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    Ozempic

    enOctober 10, 2023
    What larger factors contribute to obesity beyond weight loss drugs?
    How do genetics and environment influence obesity rates?
    Why are current weight loss drug trials considered exclusionary?
    What is the significance of semaglutide in obesity treatment?
    How can we shift the conversation around obesity and health?

    Podcast Summary

    • Rethinking Weight Loss Drugs: Beyond Individual ResponsibilityWeight loss is influenced by various factors beyond personal choices, highlighting the need for comprehensive and inclusive approaches to address obesity.

      The focus of discussions surrounding weight loss drugs like Ozempic and Wagove often neglects the larger social and systemic factors that contribute to obesity. While these drugs may offer significant weight loss results, it is important to recognize that weight is not solely determined by individual choices or willpower. The narratives around these drugs often reflect a narrow, individualistic perspective, disregarding the complex nature of obesity and the need for comprehensive, multifaceted approaches to address it. Instead of placing all the blame or responsibility on individuals, it is crucial to consider the impact of factors such as genetics, environment, and socioeconomic conditions. By shifting the conversation to a more holistic understanding of weight and health, we can foster a more inclusive and effective approach to tackling obesity.

    • Challenging Stigma and Misconceptions Around Weight Loss MedicationsWeight loss medications should be viewed as part of a comprehensive healthcare plan, and societal attitudes towards body image and health should be more understanding and compassionate.

      The narratives surrounding weight loss medications like Ozempic and Wegovy can be poisonous and harmful. It is important to recognize that these medications should not be seen as individual health advice or as an easy way out for weight loss. The cultural disregard and disdain for people with health conditions, such as diabetes, contributes to the stigma and pressure placed on individuals to take drastic measures for their health. This can have severe consequences, as seen in cases where individuals are unable to access necessary treatment and suffer tragic outcomes. It is crucial to have a more compassionate and understanding approach towards body image and health, recognizing that different individuals have different needs and that weight loss should not be the sole determinant of one's worth or access to healthcare.

    • Ozempic: A Promising Treatment for Type 2 DiabetesGLP 1 agonists like Ozempic mimic the hormone released after eating, reducing appetite and food intake. They also help hold food in the stomach, trigger insulin release, and manage blood glucose levels.

      GLP 1 agonists, such as Ozempic, have shown promising results in treating type 2 diabetes. These medications mimic the GLP 1 hormone that is released after eating, making you feel full and signaling your brain to stop eating. This leads to a reduction in appetite and a decrease in overall food intake. Additionally, GLP 1 agonists help hold food in the stomach for a longer period of time and trigger the release of insulin. They may even promote the growth of pancreatic beta cells, which are responsible for insulin production. Clinical trials have shown incredible results in managing blood glucose levels, which is crucial for minimizing complications associated with diabetes.

    • The Promise and Challenges of GLP-1 Agonists: Transforming Lives While Navigating ComplexitiesGLP-1 agonists like Ozempic and Wegovy offer amazing results in managing blood glucose levels and weight loss, but their cost, availability, and societal judgments create significant challenges for individuals seeking help.

      The introduction of GLP-1 agonists like Ozempic and Wegovy has shown miraculous results in managing blood glucose levels and inducing significant weight loss. These drugs have the potential to transform the lives of individuals with diabetes and obesity. However, the cost and availability of these drugs pose significant challenges. Despite their life-saving potential, pharmaceutical companies face criticism due to their profit-maximizing nature under a capitalist system. Additionally, the societal discourse surrounding weight loss medication is complex and often contradictory, with individuals sometimes being judged for seeking help. The recent shortage of Ozempic and Wegovy further complicates access to these drugs, leading to compounding pharmacies offering alternative versions without FDA approval. Overall, this highlights the need for greater affordability and accessibility to transformative medications while navigating the nuanced conversations surrounding weight and health.

