Category: physical activity, fitness, exercise

Understanding GLP-1 Drugs for Weight Loss and Diabetes

Here I review th GLP-1 drugs, approved for managing type 2 diabetes and aiding weight loss, simulate the GLP-1 hormone, promoting fullness and blood sugar control. While they can be effective, they come with risks and side effects, and long-term success requires lifestyle changes, regular exercise, and mental health support, as emphasized by healthcare professionals.

This information is current as of the date of original publication or update but may have changed by the time you read this. Do not use this information for diagnosis or treatment purposes. Before making health decisions, discuss with a qualified healthcare professional.

When I was in medical practice, patients asked me for weight loss drugs. There were a few that varied in effectiveness, side effects, and risks. In general, none were effective in significant long-term weight loss.

I also had numerous patients with type 2 diabetes who needed medication to achieve optimal blood sugar levels, but did not want or need insulin. Again, there were several, but most patients needed at least two drugs to lower the glucose to the target level.

Then came the GLP-1 drugs.

GLP-1 medications (glucagon-like peptide-1 receptor agonists) are FDA-approved drugs used to manage type 2 diabetes and chronic weight loss. Popular brands include Wegovy, Ozempic, Mounjaro, and Zepbound, which are generally meant for adults with high BMI (body mass index) or weight-related conditions. 

(Body Mass Index (BMI) is a screening tool that calculates a person’s body fat percentage based on their height and weight. It is calculated by dividing weight in kilograms (kg) by height in meters squared.)

How GLP-1 Drugs Work

  • Appetite Regulation: They mimic the GLP-1 hormone, signaling to the brain that you are full, reducing hunger and calorie intake.
  • Blood Sugar Control: They stimulate insulin release after meals and prevent the liver from producing too much glucose.
  • Slower Digestion: They delay gastric emptying, keeping food in the stomach

However, they are not perfect and have risks.

  • Possible side effects -nausea, vomiting, diarrhea, constipation, and abdominal pain, which often improve over time.
  • Potential for thyroid C-cell tumors (based on animal studies), pancreatitis, kidney issues, and severe gallbladder issues.
  •  Rapid weight loss can cause “GLP-1 face” (loss of facial fat leading to a sagging/wrinkled appearance)
  • costs over $1000 per month, and insurance coverage varies
  • FDA has warned about risks associated with unapproved, compounded versions of these medications.

Taking a GLP-1? Doctors Say Not To Forget About Movement and Mental Health

Emily Siner, Nashville Public Radio and Cara Anthony and Blake Farmer, Nashville Public Radio

Severe ankle pain drove Jelon Smart to start taking a weight-loss injection a year and a half ago.

Smart was 285 pounds and worked as a caterer in Savannah, Georgia. After she’d been standing on her feet for long hours, her ankles would be “as swollen as a football,” she said. She was walking with a limp.

An orthopedic doctor diagnosed her with Achilles tendinitis and recommended losing weight to mitigate the symptoms. Smart began taking the brand-name GLP-1 Ozempic.

The appetite suppression resulted in her shedding pounds quickly, at first.

“I lost 30 pounds initially without changing anything,” said Smart, 48. But then she found herself unable to shed additional pounds.

GLP-1 Drugs- Weight Loss Made Easy

GLP-1s have quickly become one of the most popular types of weight loss drug in America. Nearly 1 in 5 people have taken them at some point, according to research from KFF, a health information nonprofit that includes KFF Health News.

But doctors say it takes more than a regular shot for patients to achieve their weight goals in the long run.

Body mass index chart
A BMI OF 30 or more represents obesity. BMI Chart created by Vertex42.com. Used with permission.

Here’s what to know.

The Old-School Rules of Diet and Exercise

Regular exercise, smart food choices, plenty of sleep — those basic, healthy lifestyle choices are not only going to help you lose weight on a weight loss drug but also help you keep it off, said Dafina Allen, an  obesity medicine physician who runs a clinic in Saginaw, Michigan.

For example, some people find that they eat less on a GLP-1, “but they’re not improving their health because they’re not exercising. They’re not improving the quality of the food they’re eating,” Allen said.

The path to weight loss is also guided by hormones, metabolism, and genetics.

After her weight loss on Ozempic plateaued, Smart realized she needed to start moving her body, too.  “I’m in the gym now six days a week,” she said. “I went from 285 to 175” pounds. The swelling and pain in her ankle went away as well.

