A Quick (ish) Guide to Weight Loss Drugs

What are they and who are they for?

Whether it's Ozempic, Wegovy or Mounjaro you’ve probably heard of weight loss injections and may be curious about how they work and who may benefit the most from taking them (quick answer, its not Kim Kardashian). 

Ozempic & Wegovy are brand names for a drug called semaglutide and Mounjaro is the commercial name for Tirzepatide. Both of these drugs belong to a class known as GLP-1 receptor antagonists (GLP-1 for short) which work to mimic a hormone in the body called glucagon-like peptide -1 (GLP-1). Alongside weight loss these types of drugs are credited with reducing overall inflammation and reducing the risk of cardiovascular disease and type-2 diabetes. 

Why do these drugs cause weight loss?

GLP-1 drugs have been around for several years and were first used in the management of Type-2 diabetes and have only (relatively) recently been approved for weight loss. Semaglutide etc's success is due to a number of reasons but in the interest of keeping this blog short (ish) here are the main four…

  • Reduce appetite 

Weight loss drugs mimic the natural GLP-1 which is released by the gut and triggers feelings of fullness. The impact of artificial GLP-1 however is felt for longer and has a more intense effect, meaning that whilst taking this drug you will feel fuller more quickly and for longer. This can be particularly impactful in those who have dis-regulated hunger and fullness cues, due to long term yoyo dieting, binge eating, disordered eating or other issues. 

  • Slowing Gastric Emptying 

This mechanism is a little simpler, because gastric emptying slows the food which spends more time in the stomach and takes longer to pass through to the intestines. This means that people taking weight loss drugs feel fuller for longer and are therefore it is easier to reduce both the frequency and volume of food consumed throughout the day. 

  • Improving blood sugar management

GLP-1 is involved in triggering the release of insulin from the pancreas which in turn then reduces circulating glucose in the blood. Synthetic GLP-1 can therefore improve the efficiency of this process and make insulin secretion more effective – therefore blood sugars are reduced more effective. 

  • Reduce cravings, reduce food noise 

Because semaglutide affects the areas of the brain associated with appetite it has been reported by users that, “food noise” is much quieter whilst taking the drug. This is mostly anecdotal evidence but users often find that they have much less mental chatters about food and find themselves in fewer negotiations about whether or not they should eat. It may also be that less pleasure is found in food and food no longer offers the same feelings of reward, which it may have done prior to starting a weight loss drug. This is reported more so in those who have struggled historically with more emotional, hedonistic or binge eating.

Who may benefit from GLP-1 drugs? 

Currently in the UK any weight loss drug has to be prescribed by a doctor or licensed pharmacy and I cant stress enough how important it is to consult with a medical professional before trying to obtain Ozempic or any other brand. 

Though it’s easy to find a whole host of celebs who have been using these drugs to get rid of a couple of pounds these individuals are not who they are best prescribed to. Individuals who will benefit most are those who…

  • Have a BMI >30 
  • Wish to (or are required) to lose > 10% of their body weight to obtain a “normal” BMI 
  • Those with Type-2 diabetes who may benefit from the combined effect on blood sugar control and weight management. 
  • Have struggled with “yoyo” weight loss or have been dieting for several months without seeing any change in weight.

What are the risks? 

Like every drug there is a risk of side effects, the reported common side effects of GLP-1 drugs include:

Common and somewhat unavoidable side effects

  • Nausea 
  • Diarrhoea 
  • Vomiting 
  • Constipation
  • Abdominal cramps  

Common but potentially avoidable side effects

  • Fatigue 
  • Malnutrition 
  • Nutrient deficiencies (commonly iron, B12)
  • Muscle loss 

The last four side effects here are issues that can arguably have the biggest impact, from a diet and exercise perspective. Any intervention which reduces appetite has the potential to influence nutrient intake/nutritional status, muscle mass & energy levels. This is not exclusive to GLP-1 drugs, however the impact may be more extreme than typical weight loss dieting. 

How to reduce the risk of side effects

  • Ensure you still consume regular meals, even if you aren’t as interested or as hungry. This is especially important if you exercise regularly 
  • Reduce portion size but don’t neglect whole food groups. Try to keep plates balanced with veg, protein, carbs and some healthy fats 
  • Keep consuming protein in each meal, shakes and supplement can be helpful here (especially if you are exercising)
  • Consider supplements such as multivitamins, omega-3s and electrolytes 

Long story short, Ozempic or any other brand of drug can be extremely impactful to an individual wishing to lose weight and can hugely impact health outcomes in a positive way. However they are not a quick fix nor are they an easy or lazy way of losing weight – which may be some people’s opinions. For best results, real attention has to be paid to overall diet quality and exercise, so as to reduce the risk of muscle loss. However, if you get all the pieces of the puzzle right they may really help get fantastic long term results. 

If you want to chat more about this or want to know how to optimise your diet and training alongside a weight loss drug, then reach out and let’s jump on call! 

Hannah 

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