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The demand for drugs promising straightforward weight reduction has skyrocketed, with prescriptions rising 2,082% from 2019 to 2022.1 Semaglutide, extra popularly often called Ozempic, is main the pack, with the hashtag #Ozempic having obtained 1.2 billion views on TikTok2 as of July 2023 — to provide just a few indication of its reputation.
Semaglutide is offered underneath the title Ozempic as a diabetes drug and, in the next dose, underneath the title Wegovy as a weight reduction drug. It touts weight lack of 14.9% amongst adults with weight problems,3 however it comes at a steep value. Not solely does Wegovy value greater than $1,000 a month,4 it may well additionally result in debilitating unwanted effects, together with abdomen paralysis.
‘I Want I By no means Touched It’
Joanie Knight took Ozempic for about two years, when she turned unable to swallow meals. The explanation? Her abdomen was stuffed with meals. Violent vomiting and fixed nausea adopted, together with a prognosis of extreme gastroparesis, or delayed gastric emptying.5
“I want I by no means touched it. I want I’d by no means heard of it in my life,” Knight informed CNN. “This drugs made my life hell. A lot hell. It has value me cash. It value me a number of stress; it value me days and nights and journeys with my household. It’s value me quite a bit, and it’s not value it. The value is simply too excessive.”6
Gastroparesis slows or stops the motion of meals out of your abdomen to your small gut. This leads to feeling full longer, which is one mechanism by which semaglutide leads to weight reduction. Nevertheless, gastroparesis additionally results in nausea, vomiting and, in extreme circumstances, dehydration and malnutrition. Diabetes is essentially the most generally identified reason behind gastroparesis, as a result of nerve harm within the abdomen.7
Nevertheless, semaglutide and comparable medication are designed to delay gastric emptying, and nausea and vomiting — frequent signs of gastroparesis — are reported in lots of who take them. Even Novo Nordisk, which manufactures Ozempic and Wegovy, informed CNN these unwanted effects are listed on the label:8
“Gastrointestinal (GI) occasions are well-known unwanted effects of the GLP-1 [glucagon-like peptide 1] class. For semaglutide, nearly all of GI unwanted effects are delicate to reasonable in severity and of quick length. GLP-1’s are identified to trigger a delay in gastric emptying, as famous within the label of every of our GLP-1 RA drugs. Signs of delayed gastric emptying, nausea and vomiting are listed as unwanted effects.”
GLP-1s Dramatically Sluggish Digestion
Semaglutide is a glucagon-like peptide 1 receptor agonists (GLP-1RAs). As a peptide hormone, GLP-1 is, amongst different issues, a part of a gaggle of incretin hormones, that are launched if you eat to manage insulin, together with many different features.9
Together with affecting insulin, GLP-1 might affect the nervous system, resulting in an appetite-reducing response. Nevertheless, one among their mechanisms is, actually, delayed gastric emptying — an impact many who take it aren’t conscious of. In 2021, Mayo Clinic researchers wrote that “their [GLP-1 agonists and analogs] results are mediated, a minimum of partially, by retardation of gastric emptying”10 — the hallmark of gastroparesis.
In the meantime, in Wegovy scientific trials, 44% of these taking the drug skilled nausea whereas 24% had vomiting and 20% had stomach ache,11 all frequent signs of gastroparesis. Mayo Clinic researchers additionally seemed on the results of one other GLP-1 receptor agonist, referred to as liraglutide, in adults with weight problems.
They discovered the drug’s weight reduction results had been related to “delay in gastric emptying of solids,”12 and the longer meals sat within the abdomen, the higher the burden loss results turned. The delay in digestion was dramatic.
Whereas meals usually left the abdomen in simply 4 minutes amongst these within the placebo group, it took a mean of 70 minutes in those that took liraglutide. For some, the delay was much more — as much as 151 minutes. Whereas this decreased considerably by 16 weeks, with meals leaving their stomachs in about half-hour, this was nonetheless for much longer than the seven minutes within the placebo group.13
WeightWatchers Plans to Promote Weight problems Medication
WeightWatchers is transferring into the weight problems drug market through its acquisition of telehealth platform Sequence. In a press launch, WeightWatchers acknowledged, “Sequence seamlessly integrates the affected person and clinician expertise for ongoing, scientific care and medicine administration whereas offering high-touch help in navigating the insurance coverage approval course of.”14
In different phrases, WeightWatchers members will have the ability to guide a digital session with a clinician and get a prescription for Wegovy or one other GLP-1. Actually, Sequence’s program is fully based mostly round weight reduction drugs. Certainly one of their FAQs is “What if my clinician determines a prescription shouldn’t be proper for me?”15
The reply is you’ll take an consumption quiz and have an preliminary session, however, “Your program solely begins in case your clinician determines that you just’re an excellent match.” In different phrases, you’re nearly assured to get a prescription in case you join.
