Cause for caution with weight loss drugs like Ozempic | Peter Attia, M.D.
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- Опубліковано 30 вер 2024
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Here is my little PSA on Ozempic… if you’re considering this drug, check this out and check out podcast number 246 from The Drive.
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About:
The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 60 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more.
Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan.
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Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit my website where I keep an up-to-date and active list of such companies. For a full list of our registered and unregistered trademarks, trade names, and service marks, please review our Terms of Use: peterattiamd.c...
![Pros and cons of GLP-1 weight loss drugs and metformin as a geroprotective agent [AMA 45 sneak peek]](http://i.ytimg.com/vi/GCCHOBLTiCk/mqdefault.jpg)
We do have 2 hours Peter. Walk us through the FDA rabbit hole please!!! 🙏
I have as many hours as he needs 😅😅 Deeply interested
Why? To feed the desire for more conspiracy theories and spread the message that everyone lies to you? Poor little man.
@@ohmy2542 I agree with you (getting past your gratuitous sarcasm). We do not need more conspiracies. I personally ignore most sources, am veery selective social media and am quite critical and have a thick filter when I choose the people i listen to. But should we abandon even the most credible of sources for the sake of peace of mind?
ultimately its the insurance companies that are running show. money money money. people talking about spread of "conspiracies theories" are afraid of truth.
My son is an actuary in healthcare. I asked him which is cheaper for the insurance companies: paying for these drugs, or paying for the numerous health consequences of obesity. I am willing to bet it is cheaper to pay for a drug than bypass surgery, and other medical occurrences related to obesity.
No amount of warning works for ppl determined to take these drugs. They simply don’t care about side effects or surprising long term effects to actual organs in the body. As long as I’m thin kidney disease in a few years is fine.
lol. Everything you put in your body has a side effect. You're so uniformed. "THIS DRUG BAD" while you you're consuming mirco plastics and sugar all day.
Tried it for a few months for pre diabetes and did lose weight, but I had side effects of nausea and diarrhea. My appetite decreased substantially, but the side effects plus having a new thyroid lump concerned me. I’ve never had thyroid issues before, thank goodness my biopsy was normal. Too many side effects for me and possible health risks!
Well thyroid cancer as well as other seriously side effects are all out there, on the website of ozempic.
Good for you to come off it. There is a risk of thyroid cancer so you did the right thing.
Take the food pyramid and turn it upside down. Keep away from bread, pasta and rice. Increase intake of protein, VEGGIES, don't be afraid of healthy fat (avocados, olive oil, nuts) stop drinking alcohol. Start exercising, take the stairs, walk. In about 4 months weight will begin to fall off of you. Because these actions will fix insulin resistance. If you have a bad day or a bad weekend, just restart. You won't lose progress. This is sustainable and you do not feel deprived. Plus this diet makes your skin glow and fixes your digestive system, too! Just try it. I've seen the results of ozempic and it just isn't attractive. It's expensive and makes people look like melted candle wax in the face sometimes. It causes digestive problems too, the brain and gut are connected so I'm willing to bet that you will also be sluggish upstairs when you're on this drug. Anyday is a good day to begin a healthy journey! Good luck ❤
I love this. I’ve been on semaglutide for weight loss, but I’ve got an extensive training history and train 7+ hrs a week. When I heard the headlines that semaglutide causes significant muscle loss, my first question was around training and diet for the population reported on. Just like any other caloric restriction, your body is going to shed tissue based on an adaptive response and people that are morbidly obese are likely not to have a great diet and training regimen. I’ve done inbody scans and have seen some muscle loss along the way, but the predominant loss has been in adipose tissue. Not that anecdotal evidence can be extended across the population, but it just makes sense that a body that isn’t trained and supplied with sufficient protein is going to shed more metabolically active tissue during caloric restriction.
I don’t have the study/s on me, but diet restriction without exercise of weight lost was 25-30% muscle. Semiglutide of weight lost was ~50% muscle without exercise. Diet restriction with exercise lost ~ 10% of weight lost was muscle.
I don’t think protein was controlled.
I love where you two are going with this, providing solutions to make it work, thank you!
Great points. Resistance training effect on hormones like hgh and testosterone and enough protein intake would drastically change the tissue being lost. Dr Attia misses the big picture and it should obvious to him based on countless studies that discuss the importance of resistance training and protein intake. I'm not losing any muscle on ozempic and it makes intermittent fasting so much easier
Wondering this myself. Active in the gym 4-5 times a week along with being on TRT for the last two years. Lost about 20 lbs so far and haven’t noticed any significant muscle loss. Was thinking of slowly coming off. Would be interesting to hear that take.
Great comment bang on point
Take a shot every time Peter says DEXA scan or VO2 max
Lol
add the word zone 2 and see how quickly rates of acute liver failure rise
Dr. Attia: I just wanted to put this comment somewhere you might read. I just finished listening to audio version your book, outlive and wanted to thank you for putting all that time and research into it. Honestly love your tone of voice. It was like a story telling, I loved the pace of it, was surprised at the end to hear at the start you were not feeling confident about reading it yourself with your own voice, I am so glad you did whoever coached you did a great job, I felt even as I started listening at the start, this book has different quality of tone and pace and authenticity than most audio book I have heard.. You do have a great tone for podcast/radio talk. As a psychiatrist and reader, the most impactful section was the one on mental health. thanks for your honestly and destigmatizing mental illness, millions are suffering for anger and rage and emotional dyscontrol and not willing to get help. I listen to any video/book form you. thanks
He has a fantastic voice! First thing attracted me to his podcast!🤯🤯🤯
Absolutely agree with everything you say.
Funny, if you tell any one of your friends that you fasted for seven days, they'll think you're crazy. But if you inject a prescription drug, and develop a dependency on it? They get jealous!
Ozempic is a pharmaceutical dream.. it’s expensive and you have to stay on it forever or you will gain all your weight and more
Are you speaking from personal experience?
