Research into Gila monster venom (believe it or not) led to a diabetes medication with a tantalizing side effect: hunger suppression. In recent years, medications like Ozempic and other glucagon-like peptide-1 (GLP-1) agonists have surged in popularity as a trendy and accessible solution for those struggling to shed pounds.
With promises of rapid weight loss and relief from food cravings, these medications have garnered the attention of many seeking a faster route to their goals. For patients who can avoid the side effects, they work as an almost magical elixir that can deliver fast results with simplicity and ease.
But as these medications take center stage, health professionals like Dylan Webb urge caution. Webb, a certified holistic health counselor and clinic director at Ideal Health, an Anchorage company with offices in Fairbanks, points out an important nuance. “These weight loss medications have really highlighted the importance of behavior change and lifestyle change,” he says, emphasizing that “every single study will show you gain the weight right back upon medication cessation” when taking GLP-1s.
Diabetes Spinoff
Ozempic, a brand of semaglutide, is a GLP-1 receptor agonist, a drug that mimics the effects of GLP-1 hormones naturally produced by the body. GLP-1 plays a crucial role in regulating blood sugar levels, digestion, and appetite. When people eat, GLP-1 is released, promoting insulin secretion and slowing down gastric emptying, which makes them feel fuller for longer.
However, the naturally produced GLP-1 is inactivated within minutes, reducing its impact and allowing natural hunger cycles to proceed. Medications like Ozempic extend the hormone’s effects by resisting its enzymatic breakdown in the body, clearing the way for the GLP-1 to suppress hunger. This means GLP-1’s suppressive effects can last for about 165 hours—a week—instead of a mere minute or two.
This prolonged action is why Ozempic is administered as a once-weekly injection. Ozempic suppresses appetite and reduces food intake, resulting in weight loss. It was originally developed as a medication to support patients with Type-II Diabetes and is still only indicated for Type-II Diabetes. But other GLP-1 formulations have been developed and introduced in its wake, including its weight-loss drug equivalent, Wegovy. It has the same active ingredient but is administered at a higher dosage.
The allure of quick, effortless weight loss comes with potential downsides. As Webb points out, one of the major concerns with GLP-1 medications is muscle atrophy.
The Downsides of GLP-1 Agonists
For many people, the promise of quick weight loss is tempting. But there’s a catch: GLP-1 drugs can help reduce fat, but they don’t discriminate between fat and muscle. Webb notes that “30 to 50 percent of weight loss on these medications come from the loss of muscle tissue. Mostly caused by poor nutrition—specifically not eating enough protein—because the medication can literally make you not want to eat.”
Losing muscle not only lowers metabolism but also makes maintaining weight harder in the long run. This muscle loss, paired with the fact that most people regain fat when they stop the medication, leaves many worse off than when they started. “All the weight comes right back,” Webb says. “Every study shows that. They’re gaining fat back, not muscle. Now they’re worse off metabolically.”
This makes a strong case for the importance of focusing on fat loss and muscle preservation rather than simply reducing overall body weight. “In the physician community, that’s the conversation: focusing more on fat loss than just total body weight reduction,” Webb adds.
Another concern is that GLP-1 agonists slow down the digestive system, which can lead to side effects like nausea, vomiting, diarrhea, gas, and bloating. Additionally, long-term use may cause nutritional deficiencies due to reduced appetite and food intake. People may not get enough protein or essential nutrients, leading to further muscle loss and electrolyte imbalances.
There are also individuals for whom GLP-1 drugs are unsuitable. People with a history of thyroid cancer or pancreatitis should avoid these medications. Webb says it can be a struggle for some to get the medication covered by insurance based on their medical condition.
Medication Alone Isn’t the Answer
Webb emphasizes that while GLP-1 agonists can be helpful tools for certain individuals, they are not a magic solution. “People are going to these medications saying it’s the Holy Grail and it’s going to be the solution to my weight problem,” Webb says. But as with any weight-loss strategy, success depends on making lasting changes to one’s diet and behavior. “There’s no magic pill, no magic protocol, and no magic procedure—including gastric bypass [surgery]. People can gain the weight back,” he says.
Webb’s clinic only recently began offering GLP-1 medications, but Ideal Health uses them situationally and only alongside a comprehensive weight-management program that emphasizes food as medicine and sustained lifestyle changes. “We do it in combination with our medically designed protocol,” Webb explains. “The reason why we do both is to help with reducing hunger and reducing cravings with that medication, which can aid with compliance to the protocol we’re prescribing. We also ensure adequate protein intake to prevent muscle loss.”
The Power of Food and Lifestyle
At the heart of Webb’s clinic’s approach is the belief that sustainable weight loss is built on healthy dietary habits and lifestyle changes. “Our focus is helping people lose weight through food. A disease brought on by food should be addressed through food. It’s really about changing behavior and understanding there is no vaccine against obesity,” Webb says.
Webb sees food as the best medicine, encouraging his patients to reduce processed foods high in sugar and replace them with healthy proteins and vegetables low on the glycemic index.
Exercise is also a vital component of a healthy lifestyle, but it shouldn’t be viewed as the primary tool for weight loss. Webb adds, “Exercise is a very important component to a healthy lifestyle, but it shouldn’t be a primary piece to weight loss. Weight loss occurs through change in diet.”
This approach has produced remarkable success stories. Webb says one patient in Fairbanks has lost 292 pounds without any medication, strictly through dietary changes and exercise. Another 78-year-old insulin-dependent diabetic was able to put her diabetes into remission and maintain her weight and healthy blood sugar levels without insulin.
What Drives the Popularity of GLP-1s
Why, despite the potential downsides, are so many people turning to GLP-1 drugs? Webb believes it’s a reflection of the growing desperation many people feel. “People are feeling hopeless. There has been no improvement in our food or the food manufacturing industry,” he says. “Processed foods are everywhere, loaded with additives that make them addictive and unhealthy.”
For those struggling with food cravings and weight regain after repeated failed attempts, GLP-1 drugs offer a lifeline, an option that doesn’t require willpower. “I think what leads people to these drugs is, ‘Hey, I’ve tried it all. I’ve done Weight Watchers and Jenny Craig, and I’ve tried diet and exercise, and I’ve gained my weight back,’” Webb says. “They become hopeless and go to these new drugs for help.”
Finding the Balance
Ultimately, Webb’s message is that GLP-1 medications can be helpful as a tool to support lasting lifestyle changes, but they are not a cure-all. “People just want to use GLP-1s and lose their 10 to 15 pounds,” he says. “But this medication isn’t the fix, the vaccine, the Holy Grail when it comes to weight management.”
Webb’s approach focuses on education, behavior change, and support. He’s proud of his work as a health coach, an industry sector growing in popularity where he is driven by making real differences in people’s lives. “I love nutrition, I love science, and I recognize the need,” he says. “I get passionate about this subject. And I like working with people and educating them and providing that support and accountability. I think most people can relate to this idea of, ‘I know what I need to do, I just need to do it.’”
Related Topics:
