Wegovy and ozempic, two medicines from the class glucagon like peptide analog(GLP-1), have recently garnered a lot of attention for their potential to help with weight loss and are being embraced by both celebrities and everyday people. These are not exclusive ones from this class, but have been studied extensively for weight loss. Other examples include trulicity, victoza, mounjaro). Rybelus is available in oral form.
Both wegovy and ozempic are given by injection once a week. They work by curbing hunger. While the exact mechanism is unclear, it increases transit time for food through stomach and small intestine, thereby making people feel full longer. Most likely, there is also some effect at the level of central nervous system.
Here are few things to keep in mind:
1: people taking the medicine lose weight, on average 33.6 lbs in a little over a year, compared to 5.7 lbs that others lose with traditional diet and exercise.
2: the weight loss with the medicine is often faster than bariatric surgery, especially in the first 1 year, although long term effects are yet to be seen.
3: Nausea, vomiting and constipation are the most common side effects, especially with higher doses of the medicine as used in weight loss. (74.2% people on these medicines experienced these side effects, as opposed to 44.9% taking the placebo). Nevertheless, 81% people in the trial were able to remain adherent to the treatment at 1.3 years.
4: More serious side effects involved gall bladder diseases, especially gallstones ( 9.8% people on the medicine as opposed to 6.4% who were on placebo arms/aka sugar pills or injection in this case ).
5: Depression or suicidal ideation with these medicines got a lot of press initially, but the findings are mixed at this time, with other studies showing it improves mood. Long term data is needed.
6: The medicine can be costly and may not be covered by your insurance. Additionally there may be supply chain issues with huge demand.
7: Long term data about safety is lacking.
8: In rat models there was increase in thyroid cancer risk, although not seen in human phase of the trial. If there is family history or personal history of thyroid cancer, or other types of endocrine organ cancer, exercise caution.
9: Majority of trial participants were white women. Effects on others may not have been studied well.
So, is this the right medicine for you?
If you have medical illness due to increased body weight ( ie heart failure, heart attack, sleep apnea, diabetes) and you need to lose over 10 lbs, I would think you have a compelling reason to try. Especially if you are not worried about long term effects of the drug ( a situation where short terms effects of excessive weight is killing you faster than any unknown long term effects of this drug).
However if you need to lose 10lbs or less , this is possible to achieve with diet and exercise alone and I would refrain from using medicines to achieve the end results.
No matter what decision you make, it's important to have guidance from a healthcare professional to ensure safe and effective use of these medications.
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