PHARMA or SURGERY: You decide
When considering weight loss strategies, two primary options often emerge: GLP-1 analogs like Semaglutides (OZEMPIC and Wegovy) and Tirzepatide (Mounjaro), as well as Bariatric Surgery. These methods vary significantly in terms of their mechanisms of action, potential weight loss results, side effects, risks, and associated expenses.
Interestingly, both medications and bariatric surgery share a common mechanism for inducing weight loss: they activate a crucial hormone called Glucagon-Like Peptide-1, or GLP-1.
What is GLP-1 ?
GLP-1, or Glucagon-Like Peptide-1, is a hormone predominantly produced in the human intestines and is secreted upon nutrient contact. It is synthesized within the enteroendocrine L-cells in the small intestine, especially in the ileum and colon. These L-cells are specialized to react to the presence of nutrients such as carbohydrates, fats, and proteins in the gastrointestinal tract.
Once GLP-1 is in our blood stream, it produces the following effects:
1- increase in insulin secretion from the pancreas improving Type II Diabetes
2- Reduce gastric emptying,
3- Induce satiety.
4- Impact on Food Preferences. Patients are not that much attracted to certain foods
5- Energy Expenditure: Some studies suggest that GLP-1 can increase energy expenditure
Results:
Semaglutide, when prescribed for weight loss, has been shown in clinical studies to lead to significant weight reduction in many individuals. The exact amount of weight loss varies depending on several factors, such as the dosage of the medication, the length of time it is taken, individual metabolic differences, and whether it is combined with lifestyle changes like diet and exercise.
Typically, people using semaglutide experience an average weight loss ranging from about 5% to 15% of their initial body weight. This range can be higher or lower depending on the individual's response to the medication. The weight loss is usually more pronounced at higher doses of semaglutide and with longer duration of treatment.
It's also observed that the effectiveness of semaglutide in promoting weight loss is enhanced when it is combined with lifestyle modifications. This includes following a balanced diet and engaging in regular physical activity. The weight loss journey with semaglutide is gradual, and the most significant results are often seen over several months of consistent use.
The drawbacks of injectable weight loss medications:
There are several drawbacks associated with the use of semaglutides, such as Wegovy and Ozempic, which include:
1- Method of Administration: These medications require regular injections, which might be inconvenient or uncomfortable for some patients.
2- Cost: Semaglutides can be expensive, often costing around $1,200 per month. While insurance may cover these costs for diabetes treatment, coverage for weight loss purposes is often not provided, leading to high out-of-pocket expenses.
3- Side Effects: Common side effects of semaglutides include nausea, diarrhea, and fatigue. These side effects can be bothersome and may affect a patient's quality of life or willingness to continue the treatment.
4- Weight Regain After Discontinuation: A significant drawback is the possibility of regaining weight after stopping the medication. Studies have shown that a significant portion of the weight lost can be regained within a year of discontinuing the treatment.
These drawbacks need to be carefully considered against the benefits when deciding to use semaglutide for weight management or diabetes treatment
Semaglutides: Warning and Precautions
(Source: Novo Nordisk)
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Risk of Thyroid C-Cell Tumors
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Acute Gallbladder Disease
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Hypoglycemia
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Acute Kidney Injury
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Hypersensitivity Reactions
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Diabetic Retinopathy Complications
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Heart Rate Increase
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Suicidal Behavior and Ideation