The New Weight Loss Drugs OZEMPIC, MOUNJARO (semaglutide, tirzepatide) | Dr. Spencer Nadolsky
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- Опубліковано 10 чер 2024
- Weight loss drugs Ozempic, Wegovy and Mounjaro have been all over the headlines. What do they do, how do they work and are they safe? A look at Ozempic, Wegovy and Mounjaro (Semaglutide & tirzepatide, GLP-1 mimetics) for obesity and weight loss.
Dr. Nadolsky:
Twitter: / drnadolsky
drspencer.com
IG: @drnadolsky
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Twitter: / nutritionmades3
Animations: Even Topland @toplandmedia
References:
1-www.sciencedirect.com/science...
2-journals.physiology.org/doi/f...
3-link.springer.com/article/10....
4-www.nature.com/articles/nrd1828
5-www.nejm.org/doi/full/10.1056...
www.nejm.org/doi/full/10.1056...
6-jamanetwork.com/journals/jama...
7-www.sciencedirect.com/science...
8-www.hindawi.com/journals/jdr/...
9-dom-pubs.onlinelibrary.wiley....
10-www.frontiersin.org/articles/...
11-journals.sagepub.com/doi/pdf/...
12-www.frontiersin.org/articles/...
13-www.nejm.org/doi/full/10.1056...
14-www.ncbi.nlm.nih.gov/pmc/arti...
15-dom-pubs.onlinelibrary.wiley....
16-www.nature.com/articles/s4159...
Disclaimer: The contents of this video are for informational purposes only and are not intended to be medical advice, diagnosis, or treatment, nor to replace medical care. The information presented herein is accurate and conforms to the available scientific evidence to the best of the author's knowledge as of the time of posting. Always seek the advice of your physician or other qualified health provider with any questions regarding any medical condition. Never disregard professional medical advice or delay seeking it because of information contained in Nutrition Made Simple!.
#NutritionMadeSimple #GilCarvalho
0:00 Intro
0:26 COIs
3:14 New weight loss drugs
9.32 Efficacy
11:06 Dual effect of tirzepatide
13:49 What patients report
17:30 Stigma and perception
22:34 Obesity and the brain
23:46 Side effects
34:45 Fat mass vs lean mass
41:24 Do you have to take them forever?
Some report that when on these weight loss drugs they also lose their cravings for other things like alcohol, gambling, bing shopping. I find that interesting.
Wow I have never seen a doctor or thin person speak with such great empathy about obesity and the people who struggle with weight. Thank you for this video.
Absolutely, at 15:00 he mentions that often obese people (myself included) are not lazy or unsuccessful in other areas of their lives. This is something that is not noted enough, it’s too easy just to blame it on willpower.
Yes turns off the food noise and I now have control!
I am currently on Ozempic for diabetes and weight loss. In addition to the benefits you both described like feeling less hungry and eating less, I will also say it helps in other ways too. I feel like since I am not craving food as much, it has allowed me to make positive changes to my diet. For example, eating more protein, fruit, and vegetables. And less of the bad high carb/sugar foods. I have been on it for 4 weeks and so far I am down 10 pounds, from 295 to 285.
Congratulations! I’ve been on it for a week and a half and I can feel the change, especially feeling full with half of the food. I would normally eat a meal. Like you, I have been making better food choices, along with a nutritionist to help me. Wishing you good luck with your success, and better health!
If you are looking for topics that will be useful to your audience, I have several! (I’ll post them from time to time.) First, bone health. I have had several bone scans over the years, showing steadily decreasing bone mineral density to the osteopenia range, and I understand that the decrease in estrogen during menopause may make the problem worse. 1) Could you explain the mechanism behind bone loss and regeneration? Is reversal possible? Is a trabecular bone scan a better estimate of bone health than a DXA? 2) There’s some support for the notion that prunes reduce bone density loss. Is that because prunes are special, or would any food high in anti-oxidants do? (I already eat a varied, nutrient-dense diet.) 3) What other foods should I be consuming? (I’m a little limited due to intolerances or reactions to a number of foods (like dairy) and most supplements and processed foods.) I’ve started chia seeds for calcium, greens (esp collards) for vitamin K1, and am getting my vitamin D from the sun. I’ve started jumping up and down on hard surfaces and lifting heavy weights for a few minutes a day. 4) What else should I do? Should I have my estrogen levels tested and use a prescription cream if necessary?
BTW, I really appreciate your work: you are modeling rational, low-ego public discourse and that will have an impact far beyond the world of nutrition.🌞
thanks! most of our content is guided by viewer requests. looking at bone health/osteoporosis is a great idea. We only have 1 video looking at bones & fractures and it was a while back. We can't turn over the video topics as fast as we'd like since it often requires booking a leading specialist and/or going over large amounts of evidence in a wide field, but we do deliver (eventually) :)
I second this request!
I third it. If you need any motivation, bone fragility is a major health threat.
I've been on Ozempic for a little over 3 months now. I've gone from 228 pounds to 197 as of writing this. It isn't a magic bullet, but it sure helps. I've been tracking my calories and exercising.
