Our desperation to lose weight has spawned a million fads, classes, diets, and trends. We’ve tried jazzercise, boxercise, dancercise, fasting, Atkin’s and paleo — and it feels like work. We’re either sweating or starving, or sweaty and starving.
That all changed when GLP-1s such as Ozempic and Mounjaro were released and, suddenly, weight loss didn’t involve so much effort anymore. Just stab yourself in the waist and, hey presto, adios to ten kilos. It all seemed too good to be true — but somehow, it wasn’t. (Spoiler: it was).
The undeniable appeal of GLP-1s is they help you lose weight with ease. The problem lies in the fact that using them won’t serve the future you very well. While they work, in part, to slow the speed of food moving through the stomach and by stimulating feelings of satiety — leaving you to feel fuller, for longer — there are unintended consequences of a reduced-calorie diet that limits nutrient intake.
Longevity clinic HUM2N’s Dr. Mohammed Enayat believes these jabs are, at best, suboptimal when it comes to longer term health, and, at worst, potentially dangerous for later life. His concern is that GLP-1 use can lead to “increased frailty and less independence in terms of quality of life, less function, less mobility, increased fracture risk which is very debilitating for the more elderly population.”
Why? Dr Enayat points to the way the drugs don't appear to discriminate where the weight loss comes from — meaning that you are often losing muscle in addition to fat, something that is critical to our health and affects our metabolic rate, lifespan, and overall wellbeing. Without muscle, we not only become frailer in later life, but studies show a correlation between higher muscle density and lower mortality rates.
According to Dr. Enayat, some clinical studies have shown that up to 40 per cent of weight lost from drugs like Ozempic could be lean muscle mass, and that, “as we get older it’s really hard to maintain muscle mass already, but in the presence of GLP-1s you’re fighting an uphill battle”.
Up to 40 per cent of weight lost from drugs like Ozempic could be lean muscle mass
In addition to muscle loss, Dr. Enayat says he’s seen new patients at his clinic who have been on GLP-1s for years without supervision who are, “showing signs of frailty, weakness, low mood, low motivation, reduced exercise tolerance. We put this down to being in a long-term calorie-deficit state.” Essentially, after spending a prolonged period of time restricting calories and nutrients, it’s not uncommon for people to find that their mental state, energy levels, and ability to exercise end up in a state of decline.
Read more: Can’t afford Mounjaro? How to come off it without gaining weight
Ultimately, Dr Enayat believes that we’ve been approaching weight loss from the wrong angle.
“We should be focusing the narrative less about weight, and more about body composition, where we’re focusing on maintaining muscle mass and reducing body fat percentage.” But it’s not all doom and gloom — there are still accelerants out there, of sorts, that can help us with a little boost, or a “cheat” in the quest of smaller waistlines.
One option he recommends is MOTS-C. It’s an injectable peptide, like GLP-1, which instead of causing feelings of satiety, stimulates the breakdown of fats while conserving energy. And where GLP-1s can cause people to turn away from exercise, either due to a lack of energy or an assumption of reduced need, the use of MOTS-C ultimately boosts energy levels and encourages movement and training. As a result, where the use of drugs like Mounjaro can erode healthy habits like portion control and exercise, supervised MOTS-C use helps lay the foundations of a healthier lifestyle beyond the course of treatment.
“It’s not focused on your intake, it’s focused on your output, and so when you increase someone’s output, that’s actually really healthy because they have more energy, they train more, and you’re changing them behaviourally as well.”
MOTS-C is also the cheaper option — even with the inclusion of additional blood work, monitoring, and a nutritionist’s guidance on the process. While GLP-1s cost about £200 per month with a treatment course of approximately twelve months, a year’s worth of fully supervised MOTS-C use would consist of one or two courses of treatment (for six to eight weeks), which would set you back about £1000 each time. While you won’t lose half a stone overnight, Dr. Enayat says, “you would see improved body composition, body shape, but your body weight would go down more slowly. But, guess what? That’s what we want. We don’t want to lose body weight when it’s composed of bone and muscle alongside fat.”
Ultimately, when it comes to losing the kilos, the quick-fix is always going to be the siren’s call of weight-loss options. No one wants to feel uncomfortable or deprived, running is difficult and chocolate’s always going to be intoxicating. Yet, when choosing to go down the path littered with discarded GLP-1 pens, it’s important to be aware of the potential risks.
As boring, drab, and unsexy as it might sound, when it comes to maintaining a healthy body in terms of weight, shape, and composition, there’s probably going to be an element of work required. Don’t shoot the messenger.
