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Benefits of injectable weight loss drugs: Wegovy, semaglutide, & mounjaro

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What medicine is most effective for losing weight? What do different drugs do? Today jaywill, MD talk about benefits of injectable weight loss drugs: Wegovy, semaglutide, & mounjaro. Let’s drive in.

Today we’re going to just do a little dive not the deepest dive into the newest medications they’re not really all that new some are some aren’t i’ll go over that but they are certainly the rage and that is the weight loss slash diabetes medications that go by the brain names of semaglutide, wegovy and mounjaro. These are medications that have really just been promoted like crazy. So the question is, is the hype really worth it in terms of, or justified in terms of the results?

Well let’s just talk about what they really are. So semaglutide is exactly the same as wegovy. It’s just dosed somewhat differently semaglutide is approved for treating diabetes, but can also be used as a weight loss medication wegovy is the higher dosed version. And it is approved for weight loss.  

Mounjaro is a little bit different medication, which i’ll describe which currently is not approved for weight loss but it’s on the the weight list to get approved by the fda. It’s going for that indication it is currently approved for treating diabetes. But off label, meaning it’s used for the purpose, although it’s not fda approved for that purpose. Mounjaro is used a great deal, as much as people can get a hold of it, for weight loss purposes.

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So what are first the drugs called semaglutide and wegovy? They are a family of medications called glucagon like peptide one agonist or memetics. They are mimics of a certain type of hormone that is made in the body called glp-1, glucagon like like peptide 1. So, this particular hormone, it’s almost it’s hard to say if it’s a peptide or hormone, because the difference, by the way, between a peptide and a hormone is really the length of the amino acid chain. And it’s made predominantly by specialized cells in the lining of the intestinal tract and probably as well made in the brain itself. Now, this particular hormone, i’ll just call it a hormone, is very important for regulating appetite. There are centers in the brain that are nutrient sensors their appetite regulators and this particular hormone, glp-1, is very instrumental in controlling appetite.

As well, it also when  taken and people eat, it will increase the production of insulin it actually is very beneficial, it appears for the beta cells, of the pancreas that are the cells that produce insulin by improving their health and also facilitating new ones to be made. So they seem to be protective and actually beneficial to the cells, the beta cells of the pancreas, that make insulin, as well, another part of the mechanism whereby these medications help to promote weight loss and glucose regulation is by slowing the emptying of the stomach. Therefore keeping food in the stomach will keep it fuller,and that in itself, having a lot of fullness, will suppress appetite. So there’s a variety of mechanisms. As well, there’s now data showing that this group of medications, glp-1, and by the way, there’s a whole group of additional brands out there. The ones that are getting all the attention are the semaglutide and the wegovy, but there’s a bunch of other ones that have been around for a lot of years. I think going back maybe 15 years. The differences is they apparently are not as effective for weight loss and they are more inconvenient., most of them have to be given as shots, which by the way, wegovy and semaglutide are weekly shots. These other members of the family of these medications, glp-1 agonist, have to have shots done sometimes more than once a day, or daily, or just more often. So that becomes an inconvenience and potentially compliance can go down. Basically the medications that are now really promoted the most are the weekly shots, predominantly semaglutide and then wegovy.  And we’ll get to mounjaro in a moment.

So what other benefits have been shown in studies with these medications? So what other benefits have been shown in studies with these medications? Well they appear to have a significant potential benefit for the cardiovascular system system by improving the function of the heart itself. The myocardial cells can improve heart output, cardiac output. Can also improve vascularization like blood flow to the heart and overall lowering total cause of death, what we call all cause mortality and reducing the incidence of heart attack. So that’s pretty significant. But remember this stems from glp-1 effects.