Yeah cause.. if you change your habits. It won’t come back
Hyped up drugs like this are why drug advertising is illegal in my country, unfortunately social media is making those kinds of laws obsolete.
Are they allowed to advertise these drugs on the television?
@@Successinmind_ no
@@Successinmind_the united states is the only country that allows this
@@adnanjaved2909A New Zealander has corrected me to include them as a country who also allows Pharma ads. I didn't know either.
Not a Drug imho as it’s just a peptide also it’s incredibly wonderful in micro doses so I’m sorry you can’t access in your country because I get it here for nothing and don’t use for weight loss but for anti aging etc for weight loss there are better options peptide wise like RETATRUTIDE
The constipation. Dear lord I almost went to the er it was so bad. On top of protein intake stay on top of your fiber and water intake.
Tirzepatide causes much less constipation, esp over time.
Metamucil 2x day is the easy fix for me.
Magnesium citrate.
A liquid iv mixed with Metamucil and a pouch of miralax got everything cooperating again.
I use Berberine for the glycemic benefits. I am tiny, but my bad cholesterol is borderline high likely from my “lazy keto” diet. I started taking it, I’ve dropped weight without doing anything extra ( I already do HIIT, intermittently fast, usually 16 hour, nothing crazy) and my bad cholesterol has dropped a few notches. That’s what I’ve done and I like it
How much Berberine do you use?
Bad cholesterol is BS. Look up Dr Paul Mason "high cholesterol on keto diet. Furthermore, When they check your blood youre normally fasted... guess what adds LDL to your bloodstream? Fasting.
Yes. How much Berberine. I just started it today.
Its debated if those traditionally bad cholesterol levels actually cause heart and vascular disease when on these types of diets.
Peter is a true clinical physician that never stops learning. What a wonderful mind.
I’ve been on semaglutide for 5 month. I eat between 1500 - 1700 calories a day with about 100 grams of protein. I do CrossFit 4x week. This is a typical diet deficiency. It’s not a miracle drug. It’s just helps me stay in a healthy calorie deficit. Im not losing muscle, in fact I’m starting to see my muscle definition. It’s all about slow weight loss, eating high protein in a decent deficiency, and lifting weights.
totally agree i been on it since april due to diabetes last april i run 5 days a week i do 6 mile runs and work out no muscle mass for me but i have lost 80 pounds since on it i’m loving my slim figure .
@@ajcrum3689 start lifting
What is semaglutide?
I've lost about 30 lbs in 7 weeks. Walking, walking, walking, jogging, and eating fresh foods. It's been hard work but there's nothing like diet and exercise.
With ozempic or just the exercise and clean eating or both? Great job either way! 👍
@@DDTSB2525 Just diet and exercise.
@@jojersey4081 There is hope for me then 😅
Walking is such an under-recognized way to manage weight loss. It’s amazing for that purpose.
What was your starting weight? Age & height? I’m trying tirazepatide & wanna compare people results
I am on compound pharmacy Semiglutide for 8 and a half months as of now and lost 41 pounds. From a BMI or 35 to a BMI of 29. Still going strong. I had health coaches appoiments that helped me be successful with it. Is not a walk in the park but as I was educated about how to slowly go in dosage. I am still not at the maxium amount and I am not in the rush. The forst 5 months was harder to exercise but now I can go to the gym 4 times a week and is so much easier to move without the 41 pounds. My liver enzymes are finaly in normal range after 5 plus years. I tried a lot of things before and my weight did not move at all. I am happy with it and leep doing my part.
I'm SO HAPPY that you covered this topic because I have been bringing this to the forefront in discussions with the clinicians at our clinic since we started treating patients almost 2 years ago.
My education is exercise science and nutrition, so the physicians seem to minimize the points you're mentioning and very rarely use our BIA (ONLY OPTION AVAILABLE) in our clinic.
Thank you for making this available to share, Dr. Attia🙏🏼
Working out and eating well my resting heart rate is around 57...it was mid 70's. I went and had a gambit of tests done and my body is healthier now than it's ever been. No cheats. Get that heart pumping with a good workout and eat fresh!!
It makes me so sad that ignorance guides most inflamed conversations about those that are using Semaglutide for weight loss appetite control reasons instead of diabetes. Diabetes is serious but so is a life long battle with compulsive overeating disorders. I’ve seen first hand the massive positive impact that Ozempic has had on a loved one that has no ability to control their appetite or compulsion to eat and binge. This drug needs to be prescribed to this alternative group of people that are just as at risk of complications and death as chronic eating disorders ruin lives and health too
totally agree, i am on ozempic for weight loss very successful and my daughter who suffers from bulimia would greatly benefit --- stops the food chasing so nice to have that monkey off ones' back
@@downieduck2414 I hope Dr Attia is reading these comments and finds a way from within the fraternity of physicians to advocate for disordered eating patients that are too at risk for lifelong health issues and even premature death
@@ThriveCollective1188 I think Dr Attia would support the use for people who are severely obese due to eating disorders. Someone who is 20 or 30 lbs overweight is not severely obese and could make a lifestyle choice, rather than using these drugs. This is especially true if a person is over 60 and has not been exercising. They don't have much muscle mass and it seems this is about the age women start falling and then a whole new set of problems begin when they break bones. My take is these drugs are risky for elderly people and not really necessary if one is just moderately overweight. There may be better choices.
I am currently listed for lung transplant & I had to take lots of steroids at one point. I gained almost 60lbs on my normal 160lb frame. I was able to lose 45 on my own but that last 15-20 was a challenge. Ozempic has helped me lose that and keep it at bay so I can 1. Get the best outcome from my transplant surgery and 2. Ensure I am able to keep my BMI low enough to stay on the list as they will kick u off for weight issues. As someone on 24hr oxygen cardio isn’t an option for me right now.
