Episode 157: Myth-Busting: What You Need to Know About Ozempic Medications

[00:00:00] [SPEAKER_00]: Welcome back to the Back on Track Achieving Healthy Weight Loss, where I help you get on

[00:00:05] [SPEAKER_00]: track and stay on track with your weight loss journey.

[00:00:09] [SPEAKER_00]: I'm your host, Dr. Alicia Shelly, so let's get started.

[00:00:28] [SPEAKER_00]: Welcome to the Back on Track Achieving Healthy Weight Loss podcast.

[00:00:33] [SPEAKER_00]: I'm your host, Dr. Alicia Shelly.

[00:00:35] [SPEAKER_00]: I am so excited to celebrate the birthday of the Back on Track Achieving Healthy

[00:00:41] [SPEAKER_00]: Weight Loss podcast.

[00:00:43] [SPEAKER_00]: So, we are now celebrating three years as being a podcast.

[00:00:48] [SPEAKER_00]: And I'm so excited to be able to continue to still do this for so long, but then to have

[00:00:53] [SPEAKER_00]: people like you listening and supporting the podcast.

[00:00:56] [SPEAKER_00]: Because if it was not for you, I would definitely not be here.

[00:01:00] [SPEAKER_00]: And so today we're talking about the five myths of Ozempic.

[00:01:05] [SPEAKER_00]: So for the last few years, GOP1 injectables like Ozempic, Majaro, Bogoli, and ZetBound

[00:01:11] [SPEAKER_00]: have taken the obesity community by store.

[00:01:15] [SPEAKER_00]: And I get bombarded with so many questions about them.

[00:01:19] [SPEAKER_00]: And I just want to talk about five myths that you see with Ozempic or GOP1s.

[00:01:25] [SPEAKER_00]: And regardless of how you feel about them, this is going to be educational and informational.

[00:01:31] [SPEAKER_00]: Now mind you, with all information here, I am a medical doctor, but I'm not your

[00:01:36] [SPEAKER_00]: medical doctor.

[00:01:37] [SPEAKER_00]: So it is important that you follow up with your doctor to make sure that these

[00:01:41] [SPEAKER_00]: medications are right for you or just for them to be able to do an assessment

[00:01:45] [SPEAKER_00]: and a consultation on your health first before starting any medication.

[00:01:50] [SPEAKER_00]: And once again, this information is for your information only and to give you

[00:01:54] [SPEAKER_00]: more insight into these medications.

[00:01:57] [SPEAKER_00]: Now, first off, let's talk a little bit about what these medications are.

[00:02:00] [SPEAKER_00]: Now the most popular brand names are Ozempic, Majaro, Bogoli, and ZetBound.

[00:02:05] [SPEAKER_00]: Now, Ozempic and Majaro are both FDA approved for diabetes.

[00:02:11] [SPEAKER_00]: But people do use them for weight loss.

[00:02:14] [SPEAKER_00]: And they take these same medications and gather them FDA approved for weight

[00:02:18] [SPEAKER_00]: loss. And now those medications are called Bogoli and ZetBound.

[00:02:22] [SPEAKER_00]: So if I've confused you, just take a moment.

[00:02:25] [SPEAKER_00]: Ozempic is the same medication as Bogoli.

[00:02:28] [SPEAKER_00]: Bogoli is for weight loss.

[00:02:29] [SPEAKER_00]: Majaro and Ozempic is for diabetes.

[00:02:32] [SPEAKER_00]: Majaro is the same medication as ZetBound.

[00:02:35] [SPEAKER_00]: But ZetBound is for weight loss.

[00:02:37] [SPEAKER_00]: Majaro is for diabetes.

[00:02:38] [SPEAKER_00]: So if the pharmaceutical companies didn't confuse us anymore,

[00:02:42] [SPEAKER_00]: there's a lot out there.

[00:02:44] [SPEAKER_00]: So but news is they will call them.

[00:02:47] [SPEAKER_00]: They're under the class called GOP ones.