What it's helped me with the most is cravings. When I was on a regular diet I could put my jacket on, walk to the door with the intention of driving to Taco Bell, stop myself and take my jacket off. Then put it back on, and repeat this 3-4 times before finally giving in and going to get that fast food.
On Ozempic those cravings are gone. I can eat 900-1600 calories a day and feel just fine. Very minor hunger cravings, sometimes later in the evening, easy to resist or be satisfied with a piece of fruit.
Hell yes - congrats. These agents are remarkable for dampening some intrusive thoughts - gotta get that adequate protein to maintain that lean body mass!
Congrats. Keep up with bettering your health
You said it…. It’s so muc( easier to control our food decisions.
That's so great! I understand the arguing with yourself about cravings. I've been on it for a few months and wonder if I should be on higher dose? I've gradually gone from 0.25 to 1 mg. And Dr. plans to keep me on 1 mg. But the literature says you can go up to 2.4 mg. I've only lost 12 lb in 3 months.
Oh how I love Taco Bell. Gimme nacho fries and a crunch wrap supreme, paradise.
This video should go viral. He understands the multiple factors in obesity. It's not just calories in and out, laziness, lack of "willpower". Thank you
it's not necessarily laziness or lack of willpower, but it is in fact as simple as calories in/out. It's physics. If you eat less than you burn on a day to day basis for a long enough time, weight loss NECESSARILY occurs, unless you cease to be alive. there were no overweight people interned in Auschwitz. I wouldn't dispute that for some people it's easier to a achieve a negative energy balance than others. But a negative energy balance will produce weight loss. That's how these drugs work, they make it easier to achieve calorie restriction
Get a set of exercise bands. They work well.
Today is my first day taking Mounjaro, I am a type 2 diabetic that is obese. I weigh 295 lbs, with heart disease , stents and look forward to losing much of this weight while getting my A1C into the normal range. From what I read it is possible to lose 16-25% of weight in months of use. Lets say 50 or more pounds off my current weight. Lets hope this works well for me, while lowering my A1C.
thank You! very interesting... especially to hear the history and development. What I personally appreciate is, that Dr. Nadolsky is not dependent from any pharma-institution. And excellent: the list with the scientific sources.
Excellent discussion....hits all the bases with good information.
Many many years ago I suffered from severe depression. I eventually got antidepressants. It helped, but I was guilt ridden due to depression being not well known back then and church which told me that I was possessed by the devil. and so I stopped the medication. I chose the difficult (Calvinistic) route. It took me 8 years from age 19 to 27 to recover. I wasted the best years of my life. While everyone else achieved success I was treading water and achieved very little. Since then I became an advocate for the easy route. Why suffer if you can achieve success by using technology or medication to make your life easier. Apart from medicine shortages I can see no reason why people should be shamed for using Ozempic and such drugs.
And those who can do without, kudos to you. Life is super hard for many people. If avoiding eating unhealthy food can be made easy, why not.
Totally agree. People tend to think life is supposed to be fair, like we are all born with the same opportunities. We have to play with whatever cards we are dealt and not compare to others. I'm sorry your path was so difficult.
Dr Spencer is one of my favs for true nutrition science.
Always a fascinating discussion
This man clearly understands what obese people go through. I've seen a lot of obese patients who have lost weight on semaglutide. This stuff is potent for a lot of people. I really hope this gets approved for obesity soon in the UK.
Already approved in UK but will only be available on NHS through specialist obesity clinics. It will be available privately from some high street pharmacies, who will be offering medical weight management advice.
why not do both? knowing also that changing environments is far more difficult (paradoxically!)
I gave up sugar in December and didn't lose. Stepped it up cutting carbs and didn't lose. Started walking daily, still nothing. Ozempic is the only thing that helped me lose. I had also been in a calorie deficit, nothing worked. Ozempic is the only change I've made recently and I'm down 7 pounds.
This is my history as well, female, 52. Cannot lose weight to save my life. Very frustrating. I only have about 20 lbs to lose, but 15 of that came screaming in with menopause. My food is so clean I don’t have to use deodorant (TMI sorry - but I think that tells the tale of my great food choices). Anywho - I hope you are doing well, I hope to discuss this with my GP next week.
obrigado pelo seu trabalho dr. gil carvalho
Excellent information, thank you!! :)
Great episode, thanks Dr. Gil! 1:35 Good that Dr. Spencer Nadolsky talks about addiction, and it is really interesting that this medication influences food cravings. If I eat 1 Pringle my brain immediately "tells" me to eat another one, and another one, and I don't enjoy this feeling of craving more after eating it than before, I would rather eat something and feel content afterwards. This is why I don't even eat 1 Pringle. I also drink zero alcohol, despite the social pressure. I have no hyperpallatable foods in the house, and I cook/bake everything myself and I limit SOS sugar, oil, salt. If we can change the environment, it's so much easier. Of course in an ideal world fruit-veggies-nuts-whole-grains would be subsidised instead of dairy, eggs and meat. What also helps is eliminating certain foods for ethical reasons. If you are very convinced and motivated for ethical reasons, you will not buy a lot of fast foods, because most of those foods contain milk, butter, palm oil, eggs, meats. So if your cravings cause you to ignore your own health, you still have another reason not to buy those foods.
