Episode 64 Is Ozempic the Weight Loss Solution We've Been Waiting For?

Can a single medication truly offer a miraculous solution to weight loss? Join me as I unravel the complexities behind semaglutide, also known as Ozempic, and its surge in popularity. This podcast is a summary of some of my recent reading on the subject, it is not medical advice, it is just beginning a conversation that should ultimately happen with your doctor if you are considering using weight loss medication.

This podcast episode delves into how this this medication functions, its potential side effects and social consequences; and whether it might ever be a good idea to take it.

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Credit for the music used in this podcast:

The Beat of Nature

Music by Olexy from Pixabay

Transcript

Fiona Kane: 0:31

Hello and welcome to the Wellness Connection. I'm your host, F fiona K ane. Today, my topic is actually all about semaglutide, which is a weight loss medication. It's such a topical thing at the moment. It's actually just spreading across the world. People like Oprah are taking it and everyone in Hollywood pretty much. You look at all of the Hollywood stars who've suddenly lost weight recently. Most of them it's due to this medication. Semaglutide, which is another name for it, is Ozempic. There's several other brand names I thought it was worth talking about because it's one of those medications like all things, things have benefits and the downside, and I wanted to talk about that because I know that it's already starting to sweep Australia, these sorts of medications, and it's sweeping the world and we need to know about it.

Fiona Kane: 1:26

We need to have these discussions. So I just thought it was worth having these discussions. I would also like to just mention that I am not a pharmacist or a doctor, so medications are not my specialty. I have been working with individuals for many years now with all sorts of challenges around weight and blood sugar and those sorts of things, but ultimately, I'll send you back to talk to your doctor about this. Don't make decisions based on what I say this is just me. What I've done is I've been listening to podcasts and reading literature and just soaking in as much information as I can, and this is just me, giving you a bit of a summary of some of those things that I have learned. I'm not the expert. I'm just starting a discussion in regards to this. I think it is an important topic, though, because these kinds of medications can get very popular very quickly, so people need to understand what they are and what they do.

Fiona Kane: 2:25

So semaglutide is what's called a GLP-1 receptor agonist, and what they do is they mimic intestinal hormones. So what that ultimately means is or what it does is it stops you from being hungry, so it delays gastric emptying, which is your stomach emptying, and it stops you from being hungry, so you sort of get that message to your brain that you're full even though you haven't actually eaten. So that's how it works, now, what it does. Unfortunately, though, because it delays gastric emptying, it causes a lot of gastrointestinal problems. So many people I think it's over 50% or around 50% will have digestive issues, so they'll have nausea or vomiting, or constipation or diarrhea, and they're not rare symptoms. They're very common symptoms. And then for some people. It's even worse because some of the severe things that can come about from this medication are things like pancreatitis, bowel obstructions, I think. Because it's slowing everything down, people end up with bowel obstructions and gastroparesis, which is a really nasty condition with the stomach. That is very life-changing and really severe disease. Also, what we see is we're seeing that there's things like kidney failure, but there's also depression and suicidal ideation that we see in regards to this medication.

Fiona Kane: 4:09

Now, at this stage, those numbers are relatively small. I'm not going to try and overstate those numbers, but they are there and this medication is still relatively new. It's been used with people with diabetes for quite a while now, but as far as being used as a weight loss medication, it's relatively new. So at this stage too, it's fair to say, we don't have a lot of data. There's a lot of data that's gathering, but we don't have a lot of data we don't have. Well, there's a lot of data that's gathering, but we don't have as much data as we need. And with data, what we need is we need these long-term things, we need to see what happens over time, and so it's not been used for long enough for us to have that long-term data of how it affects people. All we know is kind of how it affects people over a couple of years, because that's as long as the data is at this point in time. So it does have some really really nasty effects for some people. So we have to take into account the risk-reward situation with this medication.

