“There has been a long history of weight loss drugs and their negative consequences; will Semaglutide be different from weight loss drugs of the past?”
- Liz Keller, MS, CNS, ASCM-PT
Weight Loss Drugs:
Then, Now, and What’s Next?
You may have heard recently about someone famous or someone you know using Semaglutide injections to lose weight. Semaglutide, also commonly known as Ozempic or Wegovy, is the latest “miracle drug” to hit the weight loss market and has been developed for treating people with type II diabetes and obesity. Quick weight loss is considered “off-label” use. Still, with celebrities openly using it for this purpose, it is clear that the general population is also jumping on this trend. There has been a long history of weight loss drugs and their negative consequences; will Semaglutide be different from weight loss drugs of the past?
A Brief History of Weight Loss Drugs
- Substance used in the manufacturing of explosives was discovered as a way to lose weight by factory workers that accidentally consumed it.
- Worked by producing a thermogenic effect within the body
- Several accidental deaths from hyperthermia
- Incidents of severe rashes, damage to the sense of taste, and eye cataracts
- Removed from the market in 1938
1940- 1950s- Benzedrine
- First used as amphetamine in World War II to keep soldiers awake.
- Worked as a stimulant and appetite suppressant
- People became addicted and experienced adverse neurological and psychological effects.
1970-1980s- Ephedra and phenylpropanolamine
- It was classified as an herb and was not required to be approved by the FDA.
- Caused cardiovascular and neurological problems
- Resulted in hemorrhagic stroke and increased hypertension
- This led to 155 deaths.
1990s- Fenfluramine and phentermine (Fen-phen)
- Over 18,000,000 prescriptions were written in 1996
- Side effects included pulmonary hypertension, heart lesions, and heart valve abnormalities.
- Removed from the market in 1997
2000s- Orlistat (Alli) and Lorcaserin
- Orlistat causes anal leakage and loss of control of the bowels.
- Lorcaserin was taken off the market when it was found to increase the occurrence of cancer.
- Alli is still available as a weight-loss drug.
- Known commonly as Ozempic, Wegovy, and Mounjaro
- Ozempic- Intended as a treatment for type 2 diabetes and is approved by the FDA as a way to lower the risk of cardiovascular events
- Wegovy- used as a weight management solution for adults with obesity who have a least one weight-related condition
- Mounjaro- is also intended as a treatment for type 2 diabetes but has not yet been approved as a way to decrease cardiovascular events.
How does Semaglutide work?
- It is a synthetic version of a hormone known as Glucagon-like peptide one (GLP-1)
- When our bodies naturally produce GLP-1 in our gut, it signals to the brain that we are full.
- The synthetic injection is given to signal to people they are full. It also causes the stomach to empty more slowly and reduces appetite.
Common side effects of Ozempic and Mounjaro
- Nausea, vomiting, diarrhea, abdominal pain, and constipation
- Rare but more severe side effects include inflammation of the pancreas, changes in vision, and severe allergic reactions.
Common side effects of Wegovy
- Nausea, diarrhea, vomiting, constipation, stomach pain, headache, fatigue, dizziness, gas buildup, belching, and low blood sugar.
- More severe side effects include gastroenteritis, intestinal infection, and gastroesophageal reflux disease.
- It also contains warnings for suicidal behavior and thinking.
Since these drugs have only been on the market since 2021, long-term health data has yet to be accumulated. Also, since these drugs are intended for people with diabetes and obesity, there are no studies on the effects of healthy people looking to use them as a quick weight loss solution. Studies show that if these drugs are stopped within one year of taking them for weight loss, patients see an almost full weight regain. “On average, two-thirds of the weight lost was regained by participants within one year of stopping Semaglutide and the study’s lifestyle intervention. Many improvements in cardiometabolic variables, like blood glucose and blood pressure, reverted to baseline.” Currently, most treatments only last for three months. (Jaime P. Almandoz. What Happens When New Weight Loss Meds Are Stopped? – Medscape – Mar 27, 2023).
Thinking about what causes weight gain in the first place, other than just eating too many calories, it’s clear that no medication can be a long-term solution. Reduced physical activity, chronic stress, sleep deprivation, and hormonal dysregulation will not be fixed by tricking yourself into thinking you are full when you are not. From a personal trainer’s perspective, quick weight loss almost always comes at the cost of losing muscle mass. Less muscle mass when someone stops a medication like this can lead to decreased metabolic rate, decreased longevity, and a more challenging experience when trying to lose weight in the future. From a holistic nutritionist perspective, I expect to see a drug like this causing future eating disorders, especially when these drugs have gastrointestinal side effects. The combination of less muscle mass and aversion to specific eating foods is a recipe for weight regain disaster.
Is there a way to increase GLP-1 levels without medication?
- Some studies have shown that boosting protein at meals can increase GLP-1 levels. Other studies have shown that certain natural supplements like berberine, tea, curcumin, cinnamon, and resveratrol increase GLP-1. And I’m sure it comes as no surprise to anyone reading this article that increased physical activity has been shown to increase GLP-1.
While it seems that being “thin at any cost” is all the rage once again, looking at the history of weight loss drugs, it becomes clear that this attitude has never really gone away. Although the evidence isn’t clear yet how dangerous these drugs perform long-term, I believe it is clear that unless you change the behaviors and environment that caused the weight gain in the first place, there will always be weight regain, so they are not a long-term solution. I understand that for a person that has been struggling with their weight for years that a reduced appetite, nausea, and possible long-term metabolic issues may seem like an easier solution than a plan of balanced diet and exercise. But if studies continue to show that the weight inevitably comes back, is it really even a solution at all?
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