Understanding New Weight Loss Drugs

Weight loss drugs have been all over the media recently. The Kardishan’s use them, Oprah just had a special on new weight loss drugs. But do they really work? And what is the risk?

What are the top weight loss drugs?

1.     Semaglutide (Wegovy, Ozempic)

2.     Tirzepatide (Zepbound, Mounjaro)

3.     Liraglutide (Saxenda)

4.     Phentermine (Adipex, Suprenza)

5.     Phentermine-topiramate (Qsymia)

6.     Naltrexone-bupropion (Contrave)

7.     Setmelanotide (Imcivree)

8.     Orlistat (Xenical and Alli)

This blog post will focus on GLP-1 agonists, most commonly known as Ozempic, Wegovy or Manjaro. GLP-1 agonists are the most widely used new weight loss drugs.

How do GLP-1 agonists work?

GLP-1 agonists work by increasing GLP-1. GLP-1 is a peptide hormone that primarily acts in the gut to impact insulin signaling. This is why these drugs started out for individuals with Type 2 Diabetes.

An increase in GLP-1 slows down how fast the stomach empties and slows movement throughout the digestive system, this helps people to full faster and longer. This allows people to eat less and lose weight! There are most likely other ways that GLP-1 agonists work to promote weight loss and lower blood sugars that we don’t completely understand yet.

Can you eat whatever you want?

Nope, sorry. You still need to follow a healthy diet to lose weight and to allow these weight loss drugs to work to their full potential. In fact, it is recommend that patient’s that are prescribed GLP-1 agonists work with a dietitian to not only boost weight loss results but to also limit the risk of experiencing side effects.

Nutrition while taking GLP-1 agonists includes:

1.     Follow a high protein, low fat and low carbohydrate diet

2.     Practice mindful eating

                                                                              i.        Eat only when hungry

                                                                            ii.        Eat slowly with no distractions

                                                                          iii.       Eat only until you are about 80% full

3.     Eat small, frequent meals with smaller portion sizes

4.     Boil, bake or grill your foods

5.     Consume water rich foods like fruits and vegetables

6.     Avoid excessive sweets

7.     Work with your dietitian to set a calorie goal that meets your needs

8.     Include high fiber foods at every meal

What about physical activity?

You should work with a dietitian to increase your physical activity while taking weight loss drugs. Studies have found that increasing activity while taking GLP-1 agonists can improve weight loss results. Adding strength training, like weight lifting, is also key to avoid muscle loss that can occur with GLP-1 agonists. Lastly, studies have found that physical activity can decrease your risk of experiencing side effects associated with GLP-1 agonists.

What are the side effects of GLP-1 agonists?

The most common side effects of GLP-1 agonists are nausea, vomiting, diarrhea and constipation. But there are some things you can do to avoid these side effects, in addition to increasing activity:

o   Do not lay down within 30 minutes or eating and do not eat close to bed time

o   Have clear drinks, take small sips and don’t gulp

o   Follow a bland diet for nausea and vomiting

o   Eat enough fiber

o   Follow nutrition recommendations outlined above

This is a long-term drug

GLP-1 agonists are meant to be taken long-term to help patients not only lose weight but to keep it off. It is not a drug you take to lose a few pounds and then stop.

Think of it like high blood pressure, if you are taking blood pressure medication you don’t stop taking it when your blood pressure is within normal limits, you keep taking the medication so that your blood pressure stays within normal limits. It is the same with these weight loss drugs.

We need more long-term studies to tell us what happens when people stop taking GLP-1 agonists. However, it appears that most individuals will re-gain their weight loss if they stop taking the drug. This weight re-gain can be kept in check if individuals work with a dietitian to stay on track with their dietary goals.

Did you know that Dr. Maria is an expert in the use of GLP-1 agonists for diabetes and weight loss? She has worked with many patients using GLP-1 agonists and has provided continuing education for dietitians on the topic. Interested in learning more? Reach out to Dr. Maria!