With obesity affecting almost 2 billion adults worldwide, the recent introduction of GLP-1 agonists into the consumer market has been a welcome relief for many. The combination of busy lifestyles, high-calorie convenience food and a sedentary routine has seen global obesity rates more than double for adults between 1990 and 2022.
However, obesity can now be easily managed with these oral or injectable drugs which mimic the natural hormone, GLP-1, assisting with appetite suppression and increased feelings of satiety.
Long Term Weight Loss Remains the Biggest Challenge
Initially approved to treat the management of type 2 diabetes, GLP-1s such as Ozempic, Mounjaro, and Wegovy, are available for cosmetic weight loss.
However, receptor agonists almost always require long-term use to ensure continual weight loss.
A study shared by the University of Oxford reported that around 50% of people who discontinued the drug within 12 months returned to their starting weight within 1.5 to 2 years.
At an average rate of 0.4 kg per month, people relying on GLP-1s would regain weight faster than those committed to traditional behavioural weight loss programmes.
For newer drugs such as semaglutide and tirzepatide, weight regain is faster, at an average rate of 0.8 kg per month.
High Costs And Side Effects Are Pushing Users Away
Recent studies cite high cost as the main cause for GLP-1 users choosing to stop treatment within 12 months, with almost 50% reporting financial barriers for long term use, according to data shared by Cleveland Clinic.
In addition to cost, gastrointestinal side effects including nausea, diarrhoea or constipation deter some from continuing treatment, along with cosmetic changes including muscle and hair loss and loose, sagging skin, as shared by University of Kentucky.
Mara Gordon, a family physician from Camden, New Jersey, wrote about her experience using Ozempic in NPR, 'I'm a primary care doctor, and I'd been following the scientific literature that showed GLP-1 agonists could now be used specifically for weight loss. I wanted to try them. In the end, I was also an early quitter: I stopped taking the drug within months of starting it. Ozempic made me nauseated, gave me heartburn, disrupted my sleep. It wasn't worth it. I felt, in a word, unhealthy.'
To ensure a continued healthy weight and less side effects upon stopping treatment, healthcare professions recommend pre-planning lifestyle adjustments with a healthy diet.
Sarah Thompson, a 39-year-old administrative assistant from Orlando, FL, found certain readjustments to life without Ozempic challenging upon cessation of treatment, as reported in The Healthy. 'I made a commitment to watch my diet closely and incorporated regular walks during my breaks at work after I noticed a 12-pound increase.'
Cosmetic Use of Weight Loss Jabs Continues to Spark Debate
Controversy still lingers regarding the use of GLP-1s for cosmetic purposes when, in recent years, demand has proven to be higher than supply, resulting in widespread supply challenges for patients with a medical need for the treatment.
The Columbia University Department of Psychiatry shared that in 2023 many type 2 diabetics could not access Ozempic and the drug was placed on a drug shortage list resulting from widespread cosmetic use.
Scientists Search For New Alternatives Beyond GLP-1 Drugs
With continued research into weight loss treatments and their increased relevance in today's society, more discoveries are potentially on the cusp of realisation.
A naturally occurring molecule discovered by Stanford Medicine researchers may offer a more targeted approach to body weight reduction without some of the commonly reported gastrointestinal side effects and muscle mass loss.
The reported BRP peptide demonstrated appetite suppression effects leading to a reduction in weight gain, without the neurological effect of food aversion.
Natural offerings are also garnering interest for their contribution to weight loss treatments. Often referred to as natures Ozempic, Berberine, a bioactive alkaloid, extracted from plants like goldenseal and barberry, has gained popularity for its ability to regulate metabolism and control blood sugar and fat, as reported by Science Direct.
Specialists Warn There Is No Quick Fix For Obesity
The less appealing, long term outlook for GLP-1 treatment may dissuade some from beginning the journey and instead, seeking for a more affordable way to attain their weight loss goals with fewer side effects.
Professor Susan Jebb from Oxford's Nuffield Department of Primary Care Health Sciences advised 'Obesity is a chronic, relapsing condition, not a short-term problem with a quick fix. When people lose weight through changes to their diet and activity, they're practising the skills that help maintain that loss.'