And talking about the biological factors, I would love to see the differentiation of genetics and epigenetics. Also, neuroplasticity, how the brain is wired, is influenced by how we live, what we experienced in our life, etc. “Neurons that fire together, wire together.”
The effect on the reward centre is amazing. So many people say that these drugs make them “feel like a thin person”. They can just say no to cravings and urges to overeat. If we can develop drug to target just that, we'd have an even better solution
0:00: 🔬 Dr. Spencer Nadolsky discusses the weight loss drugs Ozempic and Mounjaro, addressing misconceptions about his relationship with big pharma.
4:31: 🍽 GLP-1 has multiple effects in the body, including slowing gastric emptying, decreasing glucagon secretion, augmenting insulin production, and regulating appetite.
9:43: 📊 Semaglutide and tirzepatide are FDA approved for diabetes and obesity, with tirzepatide likely to be approved for obesity soon, and they have shown significant weight loss effects.
14:11: 💉 Semaglutide is being studied as an oral medication for obesity, but injectable doses are currently the most effective for weight loss.
35:24: 💪 When in a calorie deficit, there is typically a loss of body fat and lean mass, including skeletal muscle, but weightlifting can help preserve lean mass.
17:57: 🍎 The drug helps people do what they already know they should do, but struggle with due to addictive-like biological drivers in unhealthy foods.
22:20: 🧠 Neurobiology plays a significant role in obesity, with some individuals having a stronger drive and cravings for certain foods due to brain differences.
26:35: 🚶♂ Walking can help prevent constipation and promote weight loss.
30:54: 🩺 Weight loss drugs may increase the risk of gallbladder attacks and gallstones, but the incidence of pancreatitis is not significantly higher.
39:37: 📝 Weight loss can lead to a loss of lean mass, and resistance training with adequate protein intake can help prevent this.
43:27: 📋 Some individuals may need to take weight loss medication chronically, but there is hope for some to come off the medication.
Recap by Tammy AI
No matter how it works, you can’t stay on it forever (costs/insurance won’t cover, etc) so it’s just a reprieve from cravings and a chance to retrain eating habits. If you don’t take advantage of the time (probably just a matter of months) given, the weight will come back because you’ve basically changed nothing about your mindset… and baby, it’s allllll about the mental attitude
I lost over 100 pounds almost 30 years ago and have never regained it because I wasn’t on a diet, I changed my eating habits. I was fortunate enough to do it “naturally” but I don’t begrudge anyone getting help, including prescribed drugs or a gastric bypass. Even a bypass has limits though (from what I understand you get about 2 years, and the weight will return, just like weight loss drugs, but with the added bonus of stomach stretching that may lead to death).
There’s no magic pill, no one’s coming to save you. You have to save yourself by changing
It’s an opportunity, that’s all
You say that it cannot be permanent but I'm not so sure. I believe the UK's NHS has agreed a purchase price for Wegovy of £73 a pen (1 month). We have 53 million adults. 25% are obese. Let say we give it to the worse, long term cases - say half of those. That's 6.6 million people - cost about £483 million a year. Obesity costs the NHS 3.5 BILLION a year. Cost to the UK economy is argued to be 10 times that. So there is an argument there that we could save money by doing this. And if the drug prices drop a fair bit, the case is more compelling.
Your way is 100x better. However we've known that for decades. We've pushed it for decades. And in that time obesity has got much worse, not better. Just because a better was exists in theory, doesn't make it a solution, unless you know of some way of actually getting those millions of people to do it? We can probably do better than we are, but I honestly don't think we're going to solve obesity with education.
Tell folks with high bp and high cholesterol that drugs cannot be permanent. This is no different. Obesity is a chronic disease, requiring chronic treatment. Baffles me that suddenly people are flailing arms "permanent tho!" when it comes to obesity. Where was the outrage for these meds for T2DM indication?
You are one of the very few people who are telling the absolute truth about all of this. Sugar is a highly addictive substance and very toxic. On my local news channel, when they are showing local events, the obesity I am seeing is staggering... Why I asked. Well, fall down that rabbit hole. High fructose corn syrup was introduced around 1980. I read all labels and am HARD PRESSED to find anything that does not have high fructose in it. I have to say this, most people are not willing to change what they are eating. I quit all artificial sugar and let that settle. Then I quit all sugar completely. I never thought I would drink coffee without sugar but I was amazed at how much our palate changes toward sugar. I prefer my Latte without anything but steamed milk.
I have to thank you for telling the truth. There is no magic bullet. When I quit smoking I read a book by Alan Carr, "How to quit smoking the easy way." Yeah, right, I thought. It worked. About 6 months ago I read his book "How to lose weight the easy way." It worked.
