By Roberta Russell
The World Obesity Atlas predicts that by 2030 one billion people in the world will be living with obesity. No area of the globe is unaffected. Closer to home, the USA is currently burdened with more obesity than any other industrialized nation. According to the United States Center for Disease Control, 93.3 million people (39.8 % of the population) are now obese.
Excess fat correlates with the occurrence of cardiovascular disease, cancer, and early death. Notwithstanding vanity and personal pride in one’s appearance, it’s no wonder that pharmacists world-wide cannot keep up with demand for the amazingly effective (at least as-long-as-you-take-them) GLP-1 class of drugs now used for weight loss.
Ozempic, the most familiar GLP-1 drug, was originally approved for diabetes, but is often used in higher doses for weight loss. Currently, the three most well-known and widely used GLP-1 drugs for weight loss are semaglutide (Wegovy), liraglutide (Saxenda), and the newer tirzepatide (Zepbound), all of which have demonstrated significant weight loss in clinical trials.
Oprah Winfrey, who has long shared her weight loss battle with her fans, and been affiliated with WeightWatchers, recently announced that she has been using Ozempic, a GLP-1 agonist, normally injected weekly, to treat obesity. Consequentially, her now slimmed-down self has left the WeightWatchers Board, sold her WeightWatchers stock, and issued a sincere apology to all the overweight and obese people to whom she has been preaching shame and blame. The problem has been biological, she intones, not a failure of will power.
See video of Oprah here, please, after you read this article
What is this life-changing class of weight loss medicine and where does it come from?
Dr. Joseph Proietto, a font of knowledge on this fast-evolving topic, is a professor emeritus at the University of Melbourne in the Department of Medicine at Austin Health, and an endocrinologist specializing in diabetes and obesity. He has honored me with his teaching and guidance for years, since I wrote Report on Permanent Weight Loss while studying at Teachers College, Columbia University.
“Where did this class of GLP-1 drugs come from?” I asked him in a phone interview several weeks ago. He shared the curious tale of the Gila (pronounced heela) monster: “In between infrequent meals, it shrinks its gut. It becomes smaller because biologically you don’t maintain an organ you’re not using.”
The Gila monster, who may eat twice per year, is the source of GLP-1 drugs like Ozempic. Credit: Shutterstock.
American researchers were originally inspired to investigate the saliva of the Gila monster, a poisonous American desert lizard who oft times eats only every six months. When it catches something to eat, as it’s chewing it releases hormones from its saliva that cause the gut to grow very rapidly. Scientists thought it would be very interesting to know what’s in the saliva of the Gila monster. It might be some interesting growth factor.
Dr. Proietto explained. “So now we’ve got these analogues of our gut hormones, which is GLP-1 (glucagon-like peptide-1) and glucose-dependent insulinotropic hormone (GIP). After we have a meal, they are released into the bloodstream for a short time, because there’s an enzyme that chews them up quickly.”
“They do practically everything except wash the dishes. They stimulate insulin secretion, but only if the sugar is elevated, and they suppress glucagon. Both of those actions lower blood sugar, so these hormones are good for both diabetes treatment and for obesity management. Obesity and diabetes are both very common conditions. One drives the other.
The companies just can’t make enough. In the process, they say, ‘We’ve got to be paid a lot of money for developing this.’ They charge ridiculous amounts of money for it.”
Diabetes and obesity drugs like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) have become world-famous, generating billions in sales and opening a new market for weight-loss drugs. The development of semaglutide, the key ingredient in the medicines, has also transformed their maker, Novo Nordisk, into Europe’s most valuable company, with profound implications for its home country of Denmark,” Bloomberg’s Sanne Wass reports. (Source: Bloomberg.) R
Dr. Proietto further explained, “They go to the stomach and slow the gastric emptying, making you feel fuller for longer. And then, they go to the brain and suppress hunger. The researchers dreamt up the compound they sequenced, but they did not know what it was. So they put it in a data base, and the computer matched up amino acids and came up with GLP-1. And then the Scandinavians started making the human version of the hormone and making it longer-acting, and now we’ve got these agents that work nicely and conveniently because they’re only injected once a week. This is considered a revolution in terms of the results one can get for weight loss with the drug.”
Dr. Proietto thinks bariatric surgery will go out of fashion eventually.
The cost of GLP-1 drugs is unreasonably high. According to Perplexity AI, the cost of Mounjaro (tirzepatide) without insurance can range from around $900 to $1,400 per month, depending on the source and prescribed dose. I know a woman who dropped half her weight and pays $1,600 per month for the highest dose, expecting to continue for the rest of her life, even though the research does not extend beyond two years, and there is evidence that extreme weight loss will most likely plateau at some point in advance of reaching an ideal goal.
Even though I am not overweight, and have not been either overweight or obese for more than 22 years (!) I can get this drug, I thought. Just follow the money.
All of the errors made in my explorational pursuit of Wegovy have been in one direction. I wanted to try the GLP-1 drugs, because I was writing this article and because I wanted to lose five pounds. Weight categories cover a wide a range, determined by Body Mass Index (BMI). So, I succumbed to the same self-serving forces as did the herein unidentified medical office prescribing weight-loss drugs.
In preparation for the lowered scrutiny and reduced price of these compounded GLP-1 drugs, I looked at perplexity.ai in my browser. Lots of options came up, both locally and online.
I picked a NYC medical office specializing in a weight-loss drug program with more flexible standards for admission and lower cost than the drug manufacturