There certainly has been a lot of press on the latest weight loss “wonder” drugs lately. Diet/weight loss is normally a topic I stay out of, but many of my students have asked me what I think of these drugs, so I thought I’d take a moment today to give my take…
For the crowd who are already bored and itching for the next dopamine hit, here is the TL;DR: Shouldn’t we, at least, be open to the idea of using any tool made available to tackle the number one killer of American adults?
It seems like the vast majority of my colleagues speak negatively about these drugs. I won’t name names, but their general opinion is that these drugs are dangerous and allow people to cheat their way to results. If you’ve been following me for a while, you probably guessed that I have a more nuanced opinion. Let’s get started…
What Are They And How Do They Work?
These drugs are called semaglutides and there are currently three on the market: Ozempic, Rybelsus, and Wegovy. They are a class of medications knows as glucagon-like-peptide-1 (GLP-1) receptor agonists and they work by mimicking the GLP-1 hormone that is released into the GI tract in response to eating. One of their roles is to prompt the body to produce more insulin which lowers blood sugar (assuming you’re not diabetic).
In larger doses, GLP-1 also interacts with parts of the brain that reduce appetite and signal a feeling of fullness. They have also shown in studies to reduce the risk of heart attack, stroke, and all-cause mortality in adults with type 2 diabetes and heart disease.
Costs
All three medications are only available by prescription and are quite costly… ranging between $900-$1400 for a 28-day supply without insurance coverage. Many insurance plans cover some of the cost for those with type 2 diabetes, but for those looking to the drugs for general weight-loss purposes, it is unlikely to be covered. Even with insurance, the cost is still hundreds of dollars per month.
*Disclaimer: The cost data above is from a semi-educated Google search. If you have any personal experience obtaining these drugs (with or without insurance) that is contrary to the information above, please drop a comment.
What’s The Beef?
I’ll spare you the generic disclaimers about side-effects… there are many and you can easily Google them. There are also a variety of long-term side effects, both known and unknown. But what really seems to be getting the goat of my fitness community is this somewhat-odd superiority complex about how using these drugs are somehow “cheating” the hard work of learning to eat better and forming better exercise habits. There also seems to be this undertone of drug companies encroaching on our turf and stealing market share.
Now look, I get it. I, too, earn a living in this field. And I can see how there may be a sense of these meds taking away from our business… but this is a pretty silly mindset. There are literally millions of Americans struggling to lose weight, and my industry as a whole is doing a pretty crappy job trying to make even the slightest dent in this problem. Are there incredible success stories in my industry? Of course there are… we certainly have ours! But when you look at the big-picture data, it’s pretty sad.
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My Take…
Let me start by addressing one of my personal biases: I’m about as anti-prescription medication as one can possibly be. I need to practically be knocking on death’s door before taking them. With that out of the way, let’s move on…
I often quote Thomas Sowell in these situations, “There are no solutions… only trade offs.” Every medicine has side effects. That’s a given. However, every medicine also solves problems. And it’s up to us as individuals to weigh those two and decide if the juice is worth the squeeze. I don’t love taking NSAIDs, but if I get up in the morning in so much pain that I can’t go to work, taking a couple of Aleve and going about my day is worth the mild constipation (sorry for the overshare).
Of the “Four Horsemen” of chronic disease, the number one killer of adults (by a VERY long shot) is cardiovascular disease… accounting for 20% of all deaths in American adults.
(Some ask what I mean when I talk about the ‘four horsemen’. Click Here for a detailed explanation).
The only good news here is that this is also the thing that we have the most control over. Besides the mortality risk, being overweight causes countless other problems that make life more challenging.
When I was 40 pounds overweight, I couldn’t sleep comfortably, was tired all the time, had high blood pressure, high cholesterol, and many daily tasks were significantly tougher than today… even though I was 20 years younger when I was overweight!
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My One Piece Of Advice If You Decide To Try The Meds…
If you do decide that you are sick and tired of being sick and tired, and want to give one of these drugs a shot, there is one thing I would challenge you to do: If you look up 6 months from now and see a better and healthier you, think of this as ‘level 1’ of the game.
What do I mean by that?
Unhealthy eating and a poor daily exercise/movement practice are both cause and correlation to being overweight. To borrow from Dr. Emerson Eggerichs, there is an energizing cycle and a crazy cycle.
The crazy cycle is: “I’m overweight because I sat around and ate too much, so now I’m unhappy, so now I sit around and eat too much, so now it’s harder to move around… so I sit even more… which makes me bored, so I eat because I’m bored, which makes me gain more weight, which makes it harder to move around, so now I… etc… etc…”
The energizing cycle is: “I started eating a little better and walking a little every day, so I lost a few pounds, which made me happy and more excited to do more physical activity, which made me lose a few more pounds which inspired me to find better recipes to eat better, which made me lose more weight, which made physical activities much easier to do, which made me want to do more of them, which made me lose more weight, which made me… etc… etc…”
So, if semaglutides kick start the energizing cycle… don’t stop there! Eating smaller amounts of unhealthy stuff is way better than eating large amounts, but eating terribly in smaller amounts doesn’t fix the long-term problems you will experience later down the road.
Let this be the beginning of something awesome! Your future body will thank you.
One Final Note…
Lastly, one of the criticisms floating around the internet about these drugs is “Ozempic Face.” It refers to people who lose a bunch of weight on the drug and their faces look more aged and/or gaunt. This is kind of silly. Sure, everyone knows from looking at babies that chubby cheeks look more youthful, but most of the time when someone loses a bunch of weight (with or without drugs) their appearance will change. There are far worse side effects to worry about. Don’t listen to this vanity-based garbage.
When I first lost my weight, I had several “friends” tell me that I looked sick. My bloodwork told a different story. I didn’t listen to the naysayers and kept pushing forward. Fast-forward 20 years… every aspect of my health (and life) is better. Focus on health, and everything else will come.
Until next time,
Jerry Trubman is a coach, clinician, author, blogger, and powerlifting state champion. With over two decades of lifting experience, he has devoted himself to seeking out better answers, and distilling them into practical programs that produce great results. Jerry has coached “Team Protocol” to 4 National Powerlifting Championships in the 100% Raw federation. He writes the internationally-read blog, “The Healthy Addiction” and lives in Tucson, Arizona with his wife, Marie, and dog, Asher.