So we we’re going to talk, not today, because this is just an introduction, but in the future, in the near future, i’m going to talk about number two, which we’re not going to talk about today, some of the potential side effects from these medications. And then the next one is going to be, what can you do? Because remember, glp-1, glucagonlike peptide 1, is made naturally in the body. When you’re taking these medications, you’re not actually taking the real thing. This is not the real mccoy. These are mimics. That’s why they call them agonists because they can bind to the receptors for the hormone, receptors for glp-1, but they’re not giving glp-1. Now, how similar is the mimic? The semaglutide and the wegovy, to the real body produced glp-1. Well, they’re close. They’re similar to about 94%. So, but they’re not clones. And by the way, i’m going to tell you in the next, you know, piece of this puzzle solving um series that i’m going to do on these medications, how some of these differences can lead to side effects. So you know, you have to stay tuned for that one.

So but now this is telling you a lot of good things, okay? Every story has two sides. So this is really not insignificant. What about the weight loss? I already told you it can have cardiovascular benefits. Now what about in terms of diabetes? It can lower the hemoglobin a1c typically by about 1 percentage point. So that’s not insignificant. And it can definitely help to regulate blood sugars. Now typically for diabetics, it’s given not as a first line treatment, particularly because of its cost, and metformin still remains in most, you know, advice given out to doctors and doctor groups. That metformin is still the number one drug to try for diabetics, but often now it’s not really adequate. I mean, metformin hasn’t solved all the problems for diabetics and certainly has not had significant weight loss benefits. And many diabetics, not all, and this actually interestingly includes type 2 and type 1 diabetics, but many of them have serious weight loss problems. They can’t lose weight and metformin has a very minimal benefit for weight loss. So this can be very beneficial. So, what is the benefit for weight loss with these medications? Well, some people lose nothing. That’s not the majority though.

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So, it turns out that it’s not uncommon for people who are taking these medications to lose 5% of their total body weight. 10% is also not uncommon. And then a smaller percentage will lose up to 15%. And then a very  small percentage will lose even 20%.so, just think, say you’re a woman and your wish is to weigh 150 pounds.but you weigh 200. So you go on this medication, and if you’re sort of typical, maybe you’ll lose 10%. So 10% of 200 pounds is 20 pounds. So realistically,  it’s not unrealistic to expect to lose, over time, not like in a month, although there are cases, there are always outliers that have phenomenal success. They have crazy amounts of weight loss because what we’re going to talk about, next time is well, what are they losing? Are they losing fat? This matters. So the bottom line is that in terms of just percentages, so a very significant percent will lose out of, if they have 200 pounds on them.

They’ll lose 20. Well, some.and this is not a rarity will lose 10, 10 out of the 200 pounds that they carry. And then a smaller percentage, but some, will lose 30 pounds. And then there’s the real outliers that will lose more. So keep in mind when we’re talking about percentages, the actual numbers,because sometimes percentages kind of bell what the actual numbers are. So you know, think about it. If you want to weigh 150 and you can actually get down to 180 or 170, that’s not insignificant. We know that even 5% weight loss, which would be to get down just 10 pounds, that that can actually have significant benefits.

And we’re going to talk in the future about, well, what can you do? Besides, take these medications? And also we’re going to talk in the future about how do you get off these drugs. Well, what i’m going to tell you right now is the pharmaceutical companies who are making these medications advise that you never get off of them. They say obesity is a chronic disease. Diabetes is not curable. So when you go on these drugs, you go on them for life. So keep that in mind. There is no official exit strategy. Not at all. They’re not even encouraging it. Not at all. So,now about madaro. So what mak it different from the glp-1 agonist? So, it has glp-1 in it. So, that’s part of the compound that makes up mounjaro. What else does it have? Gip. So, that is glucose,  my gosh now i’m forgetting.  It’s a glucose dependent insulin, insulinotropic, polypeptide. That’s why nobody says all that. It’s hard to remember, but it’s gip. So it’s another hormone that’s involved in glucose regulation, so when you take that medication, and it’s combined with the glp-1, it further increases the production of insulin to lower blood sugar. So insulin causes lowered blood sugar. But when you have higher amounts of insulin produced , you will lower blood sugar, but insulin in itself promotes fat production and fat storage. So the goal, of course, just so you know, is to not have high shooting levels of glucose. So you don’t need high amounts of insulin. You want to eat foods and have a gut microbiome that’s really healthy, you don’t get gigantic spikes of glucose and then need gigantic spikes of insulin. But that these medications do is that they aid in the production of more insulin to knock down that glucose level. You know, but that doesn’t really explain the weight loss.that’s like an important kind of a thing. So another interesting thing that the gip component does is that it tends to push the glucose that is produced, that does come. It pushes it out of the bloodstream,  and into fat. Now you say, what is that all about? Like, i want to make more fat? But what it’s doing is, it’s diverting the the higher amounts of glucose, getting it out of the bloodstream as fast as possible. And into fat tissue because you already have the blood sugar, right? It’s not decreasing the blood sugar that  gets into the bloodstream. It’s getting it out of the bloodstream more, more quickly. And where is it going to go? I mean, it’s if it’s getting out of the blood, where’s it going? Well the goal is not to have it go into your muscle um unless you’re going to be using it.