Here's the things that gets me though. If you are eating 200g of protein and working out intensely lifting weights, then why do you need Ozempic ?
Metabolic syndrome or diabetes
Yeah I'm definitely down for 2 hours on the problems Peter has with the FDA.
After my 3rd injection, I became sick for 10 days. Vomiting, constant nausea, and feeling like i was wasting away way too fast. Yes, I lost 15 lbs, but i felt like crap. In fact, 6 weeks later, I still feel crummy in general. And yes, my skin is hanging off of me in a gross way bc I've lost muscle mass. So while it worked, it wasn't worth the terrible side effects and overall crummy feeling. And this comes from a person who has been obsessed about her weight for 30 years and would previously have done anything to stay thin. Careful people.
Were you training with weights and hitting appropriate protein target?
Maybe you have a virus.
Take a smaller dose, prioritize protein intake and lift weights. Don't blame the drug. I take 0.5mg a week which is plenty to curb appetite. Use your brain and listen to your body
If you eat a high carb diet this will happen. I stuck to low carb, never had a problem.
@TheFakeyCakeMaker it can be a problem for some people. The mechanism of action decreases gut motility and that can hit some people harder than others. No one knows who will be affected like this and who won't be. A lower dose may help but for some, even the lowest dose can have some intense side effects.
Heck I know someone who is on 0.25 who will sleep closer to the toilet for a few nights so they don't poop themselves st night. But his success and diabetic management makes that worth it for him.
You can’t suppress appetite without generating anorexic tendencies at the same time. The person loses fat but then they lose muscle mass on account of malnutrition and caloric deficits too. The risk is not worth the reward for most….
Aside from Ozempic, the gastric surgeries are unhealthy too. My daughter had the gastric sleeve and she lost weight rapidly. The amount of muscle loss that goes with fat loss is concerning. I tried to reinforce how important strength training and eating adequate protein is during the process. The odd thing is the surgeon said to focus on cardio and walking. This made very little sense to me since her food intake was extremely limited. It sounds like this medication is similar when it comes to rapid weight loss.
Holy F!
Ive been pronouncing panacea wrong my whole life. I thought it was pronounced pa-NAY-sha kind of like rosacea.
You advocate 1 G protein per 1 lb weight. There is no legitimate scientific study demonstrating that recommendations.
Greg Knuckols has a good video on this. From my recollection 1.2 -1.6 grams per KG is basically the tldr for people serious into muscle growth and wanting to be full proof, but people can often get by on even less.
Idk where the 1g per lb thing comes from. It's just some bodybuilder thing that has become a staple.
The thing that change was that after using it for Type II Diabetes for years , the studies realized that the drugs make the patients loss weight , then everythinng change , because some celebrities begun to use it as a drug for losing weight.
It appears that the way this drug helps Type 2 diabetics is by helping them to finally lose weight, as obesity is the major cause of Type 2 diabetes. So my question is, why are you seemingly advocating that people who are overweight shouldn’t avail themselves of the help that these drugs provide to stick with a healthy diet until they are ill with Type 2 diabetes?
you don’t think they lose muscle just cuz they not eating enough or getting they protein in? you think that these type of drugs naturally cause muscle loss? that’d be weird
My wife used a Highly restrictive ultra low fat diet to lose weight a few years ago. She shed weight quickly but after becoming pregnant, with twins to boot, she stopped as caloric restriction isn't a good thing as your body is growing lives inside of it. Before she became pregnant, she had a ipid profile drawn. Her LDL cholesterol was 168.
As you can imagine she gained a significant amount of weight back during her pregnancy and after. She decided almost two months ago to join me in a carnivore way of eating. When you see someone do something with only positive effects and lose over 60 lbs to boot, you give it a try. She's lost in the neighborhood of 20lbs now.
She had a lipid panel drawn the other day prior to her annual visit to her family physician. Her LDL? 97. Her triglycerides dropped to 74. This is on a diet super high in saturatrd fats. Remember, 168 on ultra low fat, 97 on high saturated fat weighing close to or right at 40lbs more. The answer for ALL of us is if it comes in a bag, box or can don't eat it. If there's more than one ingredient, throw it out. Processed foods are terrible for us. Then, eat whatever whole foods make us feel good. You'll lose weight and gain energy in spades and you'll not have to worry about what the latest and greatest medicine that's FDA black listed in 10 years is doing to you.
You do not want your cholesterol too low….more people have heart attacks on low than high…..look it up…..
This caused my Dad who was put on it for type two diabetes to lose almost 40 pounds in a little over two months, but he did NOT NEED TO LOSE WEIGHT!!And yes, it’s taken about eight months to recover from being on this drug due to the loss of muscle during this short time.
ua-cam.com/video/sDGniKOwIa8/v-deo.html&ab_channel=FindTheLightrb
What was his BMI before and after losing weight?
The sh!t works. period. Maybe a little muscle goes w/ it but it mostly takes off the fat. Taking off the fat typically reduces blood pressure, inflamation, and brings glucose under control. It also allows you to get started back working out without the weight related repetitive use injuries being as large a factor.
Get a fasting blood test but lie and eat sugar instead of faster to game the test. You will test out as a diabetic or pre.... You doc will then put you on it...Once you drop your goal 40 pounds, taper off. You just reset your life! Now, don't get fat again. That's the game changer this drug is!
Peter attia the man the myth the legend!
What a fabulous mind we have for us to quire information
Peter is the best i learn so much. It’s hard to consume 200 grams of protein let alone 150 at 59 y/o
I would disagreee that Ozempic is safe.
It slows digestion to the point that food is just sitting in your stomach in particular, but moves slowly though the digestive system.
It can cause a lot of problems for anyone on it who may need surgery as they have food not moving through and just sitting in their stomach and remaining digestive system.
Diabetics already have slow digestion, which makes colonoscopy prep more extensive... days of prep rather than 24 hours.
It can cause or contribute tribute to bowel obstructions...