Photo by Julia Larson on Pexels.com

Mental Health Matters Too

The mind and body are deeply connected. Food and body image can be especially emotional, Allen said. “I can tell you about the patients that I helped lose 50 pounds, that I helped lose 100 pounds, and they still look in the mirror and are not happy.”

The key is seeking help for mental health along the way, said Gerald Onuoha, who practices internal medicine in Nashville, Tennessee. “Making sure that you’re talking to people about your problems, whether it’s a family member or a licensed professional, I think goes a long way,” he said.

Work With a Doctor To Closely Monitor Your Dosage

Onuoha said people can run into serious problems if they increase their GLP-1 dosage too quickly or don’t follow the recommended schedule. He’s seen patients come to the hospital with pancreatitis, gallstones, or acute kidney injury.

 “I always ask patients who are on GLP-1s: How long have they been on them?” he said. “Are they adhering to the directions? Because those things determine whether or not you’re going to have those complications.”

a female physician talking to a male patient
image from LIGHTSTOCK, affiliate

Part of the issue, Allen said, is that GLP-1s are relatively easy to access — and often much cheaper — through online pharmacies or websites, but those providers may not educate patients about their dosage or side effects.

“So they might just go online, find a random company that will ship it to their house, where they don’t even know what dose of the medication they’re taking, or even if the medicine is safe for them as the patient with the medical conditions they have,” she said.

People and Policy-Who Pays for GLP-1s?

GLP-1 drugs can be costly, and most insurance programs — public or private — don’t cover the medications for weight loss.

Medicaid, the government program that covers 69 million Americans, covers GLP-1s for medically accepted conditions like diabetes, but only about a dozen state Medicaid programs cover GLP-1s for obesity treatment, according to KFF.

For older Americans with Medicare, the federal government is planning to allow temporary coverage of GLP-1s for weight loss starting in July.

Katherine Ruppelt at Nashville Public Radio contributed to this report.

HealthQ is a health series from reporters Cara Anthony and Blake Farmer, approachable guides to an unapproachable health care system. It’s a collaboration between Nashville Public Radio and KFF Health News.KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Subscribe to KFF Health News’ free Morning Briefing.

This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Images in this Post

The photos in this post are for illustration only and were not in the original article.

Exploring the HEART of Health

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Dr. Aletha

Awesome August

August is a busy month despite the absence of major holidays in the US. It marks the start of the academic year and the Olympic Games. In this post I reminisce about starting medical school in August and witnessing changes in the field. Then I discuss the Democratic National Convention and the Paralympic Games.

updated August 26, 2024

August is an exception among months. It has no major or federal holidays in the United States. Although the temperatures still feel hot and muggy, many students and teachers return to school and college for the “fall” semester.

If you planned to buy a new swimsuit it’s too late. If you need a new winter coat, they’re available, if you want to try one on when it’s 95 degrees outside. Halloween, Thanksgiving, and even Christmas merchandise are already on sale.

Photo by Pixabay on Pexels.com

I started medical school in August

My first day as an MS1, first-year medical student, was August 24, 1974. After four arduous years I graduated, completed a three-year residency in Family Medicine, board-certified, and practiced for 41 years.

Today medical schools hold a White Coat Ceremony for incoming students but not then. But I was still proud to don my white coat and follow residents and attendings around the hospital.

One day a week we were sent off campus to a private doctor’s office to observe and “shadow” them. I watched a family physician interact with a wide variety of patients he treated as friends. That’s when I fell in love with Family Medicine.

Years later we practiced in the same medical group. Since I had been there first, he called me his “senior partner”. But to me, he was forever my mentor. He practiced well into his seventies, then was injured in a serious auto accident and never practiced again.

These are the only photos of me in the yearbook. I don’t think I knew there would be a yearbook. I didn’t socialize much so that must explain my absence.I wonder how they accumulated enough photos since no one had cameras on their phones then.

With that hair and jumper, I definitely look like a ’70s girl. I’ve changed and so has the Health Sciences Center; when I visit now, I hardly know my way around, with new structures and name changes.

Medicine has changed a great deal since then, and perhaps the biggest change is the increased number and percentage of women in medicine. In my class of 150 students, 25 of us were women. In the average medical school class today, that number would be 75 or more-at least half.

There are still more men than women practicing medicine. It will take a few more years to catch up as older male physicians retire and more young women physicians begin practice. I have enjoyed more female colleagues as our numbers increased over the past 40 years.

