GLP1 agonists Ozempic, Wegovy, Saxenda, Mounjaro
Benefits, Risks and other Considerations
More and more people are prescribed medications to help treat diabetes and weight loss. These include Ozempic, Wegovy, Saxenda, Mounjaro (GLP1 agonists). They are injections usually administered once per week. This blog intends to inform about the possible pros and cons of taking these medications. It also looks at possible nutritional issues and other considerations.
Benefits
Help control blood sugar: lowers HbA1c (average blood sugar level over last 3 months) by ~1%
Reduce hunger and cravings. Make you feel full for longer through slower emptying of the stomach
Help you lose weight and keep it off while continuing these medications
Protect the heart over time by helping to lower LDL-cholesterol (“bad cholesterol”) and blood pressure and by reducing the risk of strokes and heart attacks
Protect the kidneys over time by reducing kidney disease and improving kidney function in people with type 2 diabetes
Risks
Gastrointestinal side effects: nausea, vomiting, low appetite, diarrhoea, constipation, heartburn, stomach pain
Long-term risks are still under investigation. In rare cases the thyroid or pancreas may be affected. Ask your doctor about monitoring your thyroid gland and seek medical advice if you have abdominal pain.
Nutritional considerations
The gastrointestinal side effects listed can have a significant impact on nutrient intake and absorption.
Nausea, vomiting and diarrhoea can affect hydration and electrolyte balance.
Slower stomach emptying leads to decreased appetite. This affects how much you can eat and what you feel like eating.
Food intake can be drastically reduced. This also reduces the macronutrients (especially protein) and micronutrients (vitamins and minerals) that you get from your diet.
Macronutrients are important for energy production, growth, building of cells, repair of damage, digestion, and the adequate functioning of all our bodily systems.
Micronutrients are necessary for all of our cells to function. They help our immune and nervous systems to stay strong.
Nutrient deficiencies can occur over time when your nutrient intake is lower than what your body requires. A lack of nutrients can show up as physical symptoms and it can also affect your moods.
Common deficiencies like low blood iron (especially in women before menopause) or lower bone density (often in women after menopause) can become worse with inadequate nutrient intake.
Not all the weight you lose is fat. Muscle loss can make up 30-40% of all the weight loss. Maintaining muscle mass as we age is important as it helps us to stay healthy and strong. Losing muscle mass will slow down the metabolism (how we use food to make energy and building blocks).
A dietitian can help to navigate these challenges to support your well-being and health goals while losing weight.
Going for surgery
If you are planning to undergo surgical procedures involving a sedation (Twilight anaesthesia) or general anaesthesia let your surgeon and anaesthetist know that you take this medication.
Due to the delayed stomach emptying your doctors may want to provide you with adjusted medication and fasting advice. This helps to avoid possible complications such as food from your stomach traveling into your lungs where it can cause infections.
Financial commitment
Depending on what your doctor is treating (diabetes, weight loss, heart health) the costs for these medications can vary. Different brands and different doses have different costs. Medicare support may change over time as new research emerges. You can always check with your pharmacist.
Having a monthly out-of-pocket cost of hundreds of dollars, if not supported by the Pharmaceutical Benefits Scheme, can prove to be a significant financial burden. It is worth considering how long you plan to be on these drugs and what might happen when you stop them.
What happens when you stop?
GLP1 agonists are proven to work well in decreasing appetite and supporting blood sugar control and weight loss while you are using them. They are likely an ongoing, long-term treatment if you want to continue seeing results.
Studies have shown that people who stop GLP1 agonist medications tend to put the weight back on. Weight gain after stopping can be increased if your metabolism is slower due to lost muscle mass.
Blood sugars tend to rise again going hand in hand with increased hunger and cravings which were suppressed by these medications.
Optimising your food intake with a focus on vital nutrients while managing possible side effects can support your well-being on these medications but also after stopping them.
Making essential lifestyle changes such as regular resistance or strength training can help to reduce muscle loss.
These points show that GLP1 agonists should only be used with accompanying lifestyle and diet changes to give you the best results even if you decide to stop the medication.
Reasons for stopping the medication
A number of people will stop these types of medications due to impactful or ongoing side effects, injection fatigue, and high costs.
Previous supply issues and shortages have lead to medications being unavailable for periods of time.
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