Ozempic & Wegovy Side Effects. Miracle Weight Loss Drugs, but be Very Careful.
As an early investor in these drugs, I'm concerned about some of the early health data. Here's how you can protect yourself and your family.
Summary (The TLDR)
Alarming data is coming in: Some patients on Wegovy & Ozempic are seeing 50% to 60% of their weight loss come from lean tissue. (muscle). Patients may be getting lighter on the scale but increasing their body fat percentage. This is concerning. (One study here)
As a comparison, when losing weight naturally, it is typical that about 25% of your weight loss will come from lean tissue and muscle mass.
But, there is a SOLUTION! To combat this, patients taking these drugs need to strength train and eat a high protein diet. This will help retain and build lean tissues, muscle mass, connective tissue, & retain bone density.
Wegovy & Ozempic are miracle drugs for fast weight loss. Some patients are losing up to 60lbs in 6 months. But there are real risks to be aware of.
If you take these drugs and don’t change your diet & lifestyle, you will be forced to keep injecting & paying for them forever.
If you ever stop them in the future without lifestyle changes, you’ll gain all the weight back & possibly a lot more. I explain why below.
It is worth noting: The drugmaker behind Ozempic & Wegovy disclosed paying health care providers in the US over $25,000,000 over the past decade to promote these drugs. It paid $1,400,000 to one doctor alone*.
Disclosure: I am an investor in the maker of these drugs, Novo Nordisk. I’m very excited by the results of these drugs but I’m growing increasingly concerned about what I’m observing in my friends that are using them and the mounting evidence about their side effects.
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Full Article: I’m Concerned about Wegovy & Ozempic. Here is How Patients Can Protect Themselves
Ozempic is everywhere. Not since Viagra & Botox has a drug become so popular so quickly. You’ve probably heard of a friend taking it, seen a commercial, or heard of a celebrity talking about “Ozempic Face”. ("Ozempic face" refers to a condition where facial skin may sag and appear aged following the use of these drugs. This effect is likely attributed to the loss of lean tissue, a topic we will explore in detail.)
The technical name for these drugs are “GLP-1 receptor agonists” and they go by the names like Semaglutide, Wegovy, Ozempic, and a few others.
It’s understandable why they have grown so quickly. They work incredibly well, and globally approximately 1-3 billion people are overweight or obese (depending upon which statistic you trust). This is a tragedy and it leads to many long term negative health consequences.
What troubles me most about that statistic is that obesity rates in children have skyrocketed. Approximately 300-600 million kids are overweight or obese (depending upon which statistic you trust). This is quite concerning.
Safety of these drugs becomes even more important due to these two factors.
The fast and widespread adoption of them and
the fact that they were recently approved as a treatment for children.
Before we begin, the first two questions that people ask me when we talk about this topic are:
No. I did not use any medications to lose the weight. But I’m not against these drugs. I just personally didn’t want to be on any medications anymore.
Are you an investor?
Yes. I invested in Novo Nordisk before the popularity of these drugs exploded. So it’s fair to judge my writing with a skeptical eye.
These drugs have exploded in the past few months. It’s likely that one of your friends or family members are taking them and I hope you will share this article with them without any judgement or condescension.
“Ozempic and Wegovy brought in $4.8 billion of sales during just the third quarter of 2023, and the drugs account for 52% of Novo Nordisk's $23.6 billion of total revenue through the first nine months.”
It’s understandable why these drug are so popular when considering their incredible results. For example, some people that have struggled with weight loss have been able to achieve truly remarkable weight loss. Some have lost 60lbs in 6 months! That is a tremendous amount of weight loss in a short amount of time.
How does Ozempic & Wegovy work?
In plain english, these drugs help you feel fuller, faster, and for a longer amount of time after eating. Therefore you eat less and lose a heck of a lot of weight quickly.
The scientific reason these drugs work: They function as a glucagon-like peptide-1 (GLP-1) receptor agonist. They work by enhancing the body's ability to produce insulin, the hormone that regulates blood sugar, in response to high blood glucose levels. These drugs slow down gastric emptying, which contributes to a decrease in appetite and potential weight loss. This dual action makes it effective in managing Type 2 diabetes and, as a secondary effect, aids in weight management.
While these drugs are a miracle for diabetes and weight management, as with all things, they are not without their risks.
But on the positive side, there are simple steps that you can take to mitigate and potentially avoid some of the negative pitfalls.
An immediate potential side effects is nausea and vomiting. This is pretty commonly reported and disclosed to potential patients by healthcare providers very well. So we don’t need to cover it here.
There is another less common concern. Some recent studies suggest a connection between these drugs and an increase in diabetic retinopathy (DR), a severe eye problem that can lead to blindness in diabetics. It's a bit unexpected, but there's a known issue where treatments that quickly lower blood sugar can actually make DR worse. This isn’t extremely common but is still something to be aware of.
