should i use the “magic shot” to lose weight?

Talk about the magic shot (or pill) for weight loss is everywhere right now from social media to primetime TV specials, and for good reason. The obesity rate continues to rise and people who have tried traditional measures for years are desperate for anything that can help them. Let’s discuss what this magic drug is and some points for responsible usage.

The medications being discussed are all a form of and possible combination of semaglutide. The medications were originally designed to help control Type II diabetes and it was found that weight loss was an effect of taking the medication. Now, certain forms of the drug are FDA approved for treating obesity and many people are using some form of semeglutide off-label to lose weight.  There are some other health benefits being described like decreased inflammation, damaged cell repair, and decreased impulsivity regarding addictive behaviors. 

Semeglutide aids in weight loss by slowing down how fast your digestive system moves so you feel “full” faster and longer. It also works in the brain by suppressing appetite and increasing your response to the chemical messengers that tell you to stop eating. There is no magic fat melting mechanism happening. Ultimately, you lose weight through improved insulin sensitivity and most importantly a calorie deficit that is created by you eating less.

This is important to understand about these drugs!

They work by helping you eat fewer calories than you burn (calorie deficit). Traditional diets fail for many reasons and impulse control around hunger is one of them. Taking these drugs makes being in a calorie deficit easier because the appetite is decreased at the level of the brain and by feeling “full” in the gut. The same effects can happen from good nutrition and exercise, but the discomfort of exercise, hunger, and cravings limits success. Here is the magic formula:   Eat less = Calorie Deficit = Weight Loss

This all sounds great, right? 

Take this medication and it controls hunger and cravings so that you don’t even want to eat?

Is this too good to be true? Are there any side effects or downfalls?

These drugs have been used for years to treat Type II diabetes and are generally well tolerated and successful at lowering blood sugar and hemoglobin AIC. The most common side effects are nausea, diarrhea, pancreatitis, and gallstones. Other complications have been reported, but the data on those is limited and beyond the scope of this article. Overall, when people are obese and have chronic medical conditions, weight loss will dramatically help and possibly reverse some of their problems. 

Now the bad news……..

First off, when this drug is stopped, it appears that the appetite suppression effects also stop. When people come off the drug, they tend to regain weight. It’s just within the past few years it’s been widely used for weight loss. The long-term health effects are yet to be seen. 

The next issue of concern is muscle loss with rapid weight loss. Now this concern is not specific to using these drugs, it happens with any rapid weight loss from crash diets, drugs, or diseases. If weight loss happens through decreased calories alone, a significant portion of the weight lost will be muscle. Muscle is a valuable resource for the body that protects you, allows you to be active/mobile, and drives your metabolism. It is also a very “expensive” resource for your body and sacrificed when the body is in a severely calorie restricted state. When your calorie budget is low, your body knows how to cut the costs to save vital organs. A smaller version of a person with low muscle mass is NOT necessarily a healthier person.

Now, the biggest concern with these drugs……

Take a person who has lost a significant amount of weight AND a significant amount of it is muscle. For whatever reason they must stop taking the medication (cost, side effects, access). This is a set-up for disaster!

Immediately following a big loss of body weight, the body is primed to regain weight. It’s a self-preservation mechanism to save you from another perceived starvation or famine. Early in this “regain” period your body is also primed to make more fat cells because they are the best place to store energy. So, when you regain the weight that was lost, a lot of it will be FAT CELLS.

 If someone loses 50lbs and then regains 50lbs, most of it will be FAT, not muscle.  They will be back to starting weight, but a higher body fat. They will be in worse shape than when they started!

So what do I do?

The decision to use or not use these drugs is personal and must be made on an individual basis. You need to decide if the unknowns and potential risks are worth the potential benefits for you and you should have a discussion with your healthcare practitioner. However, if you do decide to use these drugs, there are some things you can do to maximize the benefits and minimize some of the potential downfalls. 

prioritize nutrition

Using these drugs is a valuable tool to take away a lot of the discomfort that comes with traditional diet. However, you do not want to simply eat less of the foods you were already eating. If your diet was “junk” then just eating less junk is going to result in more muscle loss and malnutrition. Take advantage of this tool and learn how to eat like a healthy adult. You can use this time to acquire new eating habits and tastes. What you chose to eat during your weight loss can significantly impact your body composition and how you look when you reach your weight loss goal. It will also set you up for success if you go off the drug by developing good eating habits. THE BEST WAY TO MINIMIZE REGAINING THE WEIGHT IS TO CHANGE THE BEHAVIOR THAT RESULTED IN WEIGHT GAIN IN THE FIRST PLACE. 

protect muscle

Most people with obesity are already “under muscled.” Don’t become a “skinny fat” version of yourself. It’s possible to lose weight and preserve muscle with proper nutrition and resistance training. It doesn’t have to be some crazy workout program where you live in the gym, but it does need to be a good program to help you maintain, and possibly build, your muscle. As you lose weight you may find it easier to move and exercise. Take advantage of this time to build some strength and resiliency in your body and work on better lifestyle habits. Again: THE BEST WAY TO MINIMIZE REGAINING THE WEIGHT IS TO CHANGE THE BEHAVIOR THAT RESULTED IN WEIGHT GAIN IN THE FIRST PLACE. 

invest in yourself

If you don’t have experience with resistance training or good nutrition, work with someone who does. A trainer and/or coach can help you go through weight loss and be healthy on the other side. They will teach you how to work out and can guide you with nutrition. This will not only help you while taking the drug, but thereafter. Once more: THE BEST WAY TO MINIMIZE REGAINING THE WEIGHT IS TO CHANGE THE BEHAVIOR THAT RESULTED IN WEIGHT GAIN IN THE FIRST PLACE. 

Some will criticize using the medication and claim it’s the “easy way.” if someone simply takes this medication WITHOUT changing their lifestyle and habits that is irresponsible use.

This is a powerful tool to make good, lasting, changes while minimizing some of the discomfort. If you use it as a sole solution and refuse to change, that could be considered the “easy way.”

However, if you use it to take away some of the agony while making earnest changes, that is taking responsibility for your for your health and life.