insurers and drug-industry middlemen are cashing in on the weight-loss drug frenzy. Business Insider. Accessed April 3, 2024. https://www.businessinsider.com/health-insurers-could-profit-weight-loss-diabetes-drugs-ozempic-wegovy-2023-9.


3. Obesity statistics and facts in 2024. Forbes. January 30, 2024. Accessed April 3, 2024. https://www.forbes.com/health/weight-loss/obesity-statistics/.


4. Chinn JJ, Martin IK, Redmond N. Health equity among black women in the United States. Journal of women’s health (2002). February 2021. Accessed April 3, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8020496/.


5. Obesity and African Americans. Office of Minority Health. Accessed April 3, 2024. https://minorityhealth.hhs.gov/obesity-and-african-americans.


6. Adult obesity prevalence maps. Centers for Disease Control and Prevention. September 21, 2023. Accessed April 3, 2024. https://www.cdc.gov/obesity/data/prevalence-maps.html.


7. Garvey WT, Batterham RL, Bhatta M, et al. Two-year effects of semaglutide in adults with overweight or obesity: The step 5 trial. Nature Medicine. 2022;28(10):2083-2091. doi:10.1038/s41591-022-02026-4


8. Rubino D, Abrahamsson N, Davies M, et al. Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity. JAMA. 2021;325(14):1414. doi:10.1001/jama.2021.3224


9. Wadden TA, Bailey TS, Billings LK, et al. Effect of subcutaneous semaglutide vs Placebo as an adjunct to intensive behavioral therapy on body weight in adults with overweight or obesity. JAMA. 2021;325(14):1403. doi:10.1001/jama.2021.1831


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