My school, the University of Oklahoma, now holds a White Coat Ceremony. Several weeks before, they ask us alumni to write a note offering advice to a student. They print it on a card and place it in the coat’s pocket.

I don’t remember exactly what I wrote. I congratulate them for getting this far and welcome them as a future colleague. I tell them all the hard work will be worthwhile because what they do is valuable. I don’t tell them it won’t always be recognized and appreciated.

I don’t know if the school includes our name on the card, but probably not. I have never heard from one of them. I always wonder if they find my advice helpful.

Why women physicians are good for health care

The first woman graduate of a United States medical school was born in Bristol England in 1821. Elizabeth Blackwell came to this country as a child and originally had no interest in medicine. But when a dying friend told her, “I would have been spared suffering if a woman had been my doctor”, she found…

Keep reading

The Olympics concluded on August 11

Most of the Olympic events occurred in August so we watched many of our favorite events, although they don’t all get equal broadcast time.

The Olympic Games remind me of my trip to Greece. I saw the Panathenaic Stadium, site of the first Olympic games in Athens.

The Panathenaic Stadium was built for the first modern Olympic Games in 1896 in Athens, Greece. It is the only stadium in the world made completely of marble.

In 330 BC a stadium was built at this site for the games of the Panathenaea. It fell into disuse with the rise of Christianity and eventually most of the site was destroyed and forgotten.

After archaeological evidence of the stadium was uncovered in the 1830s, the site was excavated in 1870. In 1895 the new stadium was built there to hold the 1896 Olympics.

From the Panathenaic Stadium, the Olympic flame is officially passed to the host country of each Olympic Games. It continues to be used for sporting events and functions.

click on any photo to start a slideshow

A unique archaeological monument, a living symbol of the ancient and modern heritage of sport and the Olympic Games.

PANATHENAIC STADIUM

The Democratic National Convention-August 19

The Democratic National Convention was held August 19-22, 2024 in Chicago, Illinois.

On July 21, 2024, by letter, President Biden informed the nation that he was withdrawing from his reelection campaign. This marks the first time in 50 years that a sitting president did not run for reelection. (And I remember that time also. Do you know which President it was?)

Chicago skyline from Lake Michigan with Navy Pier in foreground
Chicago city skyline and Navy Pier from a boat on Lake Michigan-photo by Dr. Aletha

President Biden and other Democratic leaders endorsed Vice President Kamala Harris who accepted the nomination. She chose Tim Walz, Governor of Minnesota as her running mate.

The Paralympics begin on August 28

We are not done with international sports competitions yet. The Paralympic Games begin on August 28, 2024, in Paris and conclude in September.

The word “Paralympic” derives from the Greek preposition “para” (beside or alongside) and the word “Olympic”.

Paralympics are the parallel games to the Olympics showing how the two movements exist side-by-side.

Sport for athletes with an impairment has existed for more than 100 years. It was widely introduced after World War II to assist injured veterans and civilians.

On September 22, 1989, the International Paralympic Committee was founded as an international non-profit organization to act as the global governing body of the Paralympic Movement.

The Paralympics reminds me of my late friend Bob who walked with crutches. As a boy, he was left paralyzed due to a bout of polio, before the vaccine was available. But that did not stop him from living a full life.

Bob’s wife, a medical assistant, worked in my clinic. We also attended the same church so I knew him and their three children. Despite his limited walking, Bob learned to bowl and did so competitively, winning several tournaments. He unfortunately passed in middle age of unrelated causes and his family misses him sorely.

You’ll enjoy this video about the Evolution of the Paralympic Games from the official Paralympics YouTube page.

Exploring the HEART of Health

The last President to resign without running for reelection was Lyndon Johnson, in 1968. Did you guess correctly?

I’d love for you to follow this blog and follow me on social media.

I share information and inspiration to help you transform challenges into opportunities for learning and growth.

Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.

Dr. Aletha

A tour of the U.S. Olympic Training Center, Colorado Springs, Colorado

A visit to the United States Olympic Training Center in Colorado Springs showcases the dedication and resilience of Olympic and Paralympic athletes. Promoting physical activity, it emphasizes the health benefits of exercise, while sharing the “Winning Attitudes” and determination exhibited by champions. The center inspires a commitment to personal excellence and perseverance.

Keep reading

Cover Photo

The Bizell Memorial Library on the University of Oklahoma campus in Norman Oklahoma. Photographer-Dr. Aletha