With the new year now upon us, we will be inundated with "New Year, New You” advertising some might say is unfair and even predatory tactics from companies all over the world.
Now, please don’t think that I’m being heartless with the title above, I know that living with overweight or obesity is unbelievably difficult and is a hugely complex situation…we are after all like polar bears trying to live in the Sahara Desert (our DNA is diametrically opposed to the environment we live in now). I also am aware of the irony that my companies @Build a Bridge and @Essentio Health will most definitely use this time to support people who want to make a change…but therein lies the difference, my companies will not be touting a quick fix or silver bullets… we will be supporting wholistic lifestyle change as that is the key, NOT a simple injection of a new drug which is unlikely to change a lifestyle.
But for all of those people who have asked me what these wonder drugs are, here is a little info for you. Originally developed for type 2 diabetes treatment, these Glucagon-like peptide-1 (GLP-1) receptor agonists have shown promising results in weight loss, garnering attention from both the medical community and those striving for weight management. GLP-1 receptor agonists mimic the action of the naturally occurring hormone GLP-1, which plays a crucial role in regulating blood sugar levels. The drugs, including names like liraglutide, semaglutide, and exenatide, have been primarily used to enhance insulin secretion and lower blood glucose in type 2 diabetes (Drucker, D.J., 2020, Endocrine Reviews).
However, an interesting side effect was observed: significant weight loss (Meier, J.J., 2012, Diabetes, Obesity and Metabolism). The weight loss effects of GLP-1 receptor agonists are primarily attributed to their ability to slow gastric emptying, enhance feelings of fullness, and reduce appetite (Nauck, M.A., & Meier, J.J., 2016, Diabetologia). This can lead to a reduced calorie intake and, consequently, weight loss.
Several clinical trials have demonstrated the efficacy of GLP-1 receptor agonists in weight management. For instance, a study on semaglutide showed an average weight reduction of 15% over 68 weeks in overweight or obese individuals (Wilding, J.P.H., et al., 2021, New England Journal of Medicine). These findings are significant, considering the challenges associated with weight loss through diet and exercise alone.
While the benefits are promising, it's crucial to consider the potential side effects. Commonly reported issues include gastrointestinal symptoms like nausea, vomiting, and diarrhea (Pi-Sunyer, X., et al., 2015, JAMA). There's also a concern about the risk of pancreatitis, although this remains relatively rare (Steinberg, W.M., et al., 2010, Gastroenterology). Patients with a history of thyroid cancer or familial medullary thyroid carcinoma are advised caution due to a noted risk in animal studies (FDA, 2020).
So, as I say to everyone who has already asked me the question, it's super important to approach GLP-1 receptor agonists as just a potential tool, rather than a standalone solution, for weight loss. Lifestyle modifications, including diets plentiful in fresh fruit, vegetables, fibre and protein combined with both high and low-intensity exercise (cardio, strength and stability), remain foundational...not to mention the mental shift required. These medications should be considered in the broader context of an individual's health profile and in consultation with healthcare professionals.
The advent of GLP-1 receptor agonists for weight loss marks an exciting development for people living with obesity, and while they offer a new ’tool’, a balanced approach that weighs their benefits against potential risks is essential. As research continues to evolve, these drugs could represent a significant addition to our toolbox when it comes to healthy weight management.
References
Drucker, D.J. (2020). Endocrine Reviews.
Meier, J.J. (2012). Diabetes, Obesity and Metabolism.
Nauck, M.A., & Meier, J.J. (2016). Diabetologia.
Wilding, J.P.H., et al. (2021). New England Journal of Medicine.
Pi-Sunyer, X., et al. (2015). JAMA.
Steinberg, W.M., et al. (2010). Gastroenterology.
U.S. Food and Drug Administration (FDA) (2020).