You don’t want to make fat but it does help it get into the muscle. So that’s why after you eat it’s very important to take a walk so that that that glucose that’s getting into your muscle will actually be used up and create energy. Because you can get glucose into muscle. And then get fatty muscle we do not want fat stored in our muscle. So that’s why, just as another helpful hint take a walk after you eat. So that way when the glucose gets into your muscle, you’ll burn it up. But what the other thing, what you want to do when you take the gip and it gets the glucose out and it gets into the fat, it’s so that it doesn’t get into the liver. It doesn’t get, because a non-alcoholic fatty liver is a very unhealthy liver.you’re going to have metabolic dysfunction and that feeds the machine of obesity and diabetes. Because remember, mounjaro is not approved yet. I’m sure it will be, but that’s my assumption. It’s not approved for weight loss. It’s a diabetes drug. So the idea is you don’t want to have a problem with uncontrolled glucose production. That’s called gluconeogenesis. That’s made by the liver.glucose can be made by the liver from the storage form of glucose called glycogen. So one of the special effects that mounjaro has that glp-1 doesn’t have, the glucagon like peptide one that’s in the semaglutide and in wegovy, is that it pushes the, the sugar in the blood into fat tissue to avoid getting it in to liver. And then hopefully you will then have the other effects to keep the sugar down. And it’s a very interesting thing.

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And it’s a very interesting thing. They’re not even 100% sure exactly how it causes weight loss. How interesting is that? There’s so much to learn. It also helps regulate appetite to some degree as well. And the combination of these two seems to be a little bit magical. So the weight loss with the mao the combination of glp-1 and gip is greater than it is statistically than with just the glp-1 alone. So that it’s more common for those using mounjaro to lose more than not 15 and even 20%, which is less common with the glp-1 alone.

But what we’re going to talk about next time is like, well, what about side effects? What about, you know, side effects that are uncomfortable? What about side effects that are dangerous? And there are, fortunately, i just, i don’t want you to feel like you have to wait to find out everything but i’m going to do this soon. That, fortunately, life threatening problems are not common,  but there are some risks like every drug you got to weigh risks and benefits. And i want you to know right up front that at this time, there is no off ramp from these drugs that is being offered by any of the pharmaceutical companies. In fact their advice, their official devices once you go on these medications, that you stay on them for life. So that’s important to know. And the cost is not insignificant. Sometimes it’s covered by insurance and sometimes it is not. And when it’s not, the cost is like a thousand or more dollars a month.

And then the next section that we’re going to do after we go through next time, side effects and risks, then we’re going to talk about what can you do to harness your body’s innate capability to create glp-1 and gip. It’s important to know that there are right now some very significant benefits of using these medications. It includes cardiovascular benefit. As well as weight loss benefit and diabetes control benefit so i’m not hostile to these drugs i just want to present the facts. So i look forward to talking with you again in the near future, continuing this dialogue, and having you have the information so that when and if you ever want to consider using these medications yourself, you’ll have the facts. See you soon have a great day.

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