Breathe
By Adriana Sandoval, clinical nutritionist
Ever heard the phrase about killing a fly with a cannon? Here's what I think of Ozempic and its cousins Saxenda and Rybelsus.
In this age of immediate deliveries and that everything we want is just a finger's movement away, it does not seem strange that drugs are emerging that promise us accelerated and lasting weight loss.
Ozempic, Saxenda and the new version that does not inject Rybelsus have come to fulfill the promise. Now we have to ask ourselves, at what cost? Because this is not Aladdin's lamp, here you have to pay for miracles and the cost is not low in any sense.
First I introduce you to Semaglutide, the active substance of Ozempic and according to Ariana M. Chao and collaborators (Trends Cardiovasc Med 2023), in summary it does three things:
1.- Delays gastric emptying (food stays longer in the stomach and this causes it to be absorbed more slowly).
2.- Helps to lower glucose levels in people with diabetes because it increases insulin production in the pancreas.
3.- It takes away the appetite and increases the sensation of satiety.
So it looks like there is magic, but let's look at the cons of this treatment (the pros are heard all over the place):
The first thing is that you pay for a product that costs approximately 5000 pesos per month (depending on the dose), it is injectable and also has to be refrigerated. From the first dose you start to feel the side effects: nausea, sensation of fullness, low glucose, tiredness. In some cases liquids are not tolerated and that is the reason to suspend the treatment, dehydration.
We must take into account that these are relatively new drugs in the market and we do not know what happens with long-term treatments. So far, in addition to the gastrointestinal effects that I have already mentioned, we have only seen an increase in the formation of gallstones in the gallbladder. We will have to continue reviewing studies on future risks, some types of cancer have been investigated: thyroid and pancreas, but there are no conclusive results (Front Endocrinol, 2021 Nov).
At the beginning it is recommended to start with low doses although these drugs are effective with medium or high amounts, so the functional dose will take a few weeks to take full effect. In addition, ideally you should eat a balanced diet and exercise so that the treatment is as short as possible and sustainable in the long term. So there are no shortcuts, you have to do what we already know has worked all our lives and in addition, take or inject the medication.
Let's say you managed to finish the treatment and now it's time to stop the medication and go "on your own" with food and exercise. The problem is that your appetite returns and you do not know how to manage it, it is also likely that you have not practiced making good decisions when eating and if you also have a complicated life in terms of schedules, travel and events; things get difficult.
So whether you decide to follow this treatment or not, here are some tips on what to do as soon as possible:
1.- Schedule your health: block schedules and organize your day, including time for weekly planning, food shopping, preparation and consumption.
2.- Learn to read your body's signals, what time are you most hungry, when do you eat out of anxiety, do you prefer sweet, salty, soft, crunchy, cold or hot foods? All this will give you clues to make better decisions every day.
3.- Buy fresh food, check the shopping cart, try to make sure that more than half of the food you take is fresh and does not come packaged.
Have healthy food available ready to eat and in a visible place. For example, do not leave the fruit in the refrigerator or in the kitchen, look for a table or shelf where the whole family can take it. Apply the technique of food in the supermarket, what sells best is what is at eye level and at your fingertips. Dedicate that place to fruits, vegetables, seeds, natural water. And if there are children at home, use their height as a reference.
Don't blame yourself if one day you ate too much or didn't exercise, healthy living is an endurance race, not a speed race.
Finally, I would like to comment on a review published on April 26th of this year in The American Journal of Cardiology: two groups were analyzed for more than 68 weeks, one group used semaglutide, diet and exercise; the second group was injected with a placebo and followed diet and exercise as well. The 33.4% of the patients with semaglutide lost 20% of their body weight compared to the 2.2% who lost the same percentage in the placebo group. The conclusion is that the treatment achieves what it promises, the interesting thing is whether it is ideal for you. That is for your doctor to decide, and if you are diabetic or have metabolic conditions, all the more so. Do not get carried away by the recommendations of friends or companies that offer this drug or similar in networks just by filling out a health questionnaire.
To leave the issue on the table here's a thought: are the symptoms, cost and risks worth it in the long run? Or will you be killing a fly with a gun?
The opinions expressed are the responsibility of the authors and are absolutely independent of the position and editorial line of the company. Opinion 51.
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