    • Risks of Unsafe Alternatives in Weight Loss Medication MarketThe shortage of semaglutide has led to a rise in potentially unsafe alternatives offered by compounding pharmacies, highlighting the need for better FDA oversight and addressing income barriers for accessing affordable healthcare.

      The shortage of semaglutide, a weight loss medication, has led to the rise of compounding pharmacies offering potentially unsafe alternatives. These pharmacies may be providing watered-down doses or even using a non-approved version of the drug that is hazardous to human health. The lack of FDA oversight and regulation in the compounding pharmacy industry allows for the sale of these questionable medications online, which is concerning. Additionally, the discourse surrounding this issue often neglects to address the income barriers that prevent many individuals from accessing the medication. The shortage is largely driven by those who can afford to pay out-of-pocket, while many insurers do not cover the cost. This highlights the urgent need for a resolution to this problem and better access to affordable healthcare.

    • Extensive research and clinical trials support the use of semaglutide for weight loss, providing valuable information on its effectiveness and long-term effects.Semaglutide has been extensively studied in trials involving thousands of participants, providing valuable insights into its benefits and risks for weight loss.

      The use of semaglutide for weight loss is backed by extensive research and clinical trials. These trials, known as the step trials, involve thousands of participants and are funded by Novo Nordisk. They are designed to assess the effectiveness of semaglutide in treating obesity and type 2 diabetes, as well as its combination with intensive behavioral therapy. The trials also explore the long-term effects of semaglutide and compare it to other medications. This research provides valuable information on the potential benefits and risks of using semaglutide for weight loss. It is important to note that the trials are conducted on a global scale and include diverse populations.

    • Promising Results of Semaglutide in Weight LossSemaglutide offers remarkable weight loss results, with 80% of users experiencing some amount of weight loss and additional health benefits like improved blood pressure and cholesterol levels.

      Semaglutide and liraglutide have shown significant weight loss results in clinical trials. The majority of these trials have mostly included white participants, indicating a lack of diversity in diet studies as a whole. However, the effectiveness of semaglutide in promoting weight loss is remarkable. Around 80% of people who took semaglutide lost some amount of weight, with roughly half losing 10 to 15% of their body weight. Furthermore, approximately one-third of individuals experienced a weight loss of more than 20%, comparable to the results of bariatric surgery. These drugs also have additional health benefits, including improved blood pressure, cholesterol levels, and reduced risks of heart attacks and strokes. Despite some common side effects such as gastrointestinal symptoms and potential changes in appearance, this breakthrough in weight loss medication offers promising possibilities for individuals looking to manage their weight and improve their overall health.

    • The judgments and criticisms surrounding weight loss and the risks associated with weight loss drugsDespite the potential risks, individuals are motivated to endure side effects in their pursuit of weight loss, indicating a higher commitment compared to other types of research.

      There is a significant amount of judgment and criticism surrounding weight loss. The pressure to lose weight is prevalent in our culture, yet when someone does achieve weight loss, they often face comments and scrutiny about their appearance. The discussion also highlights potential side effects and risks associated with certain weight loss drugs. These risks range from rare but severe conditions like pancreatic issues and suicidal ideation to more common side effects like gallbladder disease and acute kidney injury. However, despite these potential risks, the dropout rates in weight loss drug trials are low, indicating that people are willing to endure side effects in their pursuit of weight loss. This suggests that individuals may be more motivated to stay committed to weight loss studies compared to other types of research.

    • Limitations and Considerations of Samaglutide for Weight LossSamaglutide may offer significant weight loss benefits for some individuals, but it is not a universal solution for obesity. It is important for healthcare providers to address individual circumstances and preferences, and explore alternative approaches for those who do not find success with the drug.

