Do weight loss drugs like Ozempic, Wegovy work? What to know

As a whole, we spend more on healthcare than most other countries and have the most advanced and sophisticated healthcare system in the world. Even so, Americans live sicker and die quicker, ranking 43rd in the world when it comes to longevity.

Why? A huge factor is that Americans keep getting fatter year by year, and as we get fatter, we get sicker. How bad is the problem? According to the Centers for Disease Control and Prevention, the incidence of obesity has nearly tripled since 1960, when approximately 13% of American adults were considered obese.

Obesity destroys health in many ways and plays a critical role in promoting heart disease and stroke, and it’s also a key player in certain forms of cancer, fatty liver disease, gall bladder disease, and more. Since we know obesity is the root cause of many of these problems, what are we doing about it?

Not much.

In watching this situation evolve over many decades, I have held the belief that the American public won’t do anything to get healthier while assuming that modern medical science will eventually bail us out with medications. Perhaps that day is upon us as we have several new GLP-1 drugs, which can include drugs like Ozempic and Wegovy, that are making a splash.

Are they a reasonable solution, or better yet, the magic bullet we’ve all been waiting for? That all depends on how you look at it. If you think you are a candidate for one of these drugs, here are some things to consider.

Is it true that some people can not lose weight?

Yes, some folks cannot lose weight. Perhaps there is a genetic predisposition to certain metabolic disorders, or hormonal problems with the thyroid gland which cause metabolism to slow and you burn fewer calories (kcals) each day. Other disorders can make losing weight difficult.

However, while it’s true that some folks have a legitimate reason for being obese, this certainly is not the case for the general population. On the contrary, the vast majority of the obese consume a high-fat and high-sugar diet that provides many more calories of energy than they need, and these are converted to stored body fat. The process of storing fat is accelerated and made more efficient by being sedentary, another common trait of the typical obese American.

So, it makes sense that these new weight loss drugs should be manufactured only for the small subset of the population who cannot lose weight, and not for the obese masses. Unfortunately, that’s not the case. Oprah Winfrey recently said she uses injectable GLP-1 drugs to lose weight. To be fair, she emphasized that the drugs are accompanied by a healthier diet and lots of exercise, which is in keeping with her active involvement with promoting Weight Watchers, an organization that emphasizes a healthy lifestyle approach to losing weight.

For many, the positive effects of “sticking” to a healthier weight are much better when there is a true lifestyle change. But, as Americans, many times it’s easier to just ask for medication to “fix” our problems.

And what happens when we stop taking the drugs? The weight comes right back, and no true lifestyle change is accomplished. In other words, if you start taking these drugs, you are essentially making a lifelong commitment. Let me add that the expense can be considerable, especially if you are not medically qualified and have to pay out of pocket.

How do weight loss drugs, like Ozempic, work?

In the past, there have been weight loss drugs that were essentially amphetamines, stimulant drugs that speed up messages between the brain and body, and that didn’t work out so well. Then more “legitimate” drugs came along that when combined with a healthy diet and exercise, could help people lose 5% to 7% of their body weight. But such drugs pale in comparison with these new drugs that were created to treat Type 2 diabetes but have stolen the spotlight when it comes to fighting fat because of the potential to lose 10% to 20% of body weight.

These drugs are referred to as GLP-1 receptor agonists which mimic a naturally occurring hormone that is released in the gastrointestinal tract when eating. They cause an increase in insulin release which is helpful for Type 2 diabetics because it decreases the elevation of blood glucose. Additional effects are to send signals to the brain to curb appetite, and possibly slow digestion, creating a feeling of being full. These, of course, are the desired effects for those seeking to lose weight.

There may be uncomfortable side effects, and the most common involve the digestive system, including nausea, vomiting, etc. Proponents say these are likely to clear up as you get accustomed to the meds. As to the unknowns in the long run, there is the potential for more serious side effects involving the gall bladder and thyroid gland.

My advice? Unless you qualify as someone who needs these drugs for medical reasons, take responsibility for your weight and do the right things. A healthy diet and exercise work but it requires time, effort, and commitment.

Reach Bryant Stamford, a professor of kinesiology and integrative physiology at Hanover College, at stamford@hanover.edu.

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