[00:02:49] [SPEAKER_00]: And so this particular class helps with increasing the hormone GOP one

[00:02:54] [SPEAKER_00]: in the body.

[00:02:55] [SPEAKER_00]: This hormone is found throughout the intestines, the stomach, the brain,

[00:02:59] [SPEAKER_00]: the pancreas, lung, kidneys and so throughout the whole time.

[00:03:03] [SPEAKER_00]: And so as far as what these hormones do is that they help with

[00:03:06] [SPEAKER_00]: delaying gastric emptying, meaning that your stomach is moving slowly.

[00:03:11] [SPEAKER_00]: So you're not feeling quite as hungry when you eat.

[00:03:14] [SPEAKER_00]: You feel full.

[00:03:16] [SPEAKER_00]: We'll talk a little bit more about that in a few minutes.

[00:03:19] [SPEAKER_00]: Also, these medications can increase your insulin secretion,

[00:03:22] [SPEAKER_00]: meaning that your pancreas, when you eat something,

[00:03:25] [SPEAKER_00]: your body secretes insulin in order for it to be broken down and

[00:03:29] [SPEAKER_00]: utilized by the organs, by the muscles, by the heart for energy.

[00:03:34] [SPEAKER_00]: And so it helps this hormone helps with increasing that insulin

[00:03:37] [SPEAKER_00]: in your body so that the sugar can be utilized.

[00:03:40] [SPEAKER_00]: It also helps with cardiac function and increasing cardiac

[00:03:43] [SPEAKER_00]: protection as well as reducing inflammation of the heart

[00:03:47] [SPEAKER_00]: and decreasing how much food you intake.

[00:03:50] [SPEAKER_00]: Now these particular GOP one medications are used to treat diabetes,

[00:03:54] [SPEAKER_00]: weight loss and cardiovascular protection.

[00:03:57] [SPEAKER_00]: Now the first myth is, is Ozympic a magic bullet for weight loss?

[00:04:03] [SPEAKER_00]: And for some reason there is a belief that if they just take

[00:04:08] [SPEAKER_00]: this medication, if somebody takes this medication,

[00:04:11] [SPEAKER_00]: they'll just lose weight and they don't have to do anything else.

[00:04:14] [SPEAKER_00]: Well, that is false.

[00:04:16] [SPEAKER_00]: Although Ozympic and the medications similar delay gastric emptying.

[00:04:21] [SPEAKER_00]: If you overeat, you will gain weight.

[00:04:25] [SPEAKER_00]: Or if you are not doing the things of exercise or a few more

[00:04:29] [SPEAKER_00]: stress or not sleeping well, you won't lose weight.

[00:04:33] [SPEAKER_00]: You can gain weight.

[00:04:34] [SPEAKER_00]: I had one patient who was on these medications and he came

[00:04:38] [SPEAKER_00]: back to me after three months and he had gained 25 pounds.

[00:04:41] [SPEAKER_00]: And it's because he was stress eating.

[00:04:43] [SPEAKER_00]: He was overriding that sensation that I'm full and he was just

[00:04:47] [SPEAKER_00]: eating, eating, eating because he was under stress.

[00:04:49] [SPEAKER_00]: So, GOB ones are not a magic bullet.

[00:04:53] [SPEAKER_00]: And it is important to make sure that you are building healthy habits,

[00:04:58] [SPEAKER_00]: meaning that you are, your body's getting used to eating a balanced diet.

[00:05:02] [SPEAKER_00]: You're drinking lots of water.

[00:05:04] [SPEAKER_00]: You're exercising consistently.

[00:05:05] [SPEAKER_00]: You're getting sleep at night.

[00:05:08] [SPEAKER_00]: These are building habits that are so important to not only weight loss,

[00:05:11] [SPEAKER_00]: but just to health in general.

[00:05:13] [SPEAKER_00]: So it makes sure that while you are trying to lose weight,

[00:05:16] [SPEAKER_00]: you're building the healthy habits.