Fiona Kane: 5:13

Now, glp-1 is actually a natural hormone that we release in our intestine and we release it in response to eating. So when we eat food, we have a homeostatic mechanism where the body knows how to regulate everything. And when we eat food, this hormone is released and the message goes to the brain to set in motion the instructions to tell you to stop eating. So we have these feedback loops in our body with hormones that sort of say okay, we're eating now, all right, let's send off this message, right, okay, and eventually it sends off that message to let you know to stop eating. And it's one of the reasons that I encourage my clients to eat slowly and consciously, because you give your body time to send that message to the brain and for your brain to receive the message, whereas when we eat really really quickly, by the time our brain gets the message, we might have already sort of eaten, you know, not to satisfaction, have already sort of eaten, you know, not to satisfaction, but to sort of exploding kind of thing. So if you eat slowly enough, you allow your body to send those messages through and to know that you've had enough, whereas if you eat really quickly or if you're not paying attention, we do tend to overeat. So eating consciously resolves a lot of these issues that you issues, that your body will naturally just tell you that you've had enough. So GLP-1 actually helps with your insulin response. It crosses the blood brain barrier as well, so it's active in the midbrain and it tells you to stop eating. This drug replaces that and it does that message straight to your brain without needing the food.

Fiona Kane: 7:01

There's many issues with this that concern me, because it sounds great and it's been called a miracle drug and people are losing weight. Absolutely. The issue is that, well, for starters, straight away, just by what I've just said, just the last couple of statements, you can see that this medication, if used incorrectly or if used by people with eating disorders, you can see the attraction there for people with eating disorders. Okay, so for starters, this medication, it's going to need to be kept really, really strictly under doctors who have to actually have consultations in person with their clients to make sure that those people are safe and appropriate to go on this medication because you can just see straight away that kind of stopping you from being hungry is. I can see why it might be useful for people with severe obesity, but at the same time, if people get hold of it who are starving themselves, you can see this isn't going to be a major issue for those people.

Fiona Kane: 8:13

The other concern for me is just anything. One of my jobs is to teach my clients how to listen to their body. And when you listen to your body and you eat in a balanced way, all of these hormones do their thing. And so the idea of giving you a medication that replaces your body's hormones and then stops you from feeling hunger it kind of has the opposite thing, where it's actually making you quite disconnected from your body. And also because in many people it gives you such terrible symptoms, I think it would disconnect you from your body even further in the fact that you're feeling sick or you're feeling awful, you're feeling pain. So you kind of just try and disconnect and not listen and pay attention to your body because you're feeling pain, so you kind of just try and disconnect and not listen and pay attention to your body because you're trying to overcome that feeling. So one of my concerns is just that, really that disconnection that people will have with their body by using a medication like this instead of letting their body do it for them. So that's a big concern for me that it's having the opposite effect, because you're going to be more disconnected from your body and, in my opinion, to heal your body and to look after your health, we need to be connected. We actually need to be there and present and connected and if we're sort of not hungry and not interested in food and feeling sick and more likely it's going to have the opposite effect.

Fiona Kane: 9:32

So the other thing that I'm just checking my notes here just making sure I'm covering what I want to cover the other thing is that we have other hormones that the body makes. So we have a hormone called cholecystokinin which is released when we eat fat. We have a hormone called peptide YY I think it is and that's released when you have protein and these hormones also tell your body to stop eating. I tell your brain it's that kind of brain-body connection to tell you to stop eating which is why I always talk about with my clients when they're eating is to have a balanced meal, because if you have protein in a meal and you have fat in a meal, well, straight away you're getting those two hormones that will help you feel full, right and, to encourage you to stop eating, also keep the blood sugar levels balanced, and then, if you add things like fiber, fiber also will slow things down. So you naturally do this by having a balanced meal, and so taking medication to do that is a problem.