Skepticism is sensible on this case, because the variety of important unwanted effects tied to the medication continues to extend. On social media, many members had been shocked by the transfer, saying it “rubbed them the incorrect method.”16 As Rolling Stone reported:17
“The transfer appears to be at odds with the longstanding tenets of this system. WeightWatchers, which was first began in 1963 and instituted in strip malls throughout America, has lengthy been touted by its supporters (together with Oprah Winfrey herself, who owns stake within the firm) as a neater method to shed weight, whereas avoiding the stigma and temptation of crash diets and weight reduction tablets.
… Some Weight Watchers customers feeling caught or plateaued of their weight reduction have welcomed the change, whereas a majority in on-line chat rooms on websites like Fb and Reddit appear to have extra questions than selections.”
Case Experiences Spotlight Semaglutide-Induced Abdomen Paralysis
Gastroparesis amongst these taking semaglutide isn’t unprecedented. Case research of two girls who suffered from medication-induced gastroparesis had been revealed within the Journal of Investigative Drugs in 2021.18
The primary concerned a 52-year-old girl who took semaglutide for one month earlier than signs, together with stomach ache, bloating and nausea, started. Testing revealed delayed gastric emptying, which resolved after she stopped taking the drug. The second case concerned a 57-year-old girl affected by stomach bloating, nausea and vomiting for a 12 months.
She had began taking dulaglutide, model title Trulicity, one other GLP-1 receptor agonist, 15 months prior. Testing revealed she had extreme delayed gastric emptying, which steadily resolved when the drug was stopped.
Nevertheless, this isn’t all the time the case. In Knight’s case and one other described by CNN, signs didn’t get higher even after they stopped taking the drug. Knight ended up having abdomen bypass surgical procedure because of the extreme gastroparesis, which left her capable of “eat sufficient that I’m not malnourished.”19
Anesthesiologists Warn To not Take Ozempic Earlier than Surgical procedure
Because of the delayed abdomen emptying that happens with semaglutide, the American Society of Anesthesiologists (ASA) launched a warning for these taking the medication earlier than elective surgical procedure.20
They counsel stopping this and different GLP-1 receptor agonists earlier than the process, as they may enhance the chance of problems related to anesthesia — particularly that you might regurgitate meals that’s nonetheless sitting in your abdomen, even in case you’ve fasted appropriately.
Consequently, they suggest not taking the drugs for a day or every week previous to surgical procedure, and probably delaying the process if signs equivalent to nausea, vomiting, stomach ache or bloating are current. In a information launch, Dr. Michael W. Champeau, ASA president, defined:21
“Whereas there’s at present a scarcity of scientific information on how GLP-1 receptor agonists have an effect on sufferers having surgical procedure and work together with anesthesia, we’ve obtained anecdotal experiences that the delay in abdomen emptying could possibly be related to an elevated danger of regurgitation and aspiration of meals into the airways and lungs throughout basic anesthesia and deep sedation.
These problems will be severe, so we’re offering steering on when GLP-1 agonists ought to be stopped prematurely of an elective process.”
The probability of these utilizing semaglutide having a full abdomen is so excessive that the ASA suggests utilizing ultrasound to judge the abdomen contents previous to surgical procedure if a affected person hasn’t withheld the drug, stating:22
“If the abdomen is empty, proceed as standard. If the abdomen is full or if the gastric ultrasound is inconclusive or not attainable, contemplate delaying the process or proceed utilizing full abdomen precautions. Focus on the potential danger of regurgitation and aspiration of gastric contents with the proceduralist or surgeon and the affected person.”