[00:05:17] [SPEAKER_00]: You're not just eating whatever you want and, you know, not being as

[00:05:22] [SPEAKER_00]: active because those are all important.

[00:05:24] [SPEAKER_00]: So when we look at the studies that look at whether these medications

[00:05:28] [SPEAKER_00]: were good for weight loss, they all had lifestyle intervention.

[00:05:32] [SPEAKER_00]: So it is important that you are doing these healthy habits.

[00:05:35] [SPEAKER_00]: All right.

[00:05:36] [SPEAKER_00]: Myth number two, that these medications are just too new.

[00:05:42] [SPEAKER_00]: And actually they're not that new.

[00:05:45] [SPEAKER_00]: So in 2005, the FDA approved the first GOP one receptor agonist,

[00:05:51] [SPEAKER_00]: which was called biata or a sanitize.

[00:05:55] [SPEAKER_00]: And that was two times a day for treatment of diabetes.

[00:05:58] [SPEAKER_00]: Since then, there have been multiple medications in this particular class

[00:06:02] [SPEAKER_00]: that's come out.

[00:06:03] [SPEAKER_00]: But for the medications that we're referring to like ozympiac,

[00:06:06] [SPEAKER_00]: it was approved in 2017.

[00:06:08] [SPEAKER_00]: Wagobi was approved for 2021.

[00:06:10] [SPEAKER_00]: Manjarra was approved in 2022.

[00:06:13] [SPEAKER_00]: And Zepbown was approved in 2023.

[00:06:16] [SPEAKER_00]: So since 2021, we've had one medication after the other be approved

[00:06:21] [SPEAKER_00]: for diabetes or for weight loss within these last few years.

[00:06:26] [SPEAKER_00]: So they've been out for a while.

[00:06:27] [SPEAKER_00]: And even before these medications were approved, like I said,

[00:06:30] [SPEAKER_00]: ozympic and Manjarra were both for diabetes.

[00:06:34] [SPEAKER_00]: And so they had been out for a lot longer.

[00:06:37] [SPEAKER_00]: Also, the other thing, the myth number three is that these GOP ones

[00:06:42] [SPEAKER_00]: are dangerous, are dangerous for people.

[00:06:46] [SPEAKER_00]: Now, the one thing that I will say is that this medication

[00:06:49] [SPEAKER_00]: is not for everybody.

[00:06:51] [SPEAKER_00]: However, these medications can delay gastric emptying.

[00:06:55] [SPEAKER_00]: There is a risk of gastroparesis or slowing down the gut.

[00:07:00] [SPEAKER_00]: So it is important that you speak to your doctor

[00:07:04] [SPEAKER_00]: to make sure that you are the right candidate.

[00:07:08] [SPEAKER_00]: Now, one study found that in a group of people

[00:07:11] [SPEAKER_00]: that were taking GOP ones that 0.5 percent.

[00:07:15] [SPEAKER_00]: So 0.5 percent of people that were on GOP ones

[00:07:18] [SPEAKER_00]: were diagnosed with gastroparesis or stomach paralysis

[00:07:22] [SPEAKER_00]: or slowing down the gut.

[00:07:24] [SPEAKER_00]: And that's one case of gastroparesis for every 200 people

[00:07:27] [SPEAKER_00]: taking the drug.

[00:07:28] [SPEAKER_00]: So if you're in a room with 200 people,

[00:07:30] [SPEAKER_00]: maybe one person may have gastroparesis.

[00:07:32] [SPEAKER_00]: So it's not a very high risk factor.

[00:07:36] [SPEAKER_00]: But if you have a history already of gastroparesis,

[00:07:40] [SPEAKER_00]: then you probably should avoid these medications all again

[00:07:42] [SPEAKER_00]: because you don't want to mess up your stomach.

[00:07:45] [SPEAKER_00]: You don't want to get to the point where it's delayed

[00:07:47] [SPEAKER_00]: and now you're having more issues.

[00:07:50] [SPEAKER_00]: The other contraindication.

