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Metabolic treatments such as semaglutide (Ozempic) and tirzepatide (Mounjaro) rapidly gained recognition as potent tools for weight loss and have dominated headlines ever since. So it comes as no wonder that healthcare practitioners are now strategically utilizing these medications, alongside other FDA-approved weight loss drugs like Wegovy, to address hormone imbalance triggered weight gain. Their aim: to proactively manage and mitigate potential future health risks associated with obesity.
This paradigm shift holds particular significance for the estimated 70 percent of women who grapple with an annual increase of about 1.5 pounds during the menopausal transition—a phase that can span up to a decade. Men also face a similar struggle, as low testosterone levels are often associated with increased fat mass and reduced lean muscle mass.
To guide those frustrated with shedding extra pounds, renowned hormone specialist and Wellcore advisor, Caleb Greer, FNP-C, sheds light on these revolutionary tools and explores additional treatments that hold promise in reversing weight gain and safeguarding against a spectrum of health issues.
What are GLP-1 Agonists?
Before jumping into treatments, it’s important to first decode GLP-1 agonists, as you’ll often hear this term when referring to these medicines. Glucagon-like peptide-1 agonists (GLP-1), a class of medications that includes semaglutide, are primarily used for managing type 2 diabetes and mimic the effects of the natural hormone, influencing insulin release, inhibiting glucagon secretion, and slowing gastric emptying to regulate blood sugar levels. GLP-1/GIP dual agonists (Tirzepatide), also known as a “twincretin”, address the two main incretin hormones released with food ingestion and offer superior benefits. Beyond diabetes control, GLP-1 agonists such as semaglutide (Ozempic and Wegovy), and twincretins Tirzepatide (Mounjaro and Zepbound), have become noteworthy for their appetite-suppressing effects, as well as their ability to reduce major cardiovascular events and glucose management.
Benefits of GLP-1 Agonists
Semaglutide (Ozempic & Wegovy) and Tirzepatide (Mounjaro and Zepbound) all offer significant health benefits. Greer cites improved cardiovascular health, including positive changes in LDL cholesterol and triglycerides, orthopedic advantages related to a body mass more suitable to one’s frame, better blood sugar and insulin levels, and defense against neurodegenerative diseases. In fact, certain GLP-1 drugs show promise as potential Alzheimer’s disease and dementia treatments and are currently being studied.
While championing the use of GLP-1 agonists, Greer emphasizes the need for a systematic approach and collaboration with a specialist. Recognizing that many individuals turn to food for comfort, he cautions that patients may experience drops in baseline dopamine levels if this common coping mechanism is abruptly removed without replacement. Additionally, he stresses the importance of nutritional strategies to address potential side effects such as hair loss, skin issues, and lean muscle loss.
Greer further emphasizes the need for patients to work closely with their healthcare provider to create a lasting foundation. As with any dietary intervention, lifestyle changes like well-rounded nutrition, sleep, and exercise regimens as well as a robust support system will help ensure sustained success, even when dosage is reduced or the patient discontinues the medication.
The Next Metabolism Blockbuster
According to Greer, the latest breakthrough from pharmaceutical company Eli Lilly, parent company of Mounjaro, is poised to be the next revolutionary weight loss drug and medical journals seem to echo that sentiment. Named Retatrutide (the brand name will be revealed after completion of phase III trials), in phase II trials, participants at the 8 mg dose experienced a minimum 5% reduction in body weight, with doses of 8 and 12 mg often resulting in a striking 20-30% reductions in total body weight at 24 weeks in obese and overweight adults.
“The cherry on top of this sundae is that every single cardiometabolic risk factor also improved - systolic blood pressure, diastolic blood pressure, hemoglobin A1c, fasting glucose, fasting insulin, triglycerides, and LDL cholesterol,” said Greer.
A third clinical trial is set to run until late 2025, which means it will be a few years before we can access this exciting new drug.
A Plea For Compassion
The landscape of metabolic therapy has witnessed a surge in medical innovation, providing a beacon of hope for those who, despite their efforts, face continuous challenges. Expressing dismay at the public perception that utilizing GLP-1 agonists for weight loss is somehow "cheating," Greer underscores the vital role these tools play in aiding individuals whose progress has been hindered by injuries or hormone imbalances.
It's essential to recognize that everyone's health journey is unique, with a myriad of factors influencing one's ability to achieve and maintain a healthy weight. Rather than stigmatizing the use of such tools, he hopes to see more compassion. Many individuals rely on these medical interventions not as shortcuts, but as bridges to overcome barriers that might otherwise seem insurmountable. Empathy, understanding, and an acknowledgment of the diverse challenges people face can pave the way for a more inclusive and supportive approach to health.
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