Have you ever wondered how drugs like Ozempic, Wegovy, and Monjaro came to be discovered? There is actually a very interesting story behind these drugs.
The question around the benefit of these drugs was first asked in Canada when a hormone in the gut was discovered to regulate blood sugar levels and regulate appetite by triggering the release of insulin. This hormone was discovered to be GLP-1. How could this be turned into a diabetes medication? Clearly, for individuals with diabetes, this would be a game changer since their bodies struggle to release and bind insulin, therefore causing higher-than-normal levels of blood sugar to constantly be circulating in the bloodstream. Unfortunately, in humans, the GLP-1 hormone does not naturally occur for very long, making it hard to collect, study it, and its use as a medication perhaps not that effective. So they began looking for other sources.
Enter the Gila monster lizard, native to the southern U.S. The hormone in its venom is like a glucagon-1-peptide (GLP-1) in that it functions to regulate blood sugar levels and regulate appetite by triggering the release of insulin, but does not break down as quickly. This reptile hormone is actually called Exendin-4 and its biological purpose in the Gila monster lizard is for hibernation. This hormone became synthesized in the lab to become Ozempic.
Canadian scientists realized that this hormone, although not a human hormone but a lizard’s, could be synthesized to use in humans as an extended release of insulin to help control blood sugar in those with diabetes. What makes it appealing to those seeking weight loss, is it significantly reduces appetite since insulin is the body’s way of saying “I’m finished eating” and hunger subsides. In addition, it holds the food in your stomach for a longer period of time, so you are physically full for a longer period of time.
Let’s revisit the intended biological purpose of Exendin-4.
The Gila monster lizard hibernates like most other animals. Biologically speaking, its metabolism slows down to such a low rate to sustain the lizard’s dormant-like behavior for an extended period of time. Part of this metabolic process is that the lizard’s hormones sustain blood sugar levels to an acceptable baseline to not compromise its health during hibernation.
Humans taking Ozempic and Wegovy are not taking this medication and then hibernating.
**Bodies need a baseline amount of sugar in the bloodstream to maintain functions of organs, brain, muscle, etc. and allow us to live our daily lives. With a drop in blood sugar levels, our bodies are at risk for major health problems, or even death. With a perpetually elevated blood sugar, like what may occur with diabetes, our bodies are at risk for organ failure, and other chronic issues. Think of salt on a car, over time this causes rust, over time this rust may cause the car to no longer run. All this to say, maintaining an appropriate level of blood sugar is important for long-term and short-term health.**
This lizard produces this hormone to sustain its blood sugar levels during periods of hibernation. Let’s consider this for a moment. What does hibernation mean to you? Perhaps it means sleeping, not eating, not moving, only breathing, and even breathing slower and deeper.
Humans taking Ozempic and Wegovy are not taking this medication and then hibernating. Yet their body is getting the sign that things need to slow down. How does this work?
Many common symptoms of Ozempic and Wegovy include, but are not limited to:
Low blood sugar which causes dizziness, sweating, headaches, blurred vision, fast heartbeat, shakiness, drowsiness, confusion, etc.
Kidney failure
Gallbladder problems
Inflamed pancreas
And most commonly: nausea, vomiting, diarrhea, stomach pain, constipation, lethargy, mood changes
Humans experience these side effects because their bodies are not going into hibernation. In fact, some people are probably increasing their activity, their stress, and perhaps eating less when their energy needs are higher. Others are maintaining their activities of daily living which is still (way) more than hibernation. Therefore, your body is being told one thing by this hormone, but your actions are counteracting the biological response to the medication.
What does a registered dietitian recommend at this point?
These GLP-1 medications are not for everyone. There is research done in diabetes populations that suggest these medications are very helpful. There is much less research done in “healthy” populations where people are only taking this medication for weight loss. If you are in the later group, you may experience more side effects. It is important to ask yourself: are these side effects worth a few pounds? Am I losing this weight in a healthy, sustainable way? A tip: The more you suffer from weight loss, the less likely you are to maintain it once you stop taking the medication or using the weight loss behaviors.
Do not use these medications as permission to also eat less than your body needs, or increase activity. If you are changing your intake or your activity level, communicate this to your doctor. I would strongly recommend seeing a registered dietitian at the same time you are using these medications so that they can provide you with guidance on how to make adjustments to your intake or activity to reduce the side effects and potential for long-term complications.
Remember, this hormone is created by a lizard. For those who only want to take “natural” things, this is about as unnatural as you can get. Not only was this hormone produced by a reptilian species, its biological function is for hibernation- something us humans never do.
Where is the research at?
We don’t know the long term effects of these medications in populations other than diabetes. Long term means 5+ years (at least!).
These medications are not well tested in “normal”, “healthy”, populations- the population that is receiving these prescriptions simply by asking, but no other medically necessary reason for the drugs intended purpose of use. Talk about not trusting our healthcare system.
If your sole intention for this medication is weight loss, congratulations! This can definitely help you achieve that. The limited research out there shows that you may lose ~10-18% of your body weight, but you will regain most of it back. Meaning the overall sustained weight loss may only be 5%. So again, if you are experiencing any of the above side effects, please ask yourself, “Is it worth it?” If weight loss is your only hope from taking this medication, have you tried working with a registered dietitian first? If your nutrition and movement habits are not healthy prior to starting the medication, how will they support the weight loss when you stop the medication? Lifestyle changes and education are a big part of sustained weight loss.
If your intention behind taking these medications is for more than just weight loss, the little, short-term, research we currently do have supported improvement in blood pressure, cardiometabolic risk factors, and lowered A1C%. However, these changes only occurred in populations where lifestyle changes (in a healthy way) were also implemented and maintained once they stopped the medication. Those who did not have healthy lifestyles or regained the weight back, no longer had the health benefits.
Lastly I want to communicate that we don’t have research on how this medication impacts one’s relationship to food or activity. The clients I have worked with who have taken this medication experienced, on different levels, what I can only explain as eating disorder behaviors. This is very scary given that eating disorders are extremely chronic and life-threatening illnesses. This is not an outcome that many people consider when thinking about the glamor of weight loss, but needs to be seriously considered.
If you decide to take Ozempic or Wegovy, how can you set yourself up for success?
There are ways that you can set yourself up for success by building a team while taking these medications. This team may include a dietitian, a personal trainer, a therapist, and your physician to also monitor your symptoms and rate of weight loss. By focusing on your whole health and not just taking this drug and forgetting about all the other things, you will be in a much safer place and ideally experience long term benefits even once you have stopped the medication.
Our dietitians at Bamboo Nutrition provide a deeper, richer experience for their clients. Rather than giving handouts and a few tips about the food pyramid and what to eat or not eat, we take the time to get to know you, your goals and provide individualized recommendations that improve your understanding of nutrition, your intake on a daily basis, we address hydration, body image, and relationship with food/habits with food as well. If this sounds like a team member you’d like, reach out to us when you’re ready!
Sources:
Lizard Hormone: https://globalnews.ca/news/9793403/ozempic-canada-scientist-venomous-lizard-weight-loss/
Side Effects: https://www.ozempic.com/how-to-take/side-effects.html
Research on weight loss and health benefits: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9542252/
Podcast episode goes into further detail: https://maintenancephase.buzzsprout.com/1411126/13747346-ozempic