None of that is not safe in my book.
I’ve been on 1-2 pounds of red meat a day for 8 months and lost 45 pounds (from 260)
What happens if you stop taking the drug, does this mean the weight just returns? If that is the case does this mean you have to take it for life to maintain?
Yes. Research is pretty clear that this is a lifelong medication. Hence the concern as we don't know long term side effects.
And what about the severe side effects that are surfacing everywhere lately?
I hope we see some studies of people resistance training and getting enough protein while taking it.
Have been on Ozempic for 3 months and have lost 10 kgs with another 7 kgs to lose. Have felt nauseous and tired one or two days but other then that it’s been great. I walk my dog twice a day, I swim twice a week and go to gym for weights twice a week. I eat protein and leafy green vegetables 🥗 daily on ozempic. It’s been great for me.
ua-cam.com/video/sDGniKOwIa8/v-deo.html&ab_channel=FindTheLightrb
It paralyzes your stomach. And you will have health issues after it.
It has a longgggg. Half life of 5 days!! It works and it works well. However it does slow your gastrointestinal emptying.
I started on Ozempic in July of 2022 at 305 lb. I am now down to 252. Not as an extreme loss as others but I've held on to almost all of my muscle. Can't bench quite as much as I could but every other muscle group moves the same amount of weight as when I was heavier. I attribute my muscle preservation to not losing weight that quickly as well as keeping my protein pretty high. I will say, I don't feel the effects of the medication very much anymore. I still eat less but it doesn't have the same dramatic hunger curbing effect it used to.
How do you know you held on to your muscle did you have a body composition test before and after?
@@edgaracevedo9658 no I didn't, I'm strictly going off of the amount of weight I'm lifting. I lift every muscle group over a 3-day spread every week and haven't noticed any strength losses at all with the exception of my bench dropping about 20 lb. I feel and look just as muscular as I did when starting, just less soft.
That's a significant accomplishment. It's great to hear that you have been able to preserve your muscle mass while losing weight. Maintaining a higher protein intake can indeed help in preserving muscle mass during weight loss.
As for the medication, it's not uncommon for the initial effects to become less noticeable over time. Our bodies can adapt to medications, leading to a decrease in the hunger-curbing effect you initially experienced. It's important to discuss any concerns or changes in medication effectiveness with your healthcare provider, as they can provide guidance and make adjustments if necessary.
Keep in mind that weight loss journeys can vary from person to person, and what matters most is the progress you are making towards your goals. It's important to focus on overall health and well-being rather than solely on the number on the scale. Celebrate your achievements and continue to make choices that support your health and fitness journey.
Do u attribute following a diabetic diet along with starting this med??? Wat changes did u make???
@@jackki6869 I don't do low carb. I don't feel good on it. I just prioritize protein which naturally drops my carbs a bit.
What doctors need to do and media companies aswell, is let the public know when they are getting paid to “report” on Ozempic or any medication in general.
For me IF, exercise, carnivore mostly and meditation made me stay fit and drop weight. I am afraid AF of using drugs. Try my best to stay away primarily because side effects down the road that are unknown.
Realistically how many people are able to stick to carnivore? 😂 The top 5% of the population?
@@Successinmind_ you would be surprised. I’m not wealthy and because of IF, I don’t need to spend that much money on food anyway.
Meat, many cuts are affordable and they have always sales.
Eggs, chicken, fish, organs etc. you do not have to break the bank.
You cannot oudrug your way out of a bad diet, do it the clean way no sugars and no grains is the key.
Says someone who has never been an older diabetic person...
@@zed5129put in the work. Good luck!
The nurse practitioner used this, but she came out looking like a shrunken shell of herself. Not for me.
I’m amazed by your clinical experience. I have not lost any strength over my 7 months of using Mounjaro, and quite obviously that’s because I train to failure with the heaviest weights I can manage. I’m sure you advise your patients to do this, and that’s why your clinical experience astounds me. I’m female, 78 years old, have lost 30 pounds since starting Mounjaro, lift under the supervision of a trainer, and now lift once per week because of the recovery time I require.
I didn't lose muscle on Mounjaro either (as verified by DEXA scan), also eating an appropriate deficit, adequate protein, and lifting weights. I'm 41.
I’m 28 - did Dexa scan, I lift heavy 4 times a week, high protein, clean diet and have built muscle while on Mounjaro. It’s completely helped my metabolic disorder that was standing in my way of reaching full success, in fact, it has even gotten rid of my major depressive disorder AND rage/anger that I’d get from my period (called PMDD). Forever grateful.
Are you still overweight? Or taking it for some other reason?
@@RealBoiJare could be to not put the weight back on
Yeah, girl - get it!! 👏🏻👏🏻👏🏻🙌🙌
Its the first freaking drug that works.
I’ve been taking Wegovy for about 8 months now. I have always been a big person, even as a kid I was always much bigger than everyone. 265lbs weighing in for 9th grade football, 330 at graduation. In my mid 20s I was able to go from 375 to 285 in 18months through fasting and calorie restriction. Lots of cardio and I had a much more physical demanding job back than. Now at 36 years old my weight had crept back to 346 and I’ve struggled not losing with the same techniques I used in the past. I started taking Wegovy and at first didn’t really lose, but in 8 months I am down 26lbs and it’s starting to pick up. I didn’t have many side effects, I may have throw up a handful of times when I ate too much. What I love about it is I’m not that hungry so I can afford to spend on high quality food to eat because I’m not eating a lot of it. I hear the muscle loss argument all the time and I think it’s silly. When I was 375lbs my leg muscles were huge to move all that weight around. You’re not going to keep all that when you lose weight it’s silly to think you would unless you were training too or something. Also I’m using a composition scale now and as I’m losing I notice the percentage is starting relative to my weight so yes I’m losing muscle but it’s relative to my overall weight loss of that makes sense. I’m not working out while on this medication, I golf once a week and walk the course, and maybe do one other cardio activity each week but that’s about it. Lots of homemade food, lots of full fat milk and yogurts, real butter, olive oil, or avocado oil only. No seed oils, no fake Americanized breads, no over processed foods. If I’m craving a dessert I’ll go to an Italian bakery and buy something rather than buy some over processed Oreos for example. Just my thoughts from someone actually taking the meds. People who don’t hold onto weight so hard don’t understand how hard it can be. Some people are gifted with a great metabolism, others aren’t. I don’t have diabetes but I do get high insulin spikes after eating which is probably why I’ve always stored fat. These meds slow digestion down and make you eat less so you don’t get those spikes and don’t store fat.
