Weight Loss Meds: Making Sense of Madness

Fork U with Dr. Terry Simpson

Ozempic, Wegovy, Monjaro, and a host of other drugs – the GLP-1 agonists and near miracles weight loss drugs, and soon a more potent pill form coming.

These drugs have known side effects, and there have been increased visits to the emergency rooms. Often because people were not told foods to avoid.

As with any new drug, there are the grifters. After all, since it is a prescription, you will have supplement salesmen that promise a natural solution. What about those who claim they can "compound" the drug for you in their compound pharmacy?

Weight Watchers and Sequence

Was it a coincidence that Weight Watchers (WW) bought Sequence? Sequence is a company that prescribes these drugs through a network of physicians that you contact via telemedicine. Sequence, as it turns out, is one of the more legitimate telemedicine companies, not only trying to get you a prescription but providing a diet plan with it.

Weight Watchers purchased Sequence for over 100 million dollars. One thing missing from the frequent prescription of the new drugs is a diet plan. Weight Watchers does this.

And Weight Watchers is partially owned by Oprah Winfrey, who has been open about her weight loss struggles. Now, Oprah reports she has been on semaglutide and lost over 45 pounds.

Thus Oprah proved that the drugs, with a good diet, are a powerful tool against obesity.

It is More Than Willpower - Ask Oprah

As a weight loss surgeon, I am constantly asked about willpower and obesity. For example, Oprah Winfrey a person with more willpower than probably anyone you know. Given her resources to have people cook for her, provide her with a workout plan, and any assistance. She even bought a major portion of Weight Watchers. What made the difference? The injectable drug, semaglutide (Wegovy).

Obesity Management is more than a diet - ask Weight Watchers

The Weight Watchers diet plan has evolved over the years. Even with the Weight Watchers diet plan ranking among the best diets in the world, they purchased Sequence. Thus repositioning themselves to use their diet with the drugs to provide optimal health.

Keeping you out of the Emergency Room - Side Effects of the New Drugs

Emergency room physicians have noted an increase in patients coming to the ER after using these drugs. I was recently interviewed about this, and you can find it here.

Common side effects include nausea, vomiting, bloating, constipation, and diarrhea. Up to eighty percent of people who take these drugs have symptoms. Many of those problems can be avoided by following a few simple rules:

1. Avoid fatty foods. Fatty foods increase bloating and discomfort with these drugs. Fried chicken has sent many to the emergency room
2. Alcohol should be limited to one drink per day. Although best to avoid alcohol altogether with these medications.
3. Junk food with lots of sugar, like candy, cookies, and donuts, should be avoided while on these drugs.
4. Foods to concentrate on are fruits, vegetables, whole grains, and brothy soups like Minestrone or Dahl.

Compound Pharmacies and "generic Ozempic"

Many compound pharmacies have offered these drugs for sale. They are often at a greatly reduced price. But they are not the same drugs approved and tested by the FDA.

There is no "generic" form of Ozempic, Wegovy, or Mounjaro.

Compound pharmacies are telling their customers that, since there is a shortage of these drugs, they can compound the drug and sell it to the public.

Many of these compound pharmacies import semaglutide from overseas. It is illegal to import a drug from overseas without FDA approval. Furthermore, the drugs they import are not the same formula tested by the FDA. It is often sodium semaglutide and the FDA has warned against the use of this drug on its website (here).

In our podcast, we talk with a compound pharmacist who warns about these drugs.

In fact, the FDA has a warning for doctors:

"Healthcare professionals who are considering working with compounders to obtain semaglutide products should be aware that compounders may be using salt forms of semaglutide. FDA is not aware of any basis for compounding a drug using semaglutide salts that would meet federal requirements."

Natural Ozempic

Supplement makers are left out because now we have a drug that can treat obesity almost as well as weight loss surgery. Some claim Berberine is a "natural Ozempic." Berberine is not. Berberine is not a GLP-1 agonist; it has mild weight loss benefits. In one recent study (cited here) people lost about 4 pounds over half a year of taking it. That is nothing compared to any of the GLP-1 agonists.

But there is a natural GLP-1, and you can find it in the Gila monster.

From the saliva of the Gila Monster came the drug, Exenatide, which is a GLP-1 agonist. It was the first approved for diabetic use and was noted to have a decrease in weight. The drug is not as effective for weight loss as Ozempic.

The new weight loss medications are one step to conquer obesity. Obesity is a chronic disease. It's not about losing ten pounds. While the stars on the runway want to use it for short-term use, that is a fad.

This year, sales of Ozempic are expected to hit 17 billion dollars (ref). All of this from a drug originally developed as a medication for type 2 diabetes.