Intestinal Obstruction Danger Rises 3.5-Fold on Semaglutide
These stylish weight reduction drugs trigger different important dangers as properly and should even trigger a probably deadly intestinal obstruction. Diabetic sufferers who use the medication have a 4.5 instances increased danger of intestinal obstruction than these utilizing different drugs. A research of 25,617 folks additionally discovered use of GLP-1Ras will increase the speed of intestinal obstruction by 3.5-fold.23
The medication had been additionally discovered to extend the size and weight of the small gut in animal research, whereas in people they could enhance intestinal size and villus top; villi are the hairlike projections contained in the small gut that assist take up vitamins. Writing in Acta Pharmaceutica Sinica B, researchers defined how this might severely have an effect on intestinal operate, growing obstruction danger:24
“As a result of GLP-1RAs might trigger steady will increase within the intestinal size and villus top, the small gut might turn out to be as inelastic and fibrotic as a unfastened spring, resulting in long-term higher intestinal obstruction …”
To this point, scientific trials haven’t revealed such adjustments within the human intestine, possible as a result of it’s troublesome to measure small gut size. Additional, the most typical symptom of those adjustments is constipation, which will be attributed to many causes — to not point out, the crew famous, research usually aren’t lengthy sufficient to disclose intestinal obstruction dangers:25
“The chance of persistent intestinal obstruction in people cumulates over time, with the very best prevalence showing 1.6 years following GLP-1RA therapy. Nevertheless, scientific trials on GLP-1RAs normally don’t final for greater than a 12 months …”
Kidney, Most cancers Dangers Are Additionally Regarding
The long-term dangers of semaglutide are unknown, however already the drug carries a black field warning as a result of rodent research discovered semaglutide causes thyroid C-cell tumors “at clinically related exposures.”26 Pancreatic most cancers is one other concern. One affected person within the Maintain 5 trial developed metastatic pancreatic carcinoma about 65 days post-treatment.27
A pharmacovigilance research utilizing the FDA Antagonistic Occasions Reporting System additionally seemed into “growing information on the potential danger of pancreatic carcinoma related” with GLP-1Ras, together with semaglutide, discovering a transparent affiliation.28
“Primarily based on this pharmacovigilance research, GLP-1RAs, besides albiglutide, are related to pancreatic carcinoma,” researchers famous, including, “Primarily based on the bibliometric investigation, cAMP/protein-kinase, Ca2+ channel, endoplasmic-reticulum stress, and oxidative stress are potential pathogenesis of pancreatic carcinoma ensuing from GLP-1RAs.”29
The kidneys additionally appear to be negatively affected, with two case research displaying acute kidney harm in folks taking semaglutide. Each sufferers had persistent kidney illness because of diabetes and “skilled speedy worsening of kidney operate and elevated proteinuria after being prescribed the GLP-1 receptor agonist semaglutide.”30 Wegovy’s prescribing data additionally has a sizeable checklist of warnings and precautions, together with for:31
Acute pancreatitis |
Acute gallbladder illness |
Hypoglycemia |
Acute kidney harm |
Hypersensitivity reactions, together with anaphylactic reactions and angioedema |
Diabetic retinopathy problems |
Coronary heart fee enhance |
Suicidal conduct and ideation |
Higher Choices for Weight Loss
It’s my robust perception that we’ll by no means see the “miracle treatment” medication for weight reduction in our lifetime. Utilizing medication to shed weight might result in everlasting, debilitating well being issues — and if we do, it’s possible you’ll regain the burden in case you ever cease taking them.
Happily, there are answers that we all know immediately that deal with the basic motive why most individuals achieve weight, which is insulin resistance secondary to mitochondrial dysfunction from extra reductive stress. Extra linoleic acid (LA) from seed oils is the first reason behind mitochondrial reductive stress.
Individuals in a single research regained two-thirds of their prior weight reduction, and many of the adjustments in cardiometabolic variables additionally reverted again to pretreatment ranges one 12 months after stopping semaglutide.32 Happily, there are higher methods to shed weight that don’t put your well being in danger. Prime methods embody:
• Lowering your consumption of seed oils whereas growing your consumption of wholesome fat — Consuming an excessive amount of linoleic acid is the first issue driving the obese and weight problems epidemics. LA is a kind of omega-6 fats present in seed oils like soybean, cottonseed, sunflower, rapeseed (canola), corn and safflower.33
Take into account slicing LA right down to under 5 grams per day, which is near what our ancestors used to devour earlier than persistent well being situations, together with weight problems, turned widespread.
Ideally the precise quantity although is healthier outlined as a proportion of each day energy. LA ought to be lower than 2% of your each day energy. I used to be capable of get my proportion right down to 0.8%. You don’t want costly lab assessments, as all you want to do is fastidiously enter your meals information into Cronometer and it’ll let you know your %.
• Avoiding almost all ultraprocessed meals, quick meals and restaurant meals — Just about all of them comprise seed oils. The simplest method to do that is to arrange nearly all of your meals at house so you already know what you’re consuming.
• Utilizing time restricted consuming (TRE) — Our historical ancestors didn’t have entry to meals 24/7, so our genetics are optimized to having meals at variable intervals, not each few hours. Once you eat each few hours for months, years or many years, by no means lacking a meal, your physique forgets tips on how to burn fats as a gasoline.
Most individuals who follow TRE restrict the time they devour meals to eight to 10 hours or much less on most days of every week. In a single research, adults with weight problems who used an eight-hour consuming window misplaced extra weight, and had higher enhancements in diastolic blood stress and temper, than those that used a 12-hour or extra consuming window.34
Though TRE is an incredible device initially for most individuals, when you regain insulin sensitivity you wish to enhance your meals window to 10 to 12 hours.
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