Exercise, fruits and vegetables. Hahaha. Not rocket science
@Mullymutts86
What is Wegovy. How to use it. Forgive my ignorance please
@@eraera2022 it’s ozempic just higher dose
Doctors giving Ozempic for just weight loss have caused shortages for those of us who take it and need it for our diabetes. This medication was made for diabetics and should not have been prescribed just for weight loss. With these shortages we cannot get ours and have to be put on other meds that do not work as well. 😡😡😡
Ummm you can use diet and exercise too. It isn't necessary for diabetics either.
I took Trulicity for diabetes for 2 years. Worked great for my glucose levels and I lost 40 pounds. But I could not have a bowel movement, felt nauseous, lost muscle like crazy. In January I was told by my pharmacy that it was back-ordered, short supply. In 3 months I gained 20 pounds, glucose skyrocketed. I am now on intensive diet and exercise. Glucose is back to normal, but I HAVEN'T LOST ONE POUND! Totally screwed my metabolism! I would not recommend the GLP1 drugs for weight loss! I know lots of people online are stoked about their weight loss, but YOU CAN NEVER STOP TAKING IT!
2:58 - the math is not accurate, it’s opposite. If I have 130 lbs of muscles and 30 lbs of fat, losing 10 lbs of muscles and 10 lbs of fat will make me much leaner (=low fat %). But the overall point is clear, agree
Thanks for sharing! Although I’ve been taking it for 3 months and I’m down 30lbs. Have 3x more energy and motivation and feel great. Just my side effects 😅
I’m assuming once you got off the drug you would be just as hungry right? I’m curious about taking it for 3 months just to shed some quick pounds with the low caloric intake and then maintain body weight
@@bigpap90 yes exactly. You do get your hunger back but hopefully by then I’ve developed better eating habits 👍
Sorry, there’s no shortcut folks.
I'm on my 2nd round of Ozempic -25mg/weekly. This is as a result of my triple bypass in December, which also uncovered that I had type 2 diabetes likely for many years that I had no clue about. Prior to being prescribed Ozempic, I had already lost nearly 60 lbs and reached around 16% body fat due to changing my lifestyle, diet, incorporating steady state cardio and hitting the gym 3-4 times weekly. So I don't need or want help in the weight loss department, but I am keen on the benefits to my diabetes and heart. This warning has me now focused on monitoring for any potential muscle loss as I move forward. I can say that after my first round, my strength in the gym has continued to increase and my musculature is still growing, but now I am monitoring for the symptoms of muscle loss and upping my protein intake somewhat to hopefully mitigate any potential losses. Thanks for this video!
Is it any changes to your skin,especially face?
25mg? Are you sure you don't mean 0.25mg? 25mg is like 12x the max weight loss dose.
@@AUniqueHandleName444 yes, thanks for the correction. 0.25mg the lowest dose I believe.
I would love to see the GLP agonist tested against an "active placebo" i.e., one that causes the same amount of nausea. I suspect nausea is responsible for much of the class benefit of GLP agonists. Maybe test em against a little canister that produced a strong vomit smell that you whiffed before each meal? would probably beat Ozempic in a head-to-head for glycemic control and wt loss 😂
lol good luck to the people joining that study! I am chuckling picturing people whiffing a stench at mealtimes :-)
I’m on ozempic and have had no nausea. I’m simply not hungry.
There is no such thing as an “active placebo”. Maybe you mean an active control. Placebo by definition means it has absolutely no effect.
Placebos have no "therapeutic benefit", they can have non-therapeutic "side effects" which help prevent test subjects from breaking blind. An example would be comparing "placebos" laced with atropine to SSRIs in clinical trials because both cause dry mouth. Actually, many drug trials use all kinds of stuff in the "placebo" arms to juice the trials in all kinds of ways. GLP-1 agonists are presumed to work by mechanisms other that provoking nausea, yet many patients have significant problems with nausea. If this "side effect" was subtracted, I wonder how well the drug class would do. Don't know if all explanation was necessary since you just wanted me to substitute the word control for placebo.@@vickynissi704
many patients do, I was just wondering if this "side effect" was subtracted from glycemic/wt loss benefit in the trials, if the drug still could have got approved.@@freshdread
Are they losing more muscle mass because they're eating too little? Or is there some mechanism?
Fasting is probably the better alternative❤
What changed? Pharma marketing.
I think what he’s saying is fairly accurate but please take into consideration visceral fat, water, bone. Also please take into consideration waist circumference which is a very solid predictive factor for some health issues. Not lastly but another point- please also look at your fasting and peak sugar levels as well as average blood sugar levels before and after taking a substance. Lastly, I think the consumption of 1g per pound of body weight is NOT necessarily a standard any longer. Maintaining steady streaming of amino acids in the blood stream contributes to anti-catabolism as well as bcaa and glutamine intake. There’s TOMS more to take into consideration. I’m no where even remotely near to this Drs level of contribution to the subject but take the above two cents into consideration
TOMS = TONS
Dr. Attia is very well versed on this topic. He's a physician and someone who has extensively studied how things work for or against the human body, how it breaks things done, chemical and physical composition, etc.