In closing, I think the problem is this. People think they are "giving up" sweets and fast food, etc. With that mindset, it is only a matter of time that we go back. It is imperative to understand the degree of brainwashing and propaganizing we are blasted with each and every day. Why would we pick a cupcake with no nutritional value over an apple that is loaded with nutritional value.
This is not an accident people. Educate yourself. You do not need to take this drug. You need to change your mind. Understand 3/4 of the food we eat are literally poisoning us and keeping us unhealthy and overweight. When you actually really see the lie in all of this, walking away from sugar and bad food really is not a big deal. I make all my own soda, peeled and sliced cucumber, 1/2 in a 1/2 gallon glass jar and half in another. One applied, sliced, half in each jar. A chunk of pineapple and 3 or 4 black berries. I know, it sounds terrible but try it. This is SOOO much better than soda ever thought of being.
Sorry for the rant but you just restored my faith in humans...!
Can you please make a video on acid reflux/GERD/LPR & the best measures to take to cure/heal. Taking into consideration what to do if gastritis/esophagitis are present? Many seem to conflict each other & miss points. But I really appreciate your fact/evidence based approach with our motive of monetary gain or sponsorship. Thanks Dr. Gil!! ❤
The patients that feel tired and lethargic could be suffering from poor Vit B takeup. I know proton pump inhibitors do this so may be worth checking. Excellent video.
In a 2-year study, people started regaining weight after 68 weeks. There's only one 2 year study and in this study we see trend reversing already, if it continues they will regain all the weight after 5 years. We need 5 year long studies to decide with high probability if it works long term, as we know a lot of weight regain in people happens in 2-5 year period
I'd like to have seen a couple of points I don't remember seeing in this video. 1) Doctors are handing it out without ensuring patients follow a diet and exercise regime, despite the fact that the drug manufacturers say they should and that is how the trials were done and these weight-loss claims were generated. And 2) The concerns about GLP-1 agonists causing a continuous lengthening of the intestines and villus height which, if true, would be a serious problem.
Anytime a drug company comes out with a drug you need to be on for life, I’m always a bit suspicious , sad to say. Additionally, the fact that the drug has not been studied long enough, as statins have, for example, to be given . And the side effects do not sound fun!
Also if someone had to get off the drug due to side effects, how fast does the weight come back and possibly even more as fat and not lean mass, as he suggested?
It would be interesting to see if patients can be weaned off the medication after weight loss, normalization of metabolic problems, and time spent following a healthy lifestyle. I wonder if the “food chatter”/cravings/obsession would be decreased when their bodies were more healthy. Basically, how much of the food chatter is a result of the metabolic derangements and also some learned habit loops.
Sorry. Wrote before I finished listening. This was addressed later in the video. A study on this specific issue would still be cool though.
I wonder how much of the food cravings/chatter is from eating carbs. I know if I am not eating carbs, especially sugary/starchy carbs, my food chatter settles down dramatically.
Nobody is talking about the muscle loss side effect… which is adversely affecting my once very athletic daughter. They put her on Semaglutide because her diabetes was so high… but now she is so weak… she has gone into depression.
She needs high protein. Shakes etc. You can't just not eat.
@@gore-geousmombie4686 she tries to eat.. but gets too full. She’s diabetic. And normally regular size.
Your video are amazing-you NEED a podcast!!!
Great analogy, that’s exactly what happens when done eating, only eat what I need and no desire for sweets. So far Mounjaro is a miracle drug for me and other family members! I’m a RN and did a lot of research and was skeptical but very happily surprised with results and how long it’s actually been tested! I’m paying for the Rx not even trying to get through insurance! I do have chronic obesity, not taking for vanity!
I am on Mounjaro as well. You described it very well. The best way I have been able to describe it is magic. I know it isn't but it works on a level nothing else I have ever tried works. Actually being satisfied and pushing away the rest of a plate of amazing food because you are satisfied at less than half of what you would normally eat.
Thanks for this it was helpful. I have done 3 months on ozempic and ongoing lost 8% of weight/ 10kg. My nausea was bad for 6 weeks now none. I did get digestive issues bloating mild stomach cramps wind sulphur burbs. I added psyllium and digest enzymes from healthfood store. Added bone broth fermented foods and fibrous veg this helped dramatically.
I remember Dr. Nadolsky from the Renaissance Periodization UA-cam channel!
I love watching your videos, even if I'm not interested in the topic. You have a charm man
i was hoping there would be a "summary" chapter
Would this medication help with weight loss in someone who has pcos?
Weight loss injections have been used for some years in Romania.
Two of my ex-neighbors were prescribed this by the doctor.
Never heard the name of the products and was quite curious what they were taking.
I, personally, don't like the idea of exchanging the natural way with pharma stuff.
When I was a kid, most adults were thin. They worked a lot and had no access to junk food.
Anyway, thanks for the video. It's really informative.
And most adults died at earlier ages because they lacked pharma stuff
@@johnf4680 1. you didn't pay attention to what you read
or
2. you're missing the context just to have an argument.
