Transitioning Off Semaglutides
These medications are growing in popularity for several health conditions such as type 2 diabetes and obesity, but they come with risks and downsides as well.
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If you are taking, have taken or thought about using Ozempic, Wegovy, or other semaglutide drugs from diabetes or weight loss, you’ve likely heard about the risks when stopping the medications. Is there a way to do so safely, without backsliding?
First, let’s discuss what these drugs are and how they work. Semaglutides are a class of drug known as a GLP-1 receptor agonist. They essentially mimick the natural GLP-1 hormone that your gut produces when you eat. GLP-1 naturally suppresses glucagon, which is another natural hormone produced by the alpha cells of the pancreas with the sole purpose to increase blood sugar by releasing stored glucose from the liver. GLP-1 naturally suppresses appetite, promotes fullness, and therefore can reduce overall intake of food.
People are prescribed these medications for a variety of conditions: obesity, diabetes, and reduced risk of some cardiovascular diseases. They, like all medications, do also have some downsides and risks.
1. They can be very expensive, often prohibiting their use at all or at least limiting the duration.
2. They can cause a wide range of digestive symptoms like nausea, bloating, constipation, diarrhea, vomiting, and acid reflux.
3. When combined with other blood sugar lowering medications, may cause blood sugars to drop too much.
4. Less common, pancreatitis can develop, causing a medical emergency in some cases.
5. Some have reported kidney issues, so may be more risky to those with prior kidney problems.
6. Although very rare, some risks of thyroid cancer can also increase.
Another risk is in losing weight on these drugs without also changing the diet and lifestyle. If people continue to eat the standard American diet filled with processed foods, refined sugars, and far too many carbohydrates, especially while under eating total food, they end up losing muscle, connective tissue, and lean mass. This leaves them with sagging skin, weaker muscles, loss of physical capabilities, and far less metabolic potential. All this combined means weight regain is MUCH easier and faster when off the drug, returning to normal appetite and the same poor food choices. Exercise is another component that is vital to maintaining muscle mass. The more muscle you have, the more sugar your body can use and store. This allows you to burn more energy daily, but also have a wider range of foods to choose from. Of course, quality foods still matter. No amount of muscle will protect you from a high refined sugar diet. And lastly, quality sleep and appropriate stress management is also critical to ideal metabolic health.
To sum up the key takeaways: these drugs are powerful and can be very useful, but they shouldn’t be looked at as a miracle that allows you to eat whatever you want, stop working out, and not paying attention to having a healthy lifestyle. To get the best results, eat a quality diet, appropriate portions, strength train, get good sleep, manage stress loads, and use these medications for as short a duration and in the smallest dose possible, if you choose to use them at all.
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