Fiona Kane: 10:47

You can also see the other issue that if you're not as hungry and not eating as much, okay, I understand that that can be a great thing for weight loss. I have a big concern about nutrient deficiencies, though. So we're going to get a whole bunch of people because they're not hungry. They're just going to be nutrient deficient. They're just going to have no nutrition and actually even just something else I just thought of, then, is that, beyond the nutrient deficiencies, if you're not eating enough, you're going to get nutrient deficiencies. The other issue is, too, that I'm not eating enough fat for all the nutrition deficiency reasons, but also what happens is if we don't eat enough fat, if we're not eating fat in our diets, we tend to start to end up with things like gallstones, because if you're not pumping out that bile regularly in response to fat, the bile sits there and then it starts to form stones, gallstones. So I wonder if I don't know if they've seen this yet. We'll see if it happens. But if you're not particularly hungry, you're probably eating less fat, more likely to have gallstones develop, but also nutrition deficiencies, and they can be really severe. And the other thing too I'm just going to go further down there's more issues with this medication. So sorry, I'm just getting to the right spot because I just want to make sure I'm explaining this well.

Fiona Kane: 12:14

So when you're taking a hormone rather than making a hormone, what happens is your body stops making the hormone. So when we're sort of taking this GLP-1 hormone, then what's happening is our body's going to stop making it internally. So we're taking it exogenically, so we're taking it from outside of the body. So endogenously, inside the body, your body will stop making the hormone. And when it stops making the hormone, does it effectively start making the hormone again if you go off the medication and I don't know that?

Fiona Kane: 12:49

We know the answer to that yet I think there's a question mark around that. So do you start making it again at all? And if you do start making it again, are you making it as effectively as you used to? And is there or does it? Will it eventually be okay, came back to normal or not? How long does it take? There are things that we don't know yet.

Fiona Kane: 13:10

So, essentially, your body's got this hormone, your body's doing this job for you. You're going to take something else to do it instead, so your body's going to stop doing it. The question is, is your body going to start doing it again? That's a good question and that's something we don't fully know the answer to yet. So there's an issue there. So the other issue that we have is that it does cause muscle loss at quite an alarming rate muscle loss and bone density loss, and there's massive issues there. So psychopedia, which is that low muscle low muscle is the highest predictor of aging poorly and just lack of longevity and having difficulty as we age. So having that low muscle mass is a real issue.

Fiona Kane: 13:59

And there's doctors like Dr Peter Attia. What he says is he actually won't prescribe this medication until after he does a DEXA scan on his clients to see what their bone and muscle mass is. I don't know if a DEXA scan does it show bone mass I'm not sure, but anyway, obviously he does test on his clients just to see if he feels it's safe to even put them on this medication. And I can see that this being a big issue for women of my age who already, because of our hormone situation, are at very high risk of this low muscle mass and this low bone mass, I can see it being a real big risk. So for someone like Oprah, I can see that's a really big risk for her and sort of anyone in my age group. That's, if you're not getting those hormones anymore, those estrogen and progesterone, then you are at really high risk for having those issues. And I've talked about it before.

Fiona Kane: 14:56

But when we have low bone mass and low muscle mass, that actually really reduces our mobility. It reduces how steady we are on our feet. So because we're unsteady on our feet, because we have a low muscle mass, we're also more likely to have falls and more likely to have breaks and those breaks are more likely to be catastrophic right. So broken hips and things like that. Essentially, it reduces your independence and your function as we get older and because you're unsteady and at risk of falls and breaks. It can really cut your life short or really make your life miserable. So this is not a this, oh, a yellow muscle. It's not a small thing. It's not sort of oh yeah, you know, but I'll be skinny. Well, you may be, but it may be a real major issue for you as you get older, and it probably will be. So we do need to look at this.

Fiona Kane: 15:54

Look, the other issue too is that because you're not eating much when you're on this medication, because you're not hungry, what we're doing is we're slowing down our metabolism, right? So when you starve yourself, your body will lower its metabolic set point. So what happens then when you go off the medication? Well, when you go off the medication now, your metabolism is really slow. It takes a long time to build that up again. So it's going to take a long time to build up your metabolism again. Will you be able to or not take a long time to build up your metabolism again? Will you be able to or not? I don't know. We don't know these things. And will you make enough of the GLP-1 now that you need to make it yourself? We don't know the answer to that yet either. What I do know is that hunger is actually a sign of a healthy metabolism. So just the idea of taking away a sign of health in someone is and actually the health itself potentially is really scary.

