Drugs are not a shortcut to weight loss - opinion

This story seems to play itself out over and over again. Will this have the same ending? Is this really the answer to the overweight and obesity epidemic? This time, it comes in the form an injectable drug called Ozempic. This drug is a semaglutide which is used to treat type 2 diabetes. Someone noticed that besides treating diabetes, it was bringing about significant weight loss. Many people have been able to lose 12%-14% of their body weight by taking these injections. So is this really it? The end of obesity and the solution to many chronic diseases, especially type 2 diabetes?

On my desk is a long list of drugs. What do they all have in common? Over the last 40 years they were all approved by the Food and Drug Administration in the United States as safe and effective for weight lost. Ultimately, all of these drugs were withdrawn from the market because although they were effective for weight loss, they also harmed and killed people. Yes, you read that correctly. But that’s not all. We know about all of the various bariatric surgeries. Amongst them is LAP banding, which has a relatively high failure rate, but nevertheless, there are still bariatric surgeons using it. Weight loss surgery such as gastric bypass and sleeve gastrectomy have been far more effective than the band. However, if you don’t learn how to change your eating before the operation, you might not see much success. Twenty percent of those who have a bariatric procedure fail in just two years. Over time, that number rises. This does not take into account the number of complications after the surgery of secondary infection and leakage. 

I believe we all know someone who had a bariatric procedure and ended up with little or no weight loss. So, whether it’s drugs or surgery, there is no magic wand here.

Now, back to Ozempic. Business is business. Novo Nordisk petitioned the FDA to remarket Ozempic as a weight loss drug under a different name. They called it Wegovy. The same drug with a different name. Hmm! Now, another drug, called Mounjaro, which is a Tirzepatide, is about to be approved for weight loss. It is even more potent and can bring about 22% reduction in body weight. So it all sounds good, but it isn’t.

The United States is one of the very few countries in the world where one is allowed to advertise prescription medication. Television commercials show luscious scenery and catchy music on their advertisements and they literally seduce the consumer into thinking this is the answer. That decision should be made by a doctor and preferably without pressure from the patient who is still singing the jingle in his office. Saying things like “We’ve found a solution” is misleading and just plain wrong. In the UK, these ads have led to an investigation by the Association of the British Pharmaceutical Industry for deception and misleading the public. With all this, everyone seems to want the medicines, and still, no one wants the proven and tried way to good health – the proper diet, exercise and activity, and a good night’s sleep.

Aside from the unsustainability of these drugs, these injections can have side effects, some of them serious. They can lead to pancreatitis, kidney problems nausea, diarrhea, gallbladder disease, and may increase the risk of thyroid cancer. No one seems to be concerned about an obvious long-term problem – malnutrition. As this is an appetite suppressant, and can easily result in inadequate food intake, there is a potential for hair loss and even crazy vivid dreams. This was all pointed out in a recent Medscape editorial by Dr. Adriane Fugh-Berman and Judy Butler MS.

In addition, the World Health Organization has come out with a statement that Wegovy is not a “silver bullet” for the ever worsening obesity crisis. It also adds that even those who might really need these drugs still need to incorporate a healthy diet and exercise.

PART OF our problem with obesity and overweight is approach. There are thin people with high blood pressure, type 2 diabetes, high cholesterol and heart disease. It isn’t the weight loss, it’s the health behaviors. We take a different approach here at The Wellness Clinic. We attack disease. What do you need to do in order to prevent and reverse disease? That, in turn, will lead to weight loss. And that approach tends to bring sustained weight loss, unlike standard diets and drug therapy. The number on the scale is a good indicator of health, but it is one of many indicators. How many new healthy habits and behaviors one adopts is far more important. I tell my clients to concentrate on their program and lifestyle measures, and the rest will follow.

When we stop the injections, the weight comes back on almost immediately. And evidence indicates that it comes back in full force. That isn’t a cure for a health problem. That is a temporary fix! That may be necessary in some cases, but we can’t look at the administration of these drugs as an endgame.

 lifestyle medicine with a focus on eating whole foods

We have spoken about the negative side effects of Ozempic and Wegovy injections. So, what are the side effects of using lifestyle medicine with a focus on eating whole foods, mostly plants? Well, study after study has shown weight loss, higher energy, lower risk of most chronic diseases by about 80%, a strengthened immune system, less chance of infectious disease, and the list could go on and on. The bottom line is longer life and a much better quality of life even into our later years.

The way this category of drug works is to increase a hormone called GLP-1. Is there another way to increase GLP-1? Yes there is. According to Dr. Neal Barnard of the Physicians Committee for Responsible Medicine, consuming whole grain complex carbohydrates full of fiber goes a long way to curbing your appetite and giving you a full feeling.

There are people for whom drug therapy is needed. No one can deny that. But drug companies and many doctors are overpromoting these pharmaceuticals. Ozempic or other similar drugs are not the answer to obesity. Weight loss is a complicated subject, even though we try to simplify it for the public. It certainly is not just calories in and calories out. There are multiple factors involved. The old adage of “if it’s too good to be true, it’s too good to be true” is in play here.

But let’s get an understanding as to the basics. If we focus on the type of food we eat, meaning a plant-predominant, low-fat (including oils) diet, and if we stop consuming ultra-processed food, which still makes up over 60% of the American diet, the changes in health outcomes and weight loss can be immense. As we have been discussing a diabetes drug, I can testify to the fact that I have seen, through dietary change, fasting glucose drop hundreds of points in a matter of a just few weeks. Add activity, sleep, stress management, good social integration, not smoking or vaping, and you might just see a whole new life, without the side effects of drugs, and this will “add hours to your days, days to your years, and years to your life.”

The writer is a health and wellness coach and a personal trainer with more than 25 years of professional experience. He is the director of The Wellness Clinic and can be reached at alan@alanfitness.com.