      While there is excitement around the potential of Samaglutide as an effective weight loss drug, we must acknowledge that it is not a cure-all solution for obesity. The drug may lead to significant weight loss for some individuals, but it is not guaranteed for everyone. Additionally, the idea that this drug will end the so-called "obesity epidemic" is a misconception. There are still important issues that need to be addressed, such as reducing stigma against fat people and improving medical care for them. It is crucial that doctors and healthcare providers not solely rely on prescribing this drug without considering individual circumstances and preferences. And for individuals who have already tried the drug without significant success, alternative approaches and support should be explored.

    • The exclusionary approach of weight loss drug trials perpetuates bias and fails to represent the diverse range of individuals struggling with obesity.Current weight loss drug trials exclude a significant portion of the population, perpetuating biases against fat patients and hindering progress towards finding a universal solution to obesity.

      The current approach to weight loss drugs like Ozempic is highly problematic and excludes a significant portion of the population. These trials focus on a narrow group of individuals, excluding those with mental health disorders, histories of suicide attempts, existing cardiovascular issues, substance abuse, and even women who are pregnant or breastfeeding. By setting such strict criteria, these trials fail to represent the diverse range of people struggling with obesity. This exclusionary approach perpetuates a harmful cycle where healthcare providers already prone to biases against fat patients continue to dismiss them. Additionally, even if these drugs do show positive results in trials, they are unlikely to provide a universal solution to obesity.

    • Discrepancy between weight loss drug trial results and real-world outcomesWeight loss drug trials often show higher weight loss percentages than what is actually achieved in real-world use due to additional support, counseling, and higher adherence rates in the trials.

      The results of weight loss drug trials may not necessarily translate into real-world success. While the trials show significant weight loss percentages, the outcomes in actual use are much lower. Real-world studies have found that people lose only half the weight that was reported in the trials. This discrepancy could be attributed to the additional support and counseling provided in the trials, which is not available to everyone outside of the study. Adherence rates also differ greatly, with dropout rates as high as 70%. This highlights the importance of considering real-world conditions and factors when evaluating the effectiveness of weight loss drugs. Moreover, data consistently show that people tend to regain the weight once they stop taking the drugs. Therefore, it is crucial to approach weight loss solutions with realistic expectations and avoid making policy decisions based on inflated claims.

    • The limitations of weight loss drugs and the flawed belief in basic skills teachingSustainable weight loss requires holistic and individualized approaches, as weight loss drugs do not provide a long-term solution and teaching basic skills perpetuates stereotypes.

      Weight loss drugs like semaglutide and kirzepatide, while showing initial success in helping people lose weight, do not provide a long-term solution. Many individuals plan to stop taking these drugs once they reach a certain weight, but that's not how they work. People often regain the weight quickly, similar to the cycle of fad diets. Furthermore, the belief that teaching individuals basic skills like cooking and exercise will solve the problem is flawed. This perpetuates the stereotype that fat people are lazy or unintelligent, needing thin people to teach them how to live a healthy lifestyle. Real-world data shows that even when weight loss drugs are free, people struggle to stay on them. Therefore, it is important to recognize that sustainable weight loss requires holistic and individualized approaches.

    • Challenging Stigma: Weight Loss Drugs and Fat PhobiaSociety's preference for weight loss through exercise perpetuates discrimination against fat individuals, neglecting the struggles and lack of acceptance they face. It is essential to challenge damaging ideologies to promote acceptance for all body types.

      The stigma surrounding weight loss drugs and fatness is deeply rooted in fat phobia. Society places a higher value on losing weight through "virtuous" means, like exercise, rather than using medication. This stigma not only perpetuates discrimination against fat people but also affects those who wish to stop being fat. The discourse around body positivity often overlooks the struggles and lack of social acceptance that fat people face. Additionally, the marketing practices of pharmaceutical companies like Novo Nordisk play a significant role in shaping these stigmatizing narratives. It is crucial to recognize and challenge these damaging ideologies to promote acceptance and understanding for all body types.

    • Novo Nordisk's harmful "It's Bigger Than Me" campaign reinforces damaging narratives about obesity and body positivity, targeting black public figures and women to promote expensive treatment only available from the company.The media's role in responsible reporting and inclusive conversations about health and body positivity is crucial to combat anti-fat bias and promote the well-being of individuals.

