Weight-loss drugs: 5 extra benefits for your health
Nobody knows more about how many people struggle with their weight than a GP; most of the patients I see have been trying for years to lose weight – sometimes shifting some of the excess but rarely keeping it off. Throughout my career, options for treatment have been limited. So, overall, I’m delighted that we finally have medication options – the GLP-1 drugs – that can help deliver really meaningful weight loss.
What are weight-loss drugs?
The GLP-1 (officially GLP-1 agonist) drugs mimic the action of a naturally produced hormone, glucagon-like peptide-1. They act on your body in a number of ways – triggering insulin release from your pancreas; blocking a hormone called glucagon, which raises blood glucose; slowing stomach emptying after eating, so you feel more full; and affecting the hunger and fullness centres of your brain.
First developed to control blood glucose in people with type 2 diabetes, the ‘side-effect’ of weight loss seen in many patients was rapidly seized upon. As a result, liraglutide became the first GLP-1 to be licensed for weight loss in this group in 2014 with the brand name Saxenda. Since then, several others have been approved for weight loss and more are going through trials.
The weight loss seen with GLP-1s varies. On average, people on liraglutide lost up to 6% of their body weight after 26 weeks; on semaglutide (brand name Wegovy), 14% after 68 weeks; and on tirzepatide (Mounjaro), 18% after 72 weeks.
But it’s not just losing pounds that improves your health. Here are some of the extra benefits:
Weight-loss drugs may help with addictions. In a new study published in the Journal of the American Medical Association (JAMA), semaglutide – the active ingredient in Wegovy and Ozempic – was found to help people with alcohol addiction by reducing cravings and cutting drinking by 40%. Another study looking at people using GLP1-s showed they were over 10% less likely to misuse alcohol, cannabis or opioid painkillers. They also showed a reduced risk of suicidal thoughts or behaviours, as well as severe mental health disorders such as schizophrenia.
They protect your heart and kidneys. Mounjaro has been shown to cut the risk of heart failure and of dying from heart attack or stroke. Wegovy in people with type 2 diabetes and chronic kidney disease protects the kidneys and cuts heart deaths. And if you have type 2 diabetes, taking GLP-1s reduces the risk of dying in the long term if you have a heart attack.
Weight-loss drugs may fend off Alzheimer’s – possibly by reducing inflammation and improving the health of nerve cells.
They cut your risk of other conditions. GLP1 users are less likely to develop pneumonia, bacterial infections or inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
Anecdotally, they help quiet the brain. GLP-1s appear to switch off the food ‘noise’ that makes losing weight so hard for some people. Research shows the parts of your brain linked with appetite and reward don’t light up in the same way if you’re taking GLP1s, which helps explain why people on GLP1s find it easier to control their eating and resist cravings, and why their weight-loss journey is easier.
What about side-effects?
In clinical trials, many patients taking GLP-1s had to stop the drugs because they couldn’t tolerate the side effects – including nausea (the most common), vomiting, constipation, dehydration and gallstones. Many of these side-effects happen because the drugs are acting as they’re designed – slowing stomach emptying so you feel full for longer. They tend to be worse when you first start a new dose, and usually settle within weeks. But there are lots of steps you can take:
- Recognise you need to reset your thinking on portion size. Shrinking your meal down to side-plate size is a good place to start.
- Fatty or spicy foods are best avoided if you’re having side-effects.
- Eat slowly, pausing to check how full you feel.
- Make sure you drink plenty of clear (non-alcoholic) fluids.
- Don’t exercise too vigorously after eating.
- Finally, don’t move to a higher dose until your symptoms are under control, and contact your provider if you have concerns.
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