The Bigger Concern for me is Lean Tissue Loss or Losing Muscle Mass
Patients need to be aware of the amount of muscle mass that you may lose by taking these drugs if you don’t take preventative steps proactively.
When losing weight without the assistance of medication, it is expected that about 25% of the weight loss will come from your lean tissue like muscle mass. This would be typical especially when losing weight quickly.
In general, with weight loss, as the old adage goes: “Abs are made in the kitchen”. It’s not so much your work-out routine that will help you lose weight. The biggest impact, in most cases, is reducing the calories that you eat.
If you eat less, you’re going to lose fat, but sadly, you’re also going to lose some muscle and lean tissue. This is expected.
When weight loss occurs naturally, it primarily involves the reduction in the size of the fat cells.
What is concerning is that some patients on Wegovy & Ozempic are seeing that 30% to 60% of their weight loss is coming from their lean tissue like muscle. Patients are getting lighter on the scale but their body composition is actually become fatter sadly. (Studies here, here, & here.)
This is very concerning and requires further investigation.
It’s not perfectly clear why this lean tissue loss is happening but some doctors suspect that it is probably due to an unhealthy diet that doesn’t include enough protein and lack of physical exercise and strength training.
I think it is especially important to highlight these concerns now in light of the fact that it is advertised everywhere, that medical professionals have been paid millions of dollars to promote them*, because they are now approved for use in children, and that these drugs are the fastest growing drugs since Viagra and Botox.
I’m also concerned about this personally because several of my friends are taking these drugs with remarkable success but they are completely unaware of the risks to their lean muscle tissue. My hope is that this article may help them in some small way.
To be clear: *I mention the payment to doctors simply as a data point. It is not to imply in anyway that there is a conspiracy or corruption in the system. It just means that there is an incentive and incentives can be powerful in some cases.
But not to fear, there is good news! If you take the following steps, you can significantly mitigate these issues.
Patients using these drugs should make sure to pair them with a high-protein diet and strength training to maintain their muscle mass, retain connective tissue, and retain bone density.
A good rule is to eat about your original body weight in grams of protein per day. So if you started at 200lbs, eat about 200 grams of protein per day even as you lose the weight. This is very general but I like to keep the math super simple.
When it comes to weight training, you just need to make sure you’re pushing your muscles to their limit. Walking won’t cut it here. But you don’t need a gym membership either. You can do body weight exercises that will help like wall sits, push ups, crunches, lunges, jumping jacks, and plank as some examples. Of course, weights would be better. But we don’t strive for perfection here. We strive for the simple things that give most of the results.
Why is this so important? Because for one, we don’t just want to weigh less on the scale and still have the same amount of fat in the body. We want to have less total fat within our body. It’s the fat in the body that can cause our health problems, not just the weight on the scale. The goal should be to “increase the body’s overall proportion of lean mass – in other words, to improve body composition.”
The other issue is that if you lose your lean tissue like muscle, connective tissue, and bone density - you will be more fragile. This will make you more at risk for getting hurt, less likely to live a long time, and there is another big concern that could show up in the future if you were to ever stop taking these medications.
Your lean muscle tissue consumes a lot of your calories. In general, the same person with a lot of muscle mass will be able to consume and process more calories than someone with less muscle mass and lean tissue.
So, if you're losing significant lean muscle tissue, your body typically burns fewer calories. And as we all know, excess calories that the body can't utilize are generally converted into fat.
To say this again, essentially, if your lean tissue like muscle goes away and you keep eating the same number of calories, your body won’t consume as many calories, so the extra calories will end up getting turned into fat.
This is especially concerning if you stop taking these medications in the future. Your appetite will come back immediately, you will start eating more, and since you have less lean tissue & muscle mass - you will put on a lot more weight than you had before you started these drugs.
This gives patients using these drugs two options in my view.
Either you will need to continue taking these medications forever.
Or, you will need to adjust your lifestyle, eating, and physical activity so that you can retain the amazing weight loss that these drugs helped you to achieve.
In conclusion, GLP1 medications like Ozempic and Wegovy are incredible, but they are not a long-term fix for obesity or poor metabolic health for most people. Real, lasting health improvements come from changing behaviors and lifestyles. This means eating a diet that's good for your metabolism and staying active.
There's growing concern that these drugs have side effects that need more research, like reducing muscle mass significantly and potentially leading to weight gain when you stop taking them. While they help in reducing how much you eat, they don't ensure you're eating healthy, high-quality foods, which is key for your body's best metabolic health.
Doctors and patients should think very carefully when choosing these drugs. Safe, proven methods like a healthy diet and exercise should always be the first choices for weight loss and metabolic health.
Of course, all the standard disclaimers apply. I’m not a doctor. I’m just an idiot on the internet. Never take my word for anything and always talk to your doctor first.
I want to hear from you! Are you taking these drugs? What have been your results? Does this ring true for you or am I completely off base? I love hearing from you!