      The "It's Bigger Than Me" campaign by Novo Nordisk perpetuates harmful narratives about obesity and body positivity. The campaign promotes the idea that obesity is not the individual's fault and is instead a medical disease that requires expensive treatment, which conveniently can only be provided by Novo Nordisk. The company has specifically targeted black public figures and women as spokespeople, using their influence to reinforce these damaging messages. The media coverage surrounding the campaign also contributes to increased anti-fat bias, with sensationalist headlines and little consideration for the perspectives and needs of fat and diabetic individuals. This highlights the importance of responsible reporting and inclusive conversations about health and body positivity.

    • The Complexities of Weight Loss and ObesityThe celebration of weight loss drugs and societal pressures can inadvertently harm individuals by reinforcing harmful beliefs, triggering eating disorders, and perpetuating discrimination and prejudice. Consent and boundaries are essential in discussions about weight and body image.

      The conversation around weight loss and obesity is not as simple or positive as it may seem. While some may celebrate the potential effectiveness of weight loss drugs like Ozempic, it is important to consider the negative implications and consequences that can arise. People who lose weight often see themselves as more virtuous and may unknowingly reinforce harmful social reinforcement for weight loss. This can lead to increased stigma and even trigger eating disorders. Additionally, the rising costs of obesity and the scapegoating of fat people in insurance conversations further perpetuate discrimination and prejudice. It is crucial to be aware of the impact of these conversations and to prioritize consent and boundaries when discussing weight and body image.

    • Challenging Societal Bias and Finding Compassionate SolutionsSociety must confront biases against fat people and prioritize creating a discourse that treats all individuals with dignity and respect, while finding compassionate solutions to support those in need.

      Society needs to confront its deeply ingrained biases and prejudices against fat people. The constant messages that fat people will only be valued or accepted if they become thin perpetuate harmful stereotypes and contribute to the dehumanization of individuals. It is crucial to listen to the experiences and voices of fat and diabetic people, rather than speculating or focusing on irrelevant distractions. Instead of obsessing over the elimination of obesity or searching for quick fixes, we should prioritize designing a better discourse that treats all individuals with dignity and respect. We must work towards finding ways to provide necessary medications and support to those who need it, without perpetuating discrimination or stigmatization. It's time to show up for people and interrupt the harmful narrative that reinforces fatphobia.

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    🎙️Follow The Business of Wellness on Apple Podcasts & leave a 5-star rating & review 

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    References used for this episode:  

    1.    https://pubmed.ncbi.nlm.nih.gov/30122305/

    O'Neil PM, Birkenfeld AL, McGowan B, et al. Efficacy and safety of semaglutide compared with liraglutide and placebo for weight loss in patients with obesity: a randomised, double-blind, placebo and active controlled, dose-ranging, phase 2 trial. Lancet. 2018;392(10148):637-649. doi:10.1016/S0140-6736(18)31773-2

    2.   https://pubmed.ncbi.nlm.nih.gov/33755728/ 

    Rubino D, Abrahamsson N, Davies M, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021;325(14):1414-1425. doi:10.1001/jama.2021.322

    3.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6769337/ 

    Sargeant JA, Henson J, King JA, Yates T, Khunti K, Davies MJ. A Review of the Effects of Glucagon-Like Peptide-1 Receptor Agonists and Sodium-Glucose Cotransporter 2 Inhibitors on Lean Body Mass in Humans. Endocrinol Metab (Seoul). 2019 Sep;34(3):247-262. doi: 10.3803/EnM.2019.34.3.247. PMID: 31565876; PMCID: PMC6769337.

    4.  https://pubmed.ncbi.nlm.nih.gov/35441470/ 

    Wilding JPH, Batterham RL, Davies M, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022;24(8):1553-1564. doi:10.1111/dom.14725

     

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