3. my parents and grandparents had access to pharma stuff. 2 of my grandparents lived 89 years. They used only the pills and healthcare services that were really necessary. They worked a lot. Most people from Romania did so, in that period.
4. There are pharma products that cannot be rivaled by natural "remedies". And there are natural remedies (like work, home-grown vegetables, sleep etc) that should not be replaced by pills.
@@mancampovestiminvatam1281And you didn't watch the video, clearly...
Really interesting topic, thanks! I can really see how this pill could be a godsend for some.
Have they been studied for use with bulimia? Particularly the drugs that promote satiety and inhibit GIP?
I have IBS so it is a game changer for me.
Following the subject of obesity. Could you make a video about the myths of "metabolism boosting" and the importance of NEAT?
I am 65 years old and been lifting weights and swimming laps for 46 years. I am 6ft and weigh 242 pounds. I have improved my diet (spiniach and kale smoothies for breakfast, staying away from french fires and other starches, etc.) over the years but I can not lose weight. My problem is my constant craving. I just took my second shot of Mounjaro and so far lost 3 pounds. Your video gave me more confidence in Mounjaro. These drugs are game changers. There is going to be huge demand. Because of the high price there is going to be a hugh black market for these drugs. Lets hope our government takes note.
I completely identify with what you wrote. This is my history as well, except female, 52. Cannot lose weight to save my life. Very frustrating. I only have about 20 lbs to lose, but 15 of that came screaming in with menopause. My first is so clean I don’t have to use deodorant (TMI sorry - but I think that tells the tale of my great food choices). Anywho - I hope you are doing well, I hope to discuss this with my GP next week.
An obesogenic environment has a great deal to do with the epidemic of excess weight for the last several years. Why not change the environment?
12:22 GIP has antiemetic properties, probably helps get the GLP-1 agonist portion to higher doses as well
@@AZ89231 If you have nausea then you will not eat for sure.
indeed, why not? it's a fascinating discussion that we as a society must face with urgency. 2 of the main hurdles will be a) political will (a common hurdle with a lot of our societal issues) b) freedom. some will argue it's a personal choice and not the job of the state or regulatory agencies to tell us what we can/cannot eat. I think most would agree that at a minimum, UPFs/junk food shouldn't be subsidized with taxpayer money
Because people won’t vote for politicians who would pass the laws required. We would need some major changes to the curb the free rein the food companies have had over the years.
I don’t think it will happen. And education is not working. Nor is telling people to eat less and exercise more. People have never been better educated. But obesity is sky high. So I really think it’s drugs like these, or we carry on with current levels of obesity.
I wish it wasn’t so but I think it is.
@@mikecain6947 many of my patients have no/minimal nausea but robust reduction in cravings/intrusive thoughts about foods. There drugs are akin to antipsychotics for schizophrenics in the sense of abrogating the challenges with the complex interaction b/t human physiology and our food environment.
I love this channel!
It’s just crazy how he talks about the side effects. Sounds like removing your gallbladder or getting thyroid cancer is a lot of fun and have no impact on your lifestyle.
These drugs should be available but only if everything else fails to help. I still refuse to believe that letting people having unhealthy habits and resolving their weight problems with a pill is helping them long term.
True .. Nadolsky was pretty matter of fact about the possible need to remove one's Gall Bladder! 🥴
My mom lost her gallbladder from the Victoza I had no problems with mine. One thing that sucks about the drug family is the body builds up and it stops working after years on it.
Is one supposed to be more effective/better? (Sema vs Tirz)
Manjouro is typically meant to be superior. Go look at Vigorous Steve's video he compares the fat loss drugs with great research.
Exercise has a lot of health benefits but weight loss isn’t one of them. Most fat people know this which is why they aren’t motivated to exercise for weight loss.
I’m currently taking trizepitide 5mgs weekly 49 years old healthy no diabetes and this medication makes me feel like a million bucks…
If my wife has been struggling for last 10 years to loose weight ( she is not obese but overweight by 10-15%) excersising daily.. it’s seriously influencing her mental health to be fighting this constantly..
would this be a good idea
Cool stuff? Ozempic listed side effect PHEW: 1. inflammation of your pancreas (pancreatitis). ...
2. changes in vision. ...
3. low blood sugar (hypoglycemia). ...
4. kidney problems (kidney failure). ...
5. serious allergic reactions. ...
6. gallbladder problems. I hear you but surely we need to rethink this whole approach.
It's interesting that people will take these drug "shortcuts" and cause even more lifelong damage to their bodies. It's an epidemic of people who avoid personal responsibility, and the lifelong behaviour change of eating and exercising for health. It takes commitment to live a healthy lifestyle, it's not something you can buy from a pharmacy.
@@makeitvanilla6313 I don’t know what your background is, but your failure to understand the basic science of genetics and addiction is shocking. Your lack of personal responsibility to educate yourself on the science is the core failure here.
How expensive are these drugs?
I started on byetta and then insulin.
These drugs sound like a very compelling tool for those who struggle with weight.
The compassionate attitude toward people who find weight management a constant battle is refreshing.