Thank you, Peter. I want to lose weight without losing muscle, and I don't want to use anything other than diet and exercise. This information is nice to know for future reference.
try to be more realistic. lose lots of weight while not losing much muscle. if youre not super fat you probably cant lose weight without losing any muscle
Lift weights and mix in cardio. Not rocket science
Carnivore
Time restricted eating for 14-18 hours - eat good quality protein, good fats plenty of salads vegetables, 2-3 litres of water daily, good sleep, walk 7-10,000 steps per day, strength training 2-3 times per week, cut out processed carbs sugar - the weight will fall off you
I did almost precisely this and dropped 70lbs. in less than a year@@gloriasaliba3395
Not worth the risks.
Is it true this drug is helpful for alcohol addiction?
The only way to loose weight is to stop shoveling food in your mouth. God why don't people want to discipline themselves.
There are two steps to losing weight…eat less and eat better. Ozempic cures one of those problems. If people would take the initiative to work out and start to change their eating habits it would indeed be a miracle drug. But we both know most won’t do that, will they. I have a friend on it and she’s ecstatic about her 35lb weight loss, and she seemed aware when informed her about the density loss. While she paid lip service to making a change, quite frankly I don’t see it happening. 🙁
Yup intermittent fasting works. I do for medical reasons bc I have severe arthritis. Nothing like pain to motivate you. I lost 60 lbs and lots of muscle but gaining muscle back mostly from diet changes
lol there's always going to be a troll who's clearly projecting. Like babe, I can tell you're overweight from just reading this comment. Happy people don't comment this. You're clearly sad, depressed, overweight, and have no friends.
Sounds like people taking this drug don’t know how to eat.
The Kartrashians started this fad drug obsession.... that's why it's in the dialog.
Let that sink in.
I would never ever ever use anything that garbage family uses ❤
They started it last summer when that one wanted to fit in Marilyn Monroe's dress
My biggest concern (other than no long-term studies) is that it has been stated by other physicians, that GLP receptors are all over the body and very little research has been done on what effect GLP-agonists have on all of these non-GI systems. Many drugs have been marketed with this blind ambition - it works, we will deal with the untoward effects with post-marketing research. Don't be eager to be their guinea pigs.
Similarly, Let’s talk about the third rail for longevity docs like Attia- mRNA vaccines cough cough
Same concerns over the COVID shots. Didn't stop Attia from recommending those.. 😂
ua-cam.com/video/sDGniKOwIa8/v-deo.html&ab_channel=FindTheLightrb
Can you do a talk on Mounjaro? Type 2 diabetic who cycles 20 hours per week and watches his nutrition but blood glucose and weight loss are not improving at all. Thanks Peter!
Thank you for this short, Peter. Also, I want to give you a shout out regarding your Early program- wow! I love it! Learning so much, Peter. I feel so blessed to have access to all the knowledge, framework and strategies you have put into that program. Thank you❤
Keeping a1c in check is far more important to cardiovascular health, in the long run, than losing some muscle mass.
My medical philosophy professor told us that when new drugs come out: first of all they are lionized as a miraculous‘panacea’, then side effects occur and the drug becomes a ‘pariah’. Finally, the pros and cons even out so the reputation and usage (albeit with caveats), becomes mainstreamed.
Would I be correct in assuming you have similar concerns about Tirzepatide? I've been on it for three weeks and it's effects are amazing, but I also feel like maybe it works too well. I might not be getting enough protein..
My doctor said something about the possibility of taking it, but my understanding is that once you start you've got to stay on it or you'll gain all the weight back again.
That is right
Seems to make sense. Sounds like it works similar oathways to Keto, activatong glucogensis via protein (either via muscle mass or what you consume) to get the quick hit glucose in your blood.
Do you listen to Robert Cywes M.D., the CarbAddictionDoc on UA-cam? Jason Fung M.D. and Ken Berry M.D. are helpful. Dr. Cywes has been a Weight Loss Surgeon for over 30 years. He had a weight problem, so he knows it first hand.
How about for those of us that are actually diabetic and also want it for weight loss too? I was going to ask my doctor about it but never did and I know other people trying to get it but say they’ve been waiting several months because it’s on back order. I actually remember someone who was diabetic that was complaining a few years ago about not being able to find it and it was her main prescription because people were starting to take it for weight loss. My diabetes is pretty well controlled with metformin, a low carb diet and regular exercise like 5.8 A1C but my weight continually fluctuates and nowhere near where I want to be weight wise. Does it still help with taking off weight if you’re diabetic? I wonder would I still have to take metformin too.
Yep. The reason it works for weight loss is that it massively improves insulin resistance. I find it frustrating when people try to state it's only an appetite suppressant. I took it for a month and lost 4 lbs despite eating the same healthy diet I always do. I used to have an eating disorder so I always know exactly how much I eat and it didn't reduce my appetite at all. My IR was simply much better controlled on the drug. I also took it with Metformin.
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.
For 40+ patients, most would likely also be candidates for other hormone replacement. One way to prevent catabolism is by making sure Testosterone doesn’t bottom out (also gets worse with caloric deficit)
There is ALWAYS a price to pay for short cuts. There is a cost/benefit ratio people should consider because nothing like this comes without some detriment.
I think no matter how good the drug is, it can't be our goto for minor things like not gaining too many pounds over Christmas. I completely understand turning to Ozempic et al. as a way to combat severe obesity cases. But the first thing you try has to be better diet and more exercise.
What happened the last couple of months is Elon Musk attributed his weight loss to ozempic and then it came out other celebrities were also taking it. The media went crazy covering those stories so now everyone and their mother wants to take it.
TikTok success stories as well
The problem is intestinal obstruction. I took mounjaro and was so constipated became impacted and bowels just stopped. Tried to tell my doctor but didn’t listen. My blood sugar well controlled and great for that and lost some weight but constipation was horrible and upset stomach. Stopped the drug and hunger and blood sugar up again. Regular diabetic meds don’t work well. Obesity is a disease and leprosy of today in being ostracized..
