Today I read a post on Facebook by a dieter who said she needed her excess weight to be gone – POOF! I was kind of alarmed when I read further and saw that she’s doing intermittent fasting for 20 hours a day, only eating during a 4 hour window. She’s dropping pounds quickly even though her meals include entrees like beef with veggies and Cheese Whiz. Sounds like the type of diet I would have pulled off when I was young.
For more on those fad diets, see my earlier post called The School of Hard Diets: https://lindawbrowning.com/2023/01/22/the-school-of-hard-diets/
But is there really a diet to “poof” the pounds away like magic? I think that’s what we all wonder when we buy into diet culture. In general, when I engaged in fad diets the plan was not sustainable. Weight quickly lost can be regained even faster. We all wish that this was not the case, but it’s very hard to maintain this type of weight loss.
The latest in pharmaceutical technology has brought us a new class of drugs like Ozempic and Wegovy that almost seem to make this dream a reality. It’s a little soon to know what the long term effects will be for glucagon-like peptide 1 (GLP-1) agonist pharmaceuticals and similar drugs.
What do GLP-1 agonists do? I think that the Mayo Clinic can provide a far better explanation that I ever could!
“These drugs mimic the action of a hormone called glucagon-like peptide 1. When blood sugar levels start to rise after someone eats, these drugs stimulate the body to produce more insulin. The extra insulin helps lower blood sugar levels.
Lower blood sugar levels are helpful for controlling type 2 diabetes. But it’s not clear how the GLP-1 drugs lead to weight loss. Doctors do know that GLP-1s appear to help curb hunger. These drugs also slow the movement of food from the stomach into the small intestine. As a result, you may feel full faster and longer, so you eat less” (1).
But I wonder what the long term effects of producing the extra insulin would be. Also, how safe is it to have excess insulin in your blood for extended periods? Is it healthy to slow digestion down? I’m sure that these questions were studied, but it’s still very early so long term research isn’t possible yet.
I’ve written a number of posts on these popular drugs here: https://lindawbrowning.com/2023/01/05/60-minutes-on-obesity/ , https://lindawbrowning.com/2023/01/06/follow-up-60-minutes-on-obesity/ , and https://lindawbrowning.com/2023/02/12/maintenance-after-stopping-ozempic-and-other-weight-loss-medications/ .
But those of us who are older recall diet drug controversies like Fen-Phen (fenfluramine or dexfenfluramine, appetite depressant, and phentermine, a type of amphetamine) which later proved quite dangerous (2). These two drugs, when combined, caused heart valve damage in some dieters. (3).
“‘It’s a cycle perpetuated by the FDA,’ said Pieter Cohen, an assistant professor of medicine at Harvard Medical School. ‘It’s been going on since the amphetamines came out in the 1920s and ’30s.’ Cohen said that the problem is the FDA typically approves the drugs after they show modest, short-term weight loss — but without proof of a long-term benefit, such as a reduction in heart attacks, strokes, or cardiovascular deaths” (3).
I do not think that the new GLP-1 agonist and related drugs are in this same category at all, but you might consider waiting a bit longer, unless you also have diabetes. In that case, you are treating two diseases with one drug, and the drug is being used as originally intended (for diabetes) (1).
Also please be aware that these medications have a “black box warning” relating to a rare form of thyroid cancer. This is the FDA’s most stringent type of warning. So even though the risk seems to be small, there are always some risks with every medication.
Note that I was prescribed the GLP-1 injectable as Saxenda as Wegovy was unavailable at that time. I was quite upset when insurance declined to cover the extremely high cost. So I simply continued my diet and exercise plan and was able to meet my goal weight without medication. Even though I urge caution, I must admit that I was ready to try these meds on my doctor’s advice.
Another option for some is bariatric surgery, though it is not a magical cure-all either. Whether you choose to have an operation, take medication, or use diet and exercise alone, weight loss is not magical. There is sacrifice and hard work regardless of your method.
Unfortunately, there is no perfect diet and no perfect procedure. Thankfully, our bodies are resilient enough to survive most of what we dish out to them, particularly when we are young. However, it’s always best to seek professional medical advice before embarking on any new diet or exercise regimen. Your doctor or registered dietician likely has some ideas on how you can achieve your goals for the long term.
And that’s where we all long to be, having successfully lost our weight so we can be the healthiest and happiest version of ourselves.
(1). https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/expert-answers/byetta/faq-20057955
(2). https://www.nytimes.com/1997/09/23/science/how-fen-phen-a-diet-miracle-rose-and-fell.html
(3). https://www.medpagetoday.com/special-reports/slipperyslope/51044
Maintain Weight Loss 