If only supply could meet demand on these drugs, it seems like many diabetics are being left without their meds at the moment as demand for these medicines has surged.
Are there any foods that mimic the way these drugs work?
Yes, pasture raised beef and lamb.
Is it possible that this medication could downregulate fullness signals like leptin in the long term?
What about the people who were thin until menopause and then became insulin resistant, can these woman come off the drug and not regain the weight?
What percentage of the population need to be on a weight loss drug? What percentage would be acceptable? Ditto for ADHD, anxiety, depression, blood pressure etc etc. At some point we reach a tipping point where the majority of the people can't live the majority of their lives without being on a medication. That means there is something wrong with the world we have made.
This! I would say the majority of people are adverse to the idea of forming lifelong healthy behaviours that require effort, education and discipline. People want a quick fix or shortcut, with little reflection on the lifelong consequences of these medications.
@@makeitvanilla6313 Is your theory that people have suddenly become ill-educated, lazy and undisciplined of their own accord or has something caused that?
I'm presume, of course, that you and I are well educated, industrious and disciplined through sheer force of character! 😉
@@RogerHyam I don't think that was implied. People have always wanted quick fixes,. What has happened is the food we eat the marketing and availability. People are getting up to 80% of their cals from processed foods. We know now that these foods cause disease and overeating, partly independently of macro nutrient levels. They mess with our gut lining, our biome, our brains, our behaviours. If you did all this to people from 1823, they'd also been obese and looking for a quick fix.
Long-term we have to deal with the root causes of addiction. Many people eat comfort foods very high in calories because of some underlying stress or uneasy mental state. Lots of environmental triggers there - systemic stresses, expectations, loneliness, overly materialistic mindsets. That doesn't mean that they would be regarded as clinically mentally ill. One of the biggest problems that could be avoided is instead of doing periodical drastic diets which invariably fail because of resulting hunger, people who are in the position of course, could do wholefood plant-based (or as far as they are willing to go) which is packed with fibre which can make people feel fuller quicker. So apart from restricting the types of foods, you could more or less eat as much as you want until you are full. I may be wrong but I anticipate a massive band aid application of these drugs leaving to people ignoring the harmful effects of the food they are eating in other ways. However I am sure that for some cases it may be exactly the right treatment at least short term.
If people are eating the Standard American Diet, I don't see how any pill is going to cure the underlying causing, it at the very best scenario can treat symptoms without side effects. The best thing you can do is get off the Standard American Diet and eat more whole foods and stay away from high carb/sugar/processed foods, which are addicting and make you feel more hungry and makes it very easy to overeat.
I did that. I did clean keto and didn't lose anything until Ozempic. That's exactly what it's for is people like me. It's not magic, it's working along side my new lifestyle
Diabetic here and I can't get ozempic pharmacy always out
all fun and games until you get the worst pain of your life - pancreatitis.
Yes, morbid obesity can do that to you. Always baffles me that people think not treating obesity is somehow benign.
30:38 rapid weight loss in general increases your risk of gallstones and cholecystitis. Naturally, if people lose weight easily with these meds their risk would increase as well. So is it a side effect of the medication or if rapid weight loss? There would need to be a study that uses people losing weight as a control.
most likely weight loss as this happens in weight loss surgery patients too.
I worked for Merck for many years, running Phase III clinical trials. I just wanted to mention that the first thing we discussed on any trial was the ethics. We were even more concerned with the ethics than I experienced working in a university environment. There was only one time when I was asked to bend the rules to allow a patient in the study who didn’t meet acceptable requirements. I refused, and had a chat with their boss. Any hint of even a slight wrongdoing would be immediately acted on by your fellow staff.
If there are issues with Big Pharma, blame the non-scientists, upper management and marketing. The scientists themselves were always extremely conscientious and careful.
Queue the “you’re a shill” comments (I’m retired….).
My non diabetic friends in 2 month lost 18kg on ozempic and mounjaro . They eat all they want tiny portions and never plan to stop !
Why nobody asked the question are they losing weight because they’re eating less or are they losing weight because the drug is making their metabolic system faster
Apparently, the former. Essentially, nausea-induced super low calorie.
Because we know the answer. The effect is down to appetite suppression.
Finally, you discuss it.
I do gave a fundamental question concerning glucagon activation that theoretically should answer my other question concerning keto/low carbs diet too.
The question is: what happens to the beta cells before, during and after the conditioning ( either it’s ozempic, low carbs or keto)?
I wonder if any research has bern done into that direction, in order to conclude for example: the beta cells are no longer active. Hence, the subjects being conditioned should depend on fats as the main sources of fuel? Meaning, the death of beta cells ( might be) irreversible?
There are two opinions concerning this which can support my assumption:
1. Research done on those having smaller muscle mass in their legs due to keto.
2. Muscle breakdown for long term use, due to such medication ( that stimulates glucagon).
My interest in asking this is: Is it better to train the pancreas to have better functioning of beta cells ( all islets cells) through various types of foods ( carbs in particular) or being constrained for life due to malfunction of beta cells.