I am not clear on what your caution is. You mentioned that lean mass can be preserved with glp-1 drugs when sufficient protein and strenght exercises are applied. Same as with any other form of weightloss right? Combined with the outcome based data we have on glucose / CVD end points for these drugs, shouldn't the approach be to encourage these drugs for those with the disease of obesity? With a recommendation to eat enough protein and perform strength exercises instead of "cautioning" against potential lean mass loss, which is not proven to be any different compared to alternative weightloss methods?
the caution is that you have very little desire to eat, so unless you make it a priority it can be difficult to get that much protein in.
Efficacy versus effectiveness. You're right that if people eat enough protein and do exercise, they will maintain lean mass while losing fat. As you say, true for any dietary intervention. That's the efficacy of the intervention. But we need to consider the real world, and then people often don't adequately look after their diet and exercise, even when their doctor tells them to, because they don't know a lot about these things, they get limited to no guidance from doctors, etc. Indeed, that could be one of the reasons that they suffer from obesity to begin with. Putting people on a drug, won't fix that. And so if it's hard to do this in practice for most people, it is not a good intervention for most people.
Again, all this means is these drugs should not be over the counter but prescribed by a medical professional trained in obesity management who educates the patient on proper diet and exercise. This was literally part of the trials; has to be that trio. Once that is properly monitored the "caution" amounts to not much more than fear mongering a drug that is a game changer to folks with the disease of obesity.
He's cautious of people thinking they can keep their bad habits and take a drug to lose weight
Knowing Why and how something happens is the "rest of the story". In order to follow a plan for extending quality life and health you should have all the correct and proven information available. This is Why Peter is so Amazing. Caution is not the same as don't do it. Know the dangers before you do it. Also alternative weight loss programs can target Fat loss while not suppressing appetite. Keto / Carnivore that wants you to eat till your at satiety, But sets the Macros to follow for for the meal where muscle/lean mass is spared and body fat melts away. "Your mileage will vary"
You got the math exactly backwards. If you lost 10lbs fat and 10lbs muscle your body fat percentage would go UP if you were above 50% body fat and DOWN if you were below.
You used the example of going from 200 to 180. Well, let's say your 30% body fat (i.e. less than 50%), this means you have 60lbs of fat. If you lose 10lbs of fat and 20 lbs overall, then 50/180=28% body fat, so body fat percent went down.
Instead, what if you were 60% body fat (i.e. above 50%). This means that 120lbs of your 200 is fat. If you cut down to 110 while total body weight goes down to 180, then your body fat goes up to 61% (=110/180)
When losing weight, your body fat percentage goes DOWN whenever the %fat of the weight lost is greater than your current body fat %. So if you're less than 50% body fat and lose weight such that half your weight loss is fat, your body fat % is guaranteed to go down
What kind of strength training are these patients doing? And what does their diet look like? You seem to be saying that people lose excess muscle on Ozempic because they drastically undereat calories and protein and don't do resistance training. Is that right? Or is there reason to believe there is some physiological basis for additional muscle wasting even with an Appropriate and not overly aggressive caloric deficit, adequate protein, and strength training?
Does it cause muscle loss simply because of rapid weight loss? Or does it cause muscle wasting independent of weight loss?
75 yo type 2 diabetic. Recently came off Ozampic for colonoscpy. The inprovement in mood, motivation, sex drive, and pooping means I stayed off it. Not improving on the bike at 100 km/week but averaging low 20 km/h. Managing diet OK but I have more hunger.
“What could be wrong with it “…..that is easy…price!
In India, it is about 10 bucks a week. Almost worth it to fly over there to get it.
I won't ask you what you think of Semaglutide... I'll ask you what you think of Tirzepatide...
Also, I think you are pronouncing Semaglutide incorrectly.
I’m a 61 year old 25+ year post menopausal personal trainer/group fitness instructor/functional medicine nutritionalist on trizepitide and my muscle mass is 10% higher than females 18-24. 1gram protein to pound ideal weight and MOVE YOUR BODY 😊! If you’re foolish, unfortunately, as many are, continuing to eat the American diet, just less of it,q will end up paying the price with sarcopenia, osteoporosis.
Ozempic can cause thyroid cancer....
In mice
Okay so take the drug and keep up your protein levels say 200 grams a day you might not need the drug if you’re hitting your protein levels in the first place
For the sake of clarity, I believe Peter got his numbers wrong in his example at 2:47.
He said given a fat-loss-to-weight-loss ratio of 50% or 0.5, if someone dropped from 200lb to 180 (therefore losing 10lb fat and 10lb muscle), that would only be good if the person was MORE than 50% body fat. In fact, the opposite is true (proof below). The actual rule of thumb is that the person's body fat % needs to be LESS than the the fat-loss-to-weight-loss ratio (fat lost (i.e. 10 lb) / overall weight lost (i.e. 20 lb)) for the overall body fat % to drop. If the person's body fat % is higher than the fractional fat loss as per his example, this is actually a BAD thing.
Proof (with 2 very exaggerated examples), assuming 50% of weight lost is fat and 50% is muscle:
Ex.1) Someone at 75% body fat and 200lb total body weight who lost 10lb fat and 10lb muscle would have gone from 150lb body fat (200*0.75*100%) to 140lb body fat. this is 140lb/180lb, which is a relative increase to ~77.8% body fat.
Ex.2) Using the same logic, someone at 25% body fat & 200lb body weight would have 50lb of fat. Losing 20lb total (10lb fat, 10lb muscle) would drop them to 40lb fat and 180lb total, giving a new value of ([40/180]*100%) 22% body fat.