Fiona Kane: 16:53

Look some of the other issues that we have around this is there's an issue of. So I said one of the issues was depression for people and I could see how that could come about and it's probably it's like multifactorial. There's more see how that could come about and it's probably multifactorial. There's more than one reason it comes about. So one is, as I said before, you probably have nutrient deficiencies after a while, because when you're not eating enough food and enough nutrition and if you're feeling sick and not feeling good, you might not be eating quality food either. So when you do eat it might not be good quality. I don't know what you do eat, what people are attracted to, but they might not be attracted to all of the nutrients, to sort of that balanced diet. I don't know, but anyway you're more likely to end up with nutrition deficiencies, which I've talked about it before mood and food, that the food you eat, all the nutrients, make a lot of the serotonin and dopamine and all the great things that help you with your mood. So we really, really need to be eating this food for our mood.

Fiona Kane: 18:02

But the other thing, too is look at a couple of things. So one is, if you think about social occasions and our social connection, a really big part of that for us is food. So food is a really big way that people connect and they have parties and dinner parties and they go out to dinner and they have barbecues and they do all the social things. A lot of our social stuff is actually around food and food is the common thing that brings us together and there's people not particularly hungry and so it must make it a lot harder. I've heard people say it doesn't make it harder when they go out to dinner and go out to events and things like that, because they're not having the joy in the food and they're not likely to eat with other people or eat as much or not saying that you have to eat exactly the same as other people. But you know what I'm saying? That if you just don't have that joy in it or you're not particularly hungry, you might find that you don't have as much, you're not connecting with people, maybe you don't want to go out to a meal because you don't want to pay for a meal that you know you can't eat. I don't know, but anyway I can imagine it would have an effect that way.

Fiona Kane: 19:17

But the other concern is that sort of we're not sort of talking about. That we need to talk about is there's other reasons why people eat. So a lot of people eat to manage their emotions and I'm not saying that's necessarily a good thing, but that's a very common thing that people eat to manage their emotions. So if you are somebody who's eating to manage your emotions and that's how you feel better and feel okay and it might help you you know numb feelings and all sorts of things. If you're doing that and suddenly you're on a medication that stops you from being hungry, you can't use food for that anymore and also you can't eat a lot when you're on it. Apparently it does make you feel really sick. You just cannot eat a lot, right? So if you can't eat much and this is actually the same thing that can happen for people who have stomach surgeries as well when you can't eat much or eat the things that you used to like, that used to sort of satisfy that emotional thing. Now suddenly you don't have your crutch, you don't have your thing that you do to deal with your emotions.

Fiona Kane: 20:18

Now, of course, ideally we learn other things and we have other strategies, and that's one thing that I do work with with my clients is other strategies for managing emotions, because food is not, obviously is not a good way to do it. Uh, not in a, you know, as one of, as one of many things where it's a small amount, where it's not affecting your health, yeah sure, but if your only way of managing your emotions and the way you feel is through food, then that can obviously lead to really big challenges, right? So if you're, if you're a person who hasn't learned how to manage those things, and then suddenly you're on this medication, I would imagine you're feeling disconnected because you're not hungry and you don't really want to eat with other people. You may be having lower nutrition overall and so you're not getting the nutrients to make you feel good but to also maybe feeling more raw and feeling your emotions more, because if you've been using food to manage your emotions and numb yourself, suddenly everything's kind of raw and you feel really sharply, feeling your emotions. That might be really challenging for you.