Perhaps, as well the influence of those regimens to other islet cells ( gamma, epsilon?)
Genetics predisposition too perhaps?
Great questions, thanks.
I wonder if the “food noise” is coming from the mitochondria 😬
Dr. McDougall did a presentation on Chef AJ's channel recently where he said that these drugs work by making your body sick, in the same way a body in ketosis is an unwell body. My view is that if these drugs save peoples lives then this is a matter for doctor and patient.
Nopes, many people don’t feel anything ! My friends on 10mg and zero side effects
@Ani R And how long is this going to last.... that's the question that nobody wants to ask or even think about.
@@HereDiianas absolutely !
@HereDianna if you ask the same question for blood pressure and cholesterol meds, you already have the answer 😉
Ozempic for 6 weeks, exhausted the whole time. Lost 10 gained 15 after I stopped. Had extreme carb cravings, like I've never experienced. Still trying to lose that last 5 to get back where I was before. Never again.
it has stopped working for me when it worked it was awesome I did lose 20 lbs tho
Same as my experience. Lost 45lbs and then plateaued. Went on a Med-Keto diet and lost 60 more pounds!! Try any low carb diet (vegetarian, vegan, keto or Mediterranean) with Mounjaro and exercise/walk at least 30min a day.
Why did you choose to show the cookies instead of an apple when he was talking about both? Now ice cream. Haha I had to stop watching. No kidding
Love how I sometimes can't get my diabetes drugs because people are using it to loose weight.
I was underweight my entire life. Beacuse of it and the socity thing, I was determined to gain some. I was literally stuffing myself with food every 3 hours. Even an alarm for midnight meal. After few months like this, something snapped and the sateity that I was usually feeling after 500 calories in a meal was gone. After that point I needed like 2k calories on a meal to be satisfied. I was happy with this feeling, thought that I am on a right pat to say goodbuy to skinny me. Silly me.. problems started few months later. Joint pain, reflux and anxiety were hell. Fast forward 10 years later, been through many diets and medications. I need to look like skeleton to feel healthy, but this is hardly maintained because of this satiety issue... Never tried ozempic or its relatives, but considering it
I like sugar and I don't like plants. Ozempic @ 1.0mg a week hasn't changed that. If I were not also doing 5:2 I would no longer be losing weight on Ozempic.
Sugar is not the issue with the obesity and diabetes epidemic. It's PUFA. Everyone has always eaten lots of sugar for hundreds of years. It was in the recent decades since Vegetable oils replaced the SFA's previously used in cooking foods that lead to the great rise in weight gain and disease.
Avoid all PUFA, eat low fat, the fat you do eat should be SFA like coconut oil, butter or ghee. Oh also, lots of vegetables contain oxalates. Avoid anything with high amounts of oxalates.
Research into the philosophy and teachings of Dr Ray Peat.
it's the only thing that helped me and my appetite and cravings haven't gone away, I'm still on the clean keto lifestyle but now I'm losing weight finally
Liam: the trials on Ozempic were done in combination with a calorie controlled diet and exercise intervention. Do that and you will likely lose the weight.
I think it's easier to lose weight once you develop a habit of eating healthy foods. If you slowly can get rid of the desire to eat unhealthy foods there will come a time when you don't want them anymore, and most of them don't even taste good. It's doable, little by little, especially if you can stay away from unhealthy environments. Once the addictions are gone it's best to not lose weight too fast, because with starving it's likely the addictions will come back and ANY food will taste good again, especially high calorie ones.
This video made me hungry.
😂
Good one😂😅
Muscle loss should be minimal. Your body probably has a set point of muscle, if you are way above that, some muscle loss is likely, but if you are way under and start lifting weights, you should gain some muscle with the fat loss
See "Preserving Healthy Muscle during Weight Loss" by E.Cava et al: "In persons with normal weight, the contribution of fat-free mass loss often exceeds 35% of total weight loss". Obviously fat-free mass isn't pure muscle, but muscle loss during diets is not minimal and is well established as a major problem with fat regain post diet. The faster you lose, the worse it is.
Mitigation involves resistance training and protein intake.
Yes you can gain muscle and lose weight if you are new to training, do a proper weights programme and eat sufficient protein AND don't lose too quickly. But if you're doing what a lot of people do on ozempic, which is to eat like a sparrow and drop like 5 pound a week, you;'re gonna lose a lot of muscle.
@@RaveyDavey yeah and when they are super large maintenance is probably 4500 cal a day, then after the fat/muscle loss maintenance goes to probably 1500 cal a day. It's a worry
@@brucejensen3081 True, but not unique to these drugs. That's an age-old diet problem. What is unique though, is the killing off of cravings and compulsions. Normal diets don't do that. People on Ozempic tend to forget what living with those compulsions was like. They feel like a skinny person - they can take or leave food within reason. Thinking about eating an entire tub of ice-cream at 11pm? Nah, I won't bother that would be stupid. Simple.