Important caveat: Peter cites on the Megyn Kelly Show that from DXA scan data, the weight loss his patients are experiencing on Ozempic is roughly two thirds lean body mass and one third fat. Now given that obesity can be defined as roughly 30% body fat in females and 25% in males, despite other valid concerns he points out, their total body fat % might not be increasing as drastically as Peter suggests. Example below:
Ex.3) At 200lb, 30% body fat (the low-end obesity cutoff for females) gives 60lb of fat. Let's assume Peter's cited fat-loss-to-weight-loss ratio of 1:3.
Losing 30lb would mean losing (30lb *(1 lb fat per 3 lb total)) ~10lb fat and ~20lb muscle (ignoring other sources of weight loss for simplicity). New numbers give a 170lb woman with (60lb fat - 10lb fat) 50lb of fat. This gives her a new value of (50lb fat / 170lb total *100%) 29.4% body fat, which isn't too far off the starting point. This is expected, since the original body fat % (30%) is only slightly lower than the fat-loss-to-weight-loss ratio (33%), which would only slightly affect body fat % in the predicted downwards direction. To reiterate, this is a "good" direction only because her initial body fat % was LOWER than the fat-loss-to-weight-loss ratio. Clearly the results would be more impressive if the ratio shifted to 1:1 or even 2:1 fat:muscle.
I fully admit I'm being overly pedantic, but for those who love numbers, I hope my examples have helped clarify his argument. It's important not to overlook his bigger point (which I believe is the real takeaway) that the 1:2 fat-to-lean-body-mass weight loss ratio in this context is very concerning and ideal weight loss should be much closer to his previously-stated 3:1 ratio (i.e. only ~25% of total weight lost should be coming from sources other than fat, not 66%).
Stay healthy and curious folks!
Thank you 🙏🏼 😊could you please make a video on weight loss drugs? such as the injectables, and the pills such as contrave and metaformin. Thank you 😊
I was 167 muscle skeletal muscle mass of 97% lean. water weight 128 lbs, 2 months on, 20lbs lost 3lbs muscle loss, 5lb water loss. 12lbs fat loss. I was gaining weight with only eating 1x a day before. As an obese person I was recommended to eat 3,000 cal a day and was mind blown I never ate that much. As I added food I noticed I started losing weight. Having 167lb muscle weight, getting to a normal weight wasn’t going to happen. So I’d need to lose muscle mass for that goal, I have at least 37lb of muscle that I could lose. I was told do not lift one cardio. The crazy part 128lbs of WATER. I don’t drink soda ect. Easily can drink a gallon of water a day, it’s healthy right? You kidneys only process 2 liters a day, yes cardio sweat it out hot tubs sauna ect, realistically your not going to sweat out another litter of water. I’m not a physician not a Dr.. and I know there is missing info in this video. I never took meds not even ibuprofen for head aches ect. If I have to I feel the medication in my body. I had little to no side effects nothing so bad I couldn’t function in my daily life or be a mom to my 4 kids. Add 167+128=295 yes I’m over 300lbs add organs ect.. think about it 295lb only in muscle and water.😮😮😮😮 no fat included. Yes I need that muscle to turn to fat in order to get to a healthy weight. I have more muscle than fat. In fact my muscle is double the weight then I have of fat, I almost have double the amount of water then fat.
AGAIN I AM 295lbs JUST IN MUSCLE AND WATER ALONE.
The math is incorrect. Not that I would want to lose ANY hard-earned muscle mass, but you would benefit from the 50/50 loss if you were more then 50% MUSCLE MASS. I'll explain using his example. You are 200 pounds. You are 20% Fat Mass (FM) or 40 pounds. You therefore are 80% Lean Body Mass (LBM) or 160 pounds. You take the drug and lose 20 pounds, 50% of which is LBM and 50% is FM. You are now 180 pounds, comprised of 30 pounds of FM and 150 pounds of LBM. Your fat mass percentage is now 16.7% (30/180), which is down from your original 20%. So no, you did not get fatter.
Please make a follow up video, comparing these two!
I'd be curious if the loss of muscle mass sets folks up for worsening metabolic health down the road unless they take compensation actions. If you hit a target body weight and go off the drug, you've now got less muscle mass to help with glycogen uptake--and all that implies.
Could you lift to regain the muscle mass? Like using the drug temporarily to shed fat (and muscle) and then get off the drug and maintain weight and keep lifting
@@bigpap90 Not the expert, but it's much harder to regain lost muscle mass that to avoid losing it in the first place. In this case, that would suggest concurrently having adequate protein for your current lean muscle mass and resistance training while taking Ozempic.
Them shots killed my gi. I took victoza , bydureon, mounjaro, don't TAKE THEM IM GLAD I NEVER GOT OZEMPIC
The FDA using body weight as an index of efficacy is ridiculous. I always say to people "sure you want to lose 'weight?' Do you want to lose hair? Teeth? Bones? Muscle?" Everyone gets that - except the FDA? Also what I would say, is you'd be hard pressed to eat the requisite protein on Ozempic - you just feel way too sick. It's like saying to someone stepping off a rollercoaster - here have this chicken breast." Barf. ' I'd say that is a huge issue. You just can't eat enough protein to maintain the muscle mass and if you manage to, you can't keep it down.
So what if studies don’t look at body composition, they look at the rate of major cardiovascular events in these patients and patients on ozempic who lost weight had LESS strokes, MIs and DIED LESS FREQUENTLY. Who cares how much they bench and what people personally believe what health is ??!
I’m a member and big fan of Peter, but I have to point out his hypocrisy on this one. I’ve heard Peter discuss taking metformin, rapamiacin, even steroids of bodybuilders, and various uppers for medical residents. With the conclusion that those may be ok. But for ozempic he dismisses it for someone who needs to lose 20 lbs and says only if you need to lose 100 lbs+. It has made a difference for friends and family-especially women. In many cases it is more about how they feel about themselves, confidence and mental health. Peter pays lip service to mental health but does not seem to walk the walk. At least when it comes to how weight and mental health interact. In particular for women. I call BS.
I can't believe he's pushing other drugs instead of that one. There's definitely something up with that.