One article after another seems to appear in the media about losing weight with the drug Ozempic. They usually point out that it’s misuse threatens to create a shortage for people who actually need it. So what is all the fuss about?
Ozempic is a first-line treatment for type 2 diabetes. It increases insulin release and decreases glucagon release. The result is a reduction in blood glucose. An additional effect is that it also slows gastric emptying by stimulating the ileal brake. This brake is a hormonal response to food intake. It slows gastric emptying and this increases your feeling of satiety: the faster food digests, the faster you will get hungry again.
When we eat certain foods, this causes a release of different hormones that influence what happens to that food and how it is digested. Ozempic contains one of these hormones that slows down stomach emptying and that is how it seems to affect weight loss. It simply makes you eat less because you are full for longer. So there is nothing magical about it but there are definitely downsides to such delayed gastric emptying.
So what are these downsides?
First and foremost, there is a long list of side effects of the drug itself. You can expect to experience:
- abdominal pain
Other side effects classified as mild are:
- flatulence and burping
- fatigue (lack of energy)
- changes in perception of taste
Serious side effects are:
- hypoglycaemia (low blood sugar) when used with certain other diabetes drugs
- pancreatitis (inflammation in the pancreas)
- diabetic retinopathy (eye damage caused by diabetes)
- kidney failure
OKay, but does it at least work?
Sure…but only if you take it for life.
This study shows that users of the drug lost about 10% of their body weight in 20 weeks. Then they took some of them off and gave them a placebo and saw that those who used the placebo regained 7%. Those who kept using it continued to lose weight, but only 8% in the next 48 weeks compared to the 10% they lost in the first 20 weeks.
At best, the drug loses effectiveness over time, just like any other diet will. So the downside is that to gain further benefit, you have to keep using it. Some people accept the risk of the side effects to get those results but, as you can see, the efficacy also decreases.
what’s the alternative?
There is, of course, an alternative that works in a similar way: the high-fat aspect of keto. Fat is a known stimulator of ileal inhibition (see also here).
Since you eat plenty of healthy fats with a keto lifestyle, you stimulate this effect naturally without side effects and also keep it up longer. Add to this the natural lowering of insulin levels and you understand why a keto lifestyle is a much safer and more pleasant method for sustained fat loss.