When you stop taking it, the compulsions come right back. Are people able to deal with that? Without having had like 6 months of mental self-discipline, are they in an even worse position than a crash dieter? Hard to say but I really think these drugs are a lifetime job for many people and who knows what the real side effects will turn out to be? There is the worry about them lengthening your small intestine which wasn't mentioned in the video I believe.
What really bothers me right now is the amount of people on it who are not being made, by their doctors, to follow the regime proposed by the drug manufacturers, which is to go on a controlled diet and exercise. THAT is how these "15% of bodyweight loss" trials were done.
I’m doing great on an all meat diet FYI.
The modern world places great stress on many people in different ways. Part of overconsumtion is related to the advertising that is constant and highly effective. It is part to do with the cheapest foods being the most tempting as well as the highest calorie density.
The last 75 years or so have placed dietary stress on the population and as a result, the very expensive chronic diseases are growing very fast. There won't be the money to pay for all this healthcare forever.
Corrupt food education in schools, done by the USDA, should be illegal. Civilized societies care about their children.
Wow, the $ cost is crazy.
I’m guess it will come down. It’s £150 a month in the UK, private. So that is about the real cost including a good markup for the whole retail chain and doctor.
I pay $0 on insurance
@@RaveyDavey Where do you get it for that? I have seen the first months dose for that then it is £199 afterwards, I would be interested save myself 50 quid.
Bottom line, Tirzepatide works better. Bam!
loss of lean mass doesnt has anything to do with the drug tho. if one gets in a big calorie deficit and wont consume enough protein and wont do resisting training, losing lean mass is inevitable
I am type 2 diabetic and I had a horrible experience with Ozempic. I made a video on that if any body wants to watch. It's on my channel. I will NEVER take this drug again.
Fact check Thomas Delauer
Things only seem to work if in the end a company can make a profit off of its discovery/product. The best solution to the obesity problem is better education on healthier foods and having more whole and organic food options available to more people at lower costs, but that wont make any specific company more money. Making a lifelong drug to start giving to a majority of the population is driven by profit margins more so than if its the ethical and long term thing to do. When it comes down to it, if the patient stops eating a calorie surplus every day, the problem should resolve in time naturally.
I´m the biggest advocate for education and the power of lifestyle (it's why we make videos) but I suspect it's not a fair fight for a lot of people when it comes to hyperpalatable foods. As Dr. Nadolsky explains, many of his patients already have the basic understanding (and resources), yet can't escape the allure of these foods with enough consistency to maintain a healthy body weight. I think these meds may help level the playing field for people with that propensity. For the rest of us, who can get things on track with lifestyle alone, that's ideal
@@NutritionMadeSimple exactly. “Just eat right and exercise” is not working. The game is rigged. Humans are just not capable of dealing with the food environment we have now. And I don’t see it changing much anytime soon.
@@NutritionMadeSimple I agree with you, but it does come down to personal responsibility. No one is forcing these people to eat a diet of processed food, and only they can choose not to consume them. I would argue that it's a food addiction at that point, and should be treated with therapy and behaviour modification - not drugs. These drugs aren't without serious side effects, and they don't take the place of learning and sticking with healthy behaviours.
On a side note - I love your channel. I appreciate your thorough scientific approach to health topics!
@@makeitvanilla6313 to the extent that it's a "choice" to eat UPFs (some would disagree but we can leave that aside for now), the meds also come down to personal choice. people should be informed of the potential side effects and allowed to decide. they may be life-saving for some and totally wrong for others
@MakeItVanilla Some people were unaware of the HYPEROALATABLE ingredients in certain foods that affect the reward system of the brain... And sometimes when those people finally understand the ingredients in certain foods are making them addicted, it's too late. It's not as simple as say a drug addiction when you knew what you're taking in the first place. Cmon now, be fair, especially when so many factors are involved like what about people who cannot afford the healthier foods??
Wait until the game changer Brawndo is approved. It has electrolytes
There is no such thing as just a cosmetic weight loss application. You get benefits from weight loss down to a BMI of 17 according to Dr. Walter Willett from Harvard. Oh yes. Once you remove the sick quitters, smokers from the data. Benefits go down as far as a BMI of 17. And overweight doesn't starts at a BMI of 25. It starts at 23. Oh yes.
Gil, let me add to Spency for managing the side effects/ adverse reaction.
1. For fatigue - adequate protein, shooting for 1.6g/kg IBW and hydration +/- ⬆️ sodium (bone broth/bullion work wonders)
2. For constipation - fiber works poorly d/t slower gastric emptying - again bullion/bone broth works wonders here. Re: natriuresis of fasting
3. For diarrhea/vomiting/nausea- this is almost always related to the types of food, particularly highly processed, rich in refined carb/fat eg Chinese food, burger/fries.
If they don’t change the quality of food and don’t take this advice, they will be worshipping the porcelain god…from both directions…guarantee it. 🤣
Just don't treat your body like a trash can it's not an amusement park it's a temple that you live within
Ozem is good for weight loss but also diabetes lol. Hard to find cause many use for weight loss.
Not so. Old news. Ozempic is plenty available.
Speak in layman terms please.