Fiona Kane: 21:24

So I would say that, if you're a person who's using food to manage your emotions, that you might want to seek help from someone like me, or from a psychologist, or from a counselor or whoever it is whichever is the best for you, but to learn strategies of how to manage and deal with your emotions before you go on a medication like this, or along with go on a medication like this or along with being on a medication like this, because that would add to the risk of mental health issues if you were to start a medication like this and not know how to manage your emotions, not know how to manage your feelings. So be aware of that and look the other thing too. So be aware of that and look the other thing too. It's worth saying that the thing that people are actually dying from with this medication is actually bowel obstructions and bowel ruptures, and that's really scary stuff because it sort of slows everything down, and this is what happens, and while it's only happening in a small number of people, it is happening, and while it's only happening in a small number of people, it is happening, and we have to understand that everything has its sort of risk and reward. Look, the other thing, too, is to understand that when you're on this medication, eventually your body does build up sort of like a tolerance to it, so you do plateau and then you're so the drug's not working as well as it used to and, like I said, when you go off the medication is your body going to do it for you? I don't know. We don't fully know that yet.

Fiona Kane: 22:57

So the summary that I would have for you in regards to this is it would seem that the times that it might be useful to be on this medication under obviously under strict supervision by a physician, by a doctor, would be if you have diabetes or if you have really quite severe obesity, where it's really life-threatening for you. In those situations, for those people, it might actually be worth. When you look at the risk reward ratio, the risk might be worth it. I'm not saying it is worth it, I'm saying it might be, and it's worth talking to your doctor. If you are not in that situation and you're just wanting to sort of lose a few kilos and look good or whatever. I think the risk reward ratio I don't know that it's there, I don't know that the reward is high enough to go with the risk at this point in time. I would just say talk to your doctor, get more information and understand that.

Fiona Kane: 24:07

What we don't know is we don't know if you will need to be on the medication pretty much forever, because if you go off the medication, what we do know is when people go off the medication, they do put the weight back on. So it seems to happen in um in most cases and and we don't know, like I said, if your hormones are going to kick back in um. And I don't know in regards to with the uh, with the digestive issues, I assume that some of those, if you develop gastroparesis or those issues, that it might be permanent even if you do come off the medication. So I don't know that. It's been around for long enough yet to feel safe to say that it is a miracle drug that everyone should take. I don't think it is. Is it a useful medication?

Fiona Kane: 24:54

In some situations it looks like it is and I think if you have a doctor that is really understanding of all of the balance of all of these things and really looking out for your health in your personal situation, then they maybe will help you navigate this for yourself as to whether or not it is a healthy way to go, but I would encourage people to know that when you eat a balanced meal that's got protein and it's got fiber and it's got like vegetables for fiber, it's got good fats like avocado and olive oil, all the fat that's in eggs, that kind of thing, when you eat that way, it's a really balanced way and a lot of these hormones get released and you're eating slowly and you're eating consciously. Your body will do this for you, right? So I would just encourage you to don't rush out and jump on the boat. Please have discussions with your doctor if this is something you're considering doing. Don't try and buy it from overseas or any kind of dodgy websites or anything like that. This has got to be something that's closely monitored by a medical specialist and you really have to decide if the risk is worth it.

Fiona Kane: 26:05

I think there are high risks to it at this point in time and, not knowing the long-term effect that if you're going to mess things up long-term, that really does concern me and I'd be more comfortable with giving it a few more years and seeing what our data shows, because one thing that I have seen over the years is there's been lots of miracle weight loss drugs and everything. Everyone thinks they're great and within a few years they're gone and everyone's talking about the damage that they did. So I don't know if this is going to end up in that camp or if it's going to end up being being the miracle drug. We will see the juries out on that. But anyway, like I said before, I'm not a specialist in medications. I'm just giving you a bit of a summary of some of the things I have learned. Please talk to your doctor if you're considering taking this.

Fiona Kane: 26:55

I just think that the risk outweighs the reward in most cases. In my opinion, when it's not related to diabetes or, like I said, someone with severe issues with their weight, where it is life-threatening or going to be life-threatening, I think that's when maybe the reward is worth it. I don't know. Anyway, that's all I have to say about it at this point. That's what I know about it at this point. If I learn something new or if this information is updated, I will talk about that as well. Anyway, if you haven't already, can you please like and subscribe and share and tell other people about this? We're on a rumble and YouTube, as well as all the usual podcast platforms, and so, yeah, just please do all the things to help me get more listeners and hope you have a great week. Talk to you all again soon. Thank you, bye.