[00:07:51] [SPEAKER_00]: So there is a black box warning on these medications for all of them.

[00:07:56] [SPEAKER_00]: And that is for people who have this contraindicated

[00:07:58] [SPEAKER_00]: for people who have a family history of medullary thyroid cancer

[00:08:02] [SPEAKER_00]: or MEIN type 2 or multiple endocrine dioplasia type 2.

[00:08:06] [SPEAKER_00]: Now, MEIN 2 is also a rare inherited disorder

[00:08:10] [SPEAKER_00]: that affects the endocrine glands or organs.

[00:08:13] [SPEAKER_00]: Usually your thyroid gland,

[00:08:15] [SPEAKER_00]: periphyric gland or adrenal gland tumors is what's seen in this particular syndrome.

[00:08:20] [SPEAKER_00]: So and it too is rare.

[00:08:22] [SPEAKER_00]: So if you do have a family history or a personal history,

[00:08:25] [SPEAKER_00]: it is important that you do not take these medications.

[00:08:28] [SPEAKER_00]: Not that they have been actually found in humans to cause thyroid C-silk tumors.

[00:08:34] [SPEAKER_00]: It was actually found in rats.

[00:08:36] [SPEAKER_00]: And so because it has been found in rats,

[00:08:39] [SPEAKER_00]: they just recommend for these people who are at increased risk of getting thyroid cancer

[00:08:43] [SPEAKER_00]: to not necessarily take these medications.

[00:08:46] [SPEAKER_00]: Now, the other thing is the inverse reactions.

[00:08:48] [SPEAKER_00]: Like I mentioned before, these medications work at the level of the stomach

[00:08:53] [SPEAKER_00]: and they slow it down.

[00:08:54] [SPEAKER_00]: So a lot of times the most common side effects are going to be your nausea,

[00:08:58] [SPEAKER_00]: your vomiting, your diarrhea and constipation.

[00:09:01] [SPEAKER_00]: Now, not everybody experiences all of these four.

[00:09:04] [SPEAKER_00]: In fact, when it comes to nausea,

[00:09:06] [SPEAKER_00]: 44 percent of those people who took the highest dose of Wagovia had nausea,

[00:09:11] [SPEAKER_00]: whereas 28 percent of those people who took Zephana had the highest dose

[00:09:15] [SPEAKER_00]: had nausea. So it is important.

[00:09:17] [SPEAKER_00]: It looks like Zephana has less nausea than Wagovia,

[00:09:20] [SPEAKER_00]: but it honestly depends on your body.

[00:09:22] [SPEAKER_00]: And then the one thing is that your body will get used to the medication

[00:09:26] [SPEAKER_00]: as it goes along.

[00:09:27] [SPEAKER_00]: So it's important that you start at the lowest dose and taper up slowly

[00:09:31] [SPEAKER_00]: or as your doctor prescribes, just so that you can, number one,

[00:09:35] [SPEAKER_00]: avoid those side effects, but then also you see that weight loss.

[00:09:38] [SPEAKER_00]: I've had some several people who were during the shortages.

[00:09:43] [SPEAKER_00]: They kind of would go up to the next dose before they were ready.

[00:09:46] [SPEAKER_00]: And that's where they experienced

[00:09:47] [SPEAKER_00]: the nausea and the vomiting and all those things.

[00:09:50] [SPEAKER_00]: So myth number four is taking a Ozipik is cheating

[00:09:56] [SPEAKER_00]: or taking any Ozipik or any of the other medications is cheating.

[00:09:59] [SPEAKER_00]: And I just want to say there is no cheating in weight loss.

[00:10:03] [SPEAKER_00]: It is about finding the right tool or method that works for you

[00:10:07] [SPEAKER_00]: and utilizing that to help you with losing weight.

[00:10:11] [SPEAKER_00]: Obesity is a chronic disease.

[00:10:14] [SPEAKER_00]: And there are many reasons why people gain weight

[00:10:16] [SPEAKER_00]: and why it's harder for people to lose weight.

[00:10:18] [SPEAKER_00]: It can be genetic and maybe runs in the family.

[00:10:21] [SPEAKER_00]: It can be an endocrine disorder like hypothyroidism or PCOS.

[00:10:26] [SPEAKER_00]: It can be behavioral depression, anxiety.

[00:10:29] [SPEAKER_00]: These conditions can affect how you feel and you're like a motivation

[00:10:33] [SPEAKER_00]: that can lead to weight gain.

[00:10:35] [SPEAKER_00]: It can be sort of medications that you're taking

[00:10:37] [SPEAKER_00]: like steroids or certain antidepressants that can increase your weight.

[00:10:40] [SPEAKER_00]: And then it can be cultural or environmental.

[00:10:44] [SPEAKER_00]: Sometimes if you live in a place that's not safe,

[00:10:46] [SPEAKER_00]: you're not going to go outside and exercise because you may get killed

[00:10:50] [SPEAKER_00]: or somebody may harm you.

[00:10:52] [SPEAKER_00]: So, you know, there are many reasons why people gain weight

[00:10:55] [SPEAKER_00]: and it's harder for them to lose.

[00:10:57] [SPEAKER_00]: So, you know, the one thing I will say this is that it's not cheating

[00:11:00] [SPEAKER_00]: finding something that works for you.

[00:11:03] [SPEAKER_00]: If you have a history of high blood pressure

[00:11:04] [SPEAKER_00]: and you're on three different medications,

[00:11:07] [SPEAKER_00]: you're on what you need in order to treat the condition.

[00:11:10] [SPEAKER_00]: So I don't see it as cheating.

[00:11:13] [SPEAKER_00]: Now, do you want to maybe start with lifestyle interventions first

[00:11:16] [SPEAKER_00]: if that doesn't work, then go to medications?

[00:11:18] [SPEAKER_00]: That's fine. I think that's appropriate.

[00:11:20] [SPEAKER_00]: You know, it's depending on where you are.

[00:11:23] [SPEAKER_00]: But yeah, I hate when people shame other people for being on medications

[00:11:27] [SPEAKER_00]: when that's what they need to help manage their weight.

[00:11:31] [SPEAKER_00]: If it was blood pressure or diabetes, no one would say anything.

[00:11:34] [SPEAKER_00]: It just said, you know, treat it.

[00:11:36] [SPEAKER_00]: And so I would say taking medications is not cheating.

[00:11:40] [SPEAKER_00]: And the reason being is that weight loss is not math.

[00:11:43] [SPEAKER_00]: One plus one does not equal to.

[00:11:45] [SPEAKER_00]: You can restrict your calories by 500 calories every day

[00:11:49] [SPEAKER_00]: and exercise 150 minutes per week and still gain a pound because it is not math.

[00:11:55] [SPEAKER_00]: And so a lot of times sometimes people need something stronger

[00:11:58] [SPEAKER_00]: and medications are a way to help with reducing your weight.

[00:12:02] [SPEAKER_00]: And so that being said, do not shame your family members.

[00:12:06] [SPEAKER_00]: Do not shame yourself for taking medications

[00:12:09] [SPEAKER_00]: if that's what you need to control your weight.

[00:12:12] [SPEAKER_00]: So myth number five is you'll lose 40 pounds in one month.

[00:12:18] [SPEAKER_00]: Now, I had patients that mentioned this to me.

[00:12:20] [SPEAKER_00]: That's why I bring this up because they're especially with social media.

[00:12:24] [SPEAKER_00]: You're seeing people who lost so much weight.

[00:12:26] [SPEAKER_00]: You're like, oh, my gosh, I have to be on this medication.

[00:12:28] [SPEAKER_00]: They lost so much weight.

[00:12:29] [SPEAKER_00]: But there is a misconception that once you're on this medication

[00:12:34] [SPEAKER_00]: that you're going to lose all that weight in the first month.

[00:12:37] [SPEAKER_00]: But in actuality, that's not the case.

[00:12:39] [SPEAKER_00]: So normal weight loss expectation is one to two pounds per week.

[00:12:44] [SPEAKER_00]: And that can vary depending on the person.

[00:12:47] [SPEAKER_00]: Like I mentioned, if there's somebody who has insulin resistance

[00:12:50] [SPEAKER_00]: or has a diagnosis of diabetes or pre-diabetes,

[00:12:54] [SPEAKER_00]: because of that insulin resistance, it makes it harder sometimes to lose weight.

[00:12:58] [SPEAKER_00]: And so it may take a little bit of a slower time for you to see that

[00:13:02] [SPEAKER_00]: if you weigh over 300 pounds, you may lose weight more frequently initially

[00:13:09] [SPEAKER_00]: than if you had less weight to lose because you just have more to lose.

[00:13:13] [SPEAKER_00]: So your body will shut it off.

[00:13:14] [SPEAKER_00]: Also, as you get closer to your weight goal,

[00:13:18] [SPEAKER_00]: your weight loss will slow down because your body is resisting.

[00:13:22] [SPEAKER_00]: There is a theory called the set point theory where

[00:13:25] [SPEAKER_00]: if as you lose weight, your body works against you

[00:13:29] [SPEAKER_00]: and slows down your metabolism and increases your harmful hormones

[00:13:32] [SPEAKER_00]: so that you can gain the weight back because for the body is survival.

[00:13:36] [SPEAKER_00]: So the more weight you have on, the more you will survive.

[00:13:39] [SPEAKER_00]: So it kind of works against you.

[00:13:41] [SPEAKER_00]: And then the one thing I will say is that it is a majority of people

[00:13:44] [SPEAKER_00]: regardless of in their weight loss journey will have some plateau.

[00:13:48] [SPEAKER_00]: Where their weight loss is not as frequent as it was initially.

[00:13:51] [SPEAKER_00]: And that's just your body adjusting.

[00:13:53] [SPEAKER_00]: So my advice would be number one, focus on your mindset.

[00:13:59] [SPEAKER_00]: Focus on thinking about this journey as more of a marathon versus a sprint.

[00:14:03] [SPEAKER_00]: Sprint is very fast, but in actuality, weight loss is a marathon.

[00:14:08] [SPEAKER_00]: So it does take time.

[00:14:10] [SPEAKER_00]: It does take time to kind of continue to focus on your lifestyle changes

[00:14:13] [SPEAKER_00]: or healthy habits if you're somebody who does require medications taking that.

[00:14:18] [SPEAKER_00]: And you may need to talk with your doctor about increasing the dose

[00:14:21] [SPEAKER_00]: if for some reason you're at that plateau.

[00:14:24] [SPEAKER_00]: So just to go over these five minutes again,

[00:14:28] [SPEAKER_00]: number one is that the ozibing is a magic bullet for weight loss.

[00:14:32] [SPEAKER_00]: It is not.

[00:14:33] [SPEAKER_00]: You definitely still need the lifestyle interventions and in building healthy habits.

[00:14:39] [SPEAKER_00]: Myth number two, that ozibing or end and its friends are too new of a medication

[00:14:44] [SPEAKER_00]: actually been out for a while.

[00:14:46] [SPEAKER_00]: So over five years, they've been approved for use as a type two diabetes

[00:14:52] [SPEAKER_00]: and for weight loss.

[00:14:53] [SPEAKER_00]: Also, GOP ones are dangerous.

[00:14:55] [SPEAKER_00]: That's myth number three.

[00:14:56] [SPEAKER_00]: And then myth number four is that taking a GOP one is cheating.

[00:15:00] [SPEAKER_00]: And the myth number five is you'll lose 40 pounds in one month.

[00:15:04] [SPEAKER_00]: So I thank you so much for joining us on the back on track, achieving healthy weight loss.

[00:15:08] [SPEAKER_00]: If you all like this episode, please share with others, like it and subscribe.

[00:15:12] [SPEAKER_00]: And don't forget to leave a five star review and we'll see you all next.