In an Ozempic World, Can We Still Lose Weight Naturally?
Ozempic is everywhere. And hot on its heels, Wegovy. These drugs have been hailed by our culture as miracle drugs for weight loss, and are increasingly being used by non-obese, non-diabetic patients who simply want to shed 15+ pounds. Is this safe? Is it ethical?
Let’s dive in.
WHAT THEY DO:
Drugs like Wegovy and Ozempic (their non-branded name is semaglutide) are called GLP-1 receptor agonists and they work at the level of our GI tract. GLP-1 refers to a hormone called glucagon-like peptide-1, a type of incretin. Incretins are hormones that are released from your small intestine when your body senses that you’ve gotten enough glucose from the food you’ve just eaten; they cause your pancreas to release insulin to lower your blood sugar. Incretins like GLP-1 decrease production of another hormone called glucagon, which increases blood sugar levels. In type 2 diabetes, insulin levels decrease over time and glucagon levels rise, as part of the loss of healthy blood sugar regulation that occurs with long-term blood sugar dysfunction. This arm of diabetic blood sugar dysregulation causes what’s known as hepatic blood sugar dysregulation, which means that your liver loses its ability to regulate blood sugar production and will continue to pump out blood sugar even if you’ve just eaten a big meal.
(Your liver has so many jobs and yes, making blood sugar is one of them!).
Semaglutide also slows the rate that food leaves our stomach (called gastric emptying), and it acts on our hypothalamus, where the appetite center of our brain is found. These actions make us feel fuller longer, stimulating the satiety response that Ozempic is now famous for.
FUN FACT:
These GLP-1 drugs were first imagined when scientists extracted saliva from the desert-dwelling Gila monster, which eats only once or twice a year. They found a hormone similar to GLP-1 in its saliva, and GLP-1 agonists were born.
HOW THEY HELP WEIGHT LOSS:
This is actually an incompletely-answered question. We know that the delayed gastric emptying effect causes you to feel fuller, longer, so you eat less. Also, GLP-1 agonists have a direct effect on your hypothalamus, a master control center of your brain, where they regulate hunger-driven feeding and the pleasure-seeking motivation of eating.
Otherwise, their effect to decrease glucagon will have a long-term effect of lowering average levels of blood sugar.
The question of how a rise in insulin could cause weight loss comes up: insulin is a fat-storing hormone, and the rise in insulin seen with GLP-1 agonists makes sense in the setting of diabetes, but would argue against weight loss. It seems that the effects of lowering glucagon plus reducing our food intake has an overall negative-energy intake effect.
Interestingly—these drugs can calm our internal mental chatter about food, and keep us from thinking about food, due to their activation of the POMC neurons in the hypothalamus. This may be a huge benefit for people with a history of food obsession or binge eating disorder, where food becomes an overwhelming specter in their mind.
THE PROBLEM:
Many of the new cautions against using Ozempic for weight loss center around its effect of delaying gastric emptying. This is responsible for many of its side effects including nausea, loose stool, and of course, weight loss. But could this have more serious effects?
Long-term use of GLP-1 receptor agonists (eg for weight loss) are associated with an increased risk of gallbladder disease including gallstones, cholecystitis, and biliary disease. Another concern is gastroparesis, or stomach paralysis. We know that drugs like semaglutide slow the stomach from emptying, which is one reason we are fuller longer, which we believe provides a weight loss benefit. But when things slow down too much?…
Likely the unwanted side effects of gastroparesis and gallbladder issues are both due to the slow-down effect of GLP-1 on your digestive tract.
THE SOLUTION:
Weight loss doesn’t have to be complicated. In fact, it can actually be easy and FUN! I believe so strongly that when we do what we love - find the healthy food we love, move how our bodies want to move, focus on joy and on our own self-worth, THAT’s when our bodies change. That’s also true freedom. Imagine being free from having to give yourself weekly shots, being free from side effects of a drug that slows your stomach and makes you nauseous, AND free from the internal food chatter—and getting all of this freedom because you’ve made yourself stronger, NOT because you’re taking a drug?
Listen, some people may need Ozempic — I honestly get it. And I truly don’t begrudge them. But it’s not my way. My way is about empowerment — that means empowering you to take control of your health through diet and lifestyle measures that matter, plus building up your self-worth so that YOU become more important than food cravings in your own mind.
HOW DO I DO THIS?
My way is just one way. But for the women I work with, it’s really effective because it’s about EMPOWERMENT. As I always tell my group participants, “Once you know you can’t go back.”
Here’s what we do:
Over $600 worth of cardiometabolic labs to get to the root cause of what’s keeping your weight stuck on
Wearing a CGM (that’s a continuous glucose monitor) to reveal hidden blood sugar patterns
Symptom assessments, quizzes, and a deep dive into your personal health history to uncover hidden patterns behind your hormone balance and your weight
A customized diet and exercise plan
Customized meal plans
TONS of support in a gorup setting
1-on-1 sessions with me to co-create your individualized weight loss plan
Self-Worth Workshops - Where we heal hidden mental and emotional patterns that could be keeping the weight on
If you’re curious to see how this can help you, check out RESTORE: Weight Loss Through Natural Hormone Balance here.
xo,
Dr. Emilie
References:
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Diz-Chaves Y, Herrera-Pérez S, González-Matías LC, Lamas JA, Mallo F. Glucagon-Like Peptide-1 (GLP-1) in the Integration of Neural and Endocrine Responses to Stress. Nutrients. 2020 Oct 28;12(11):3304. doi: 10.3390/nu12113304. PMID: 33126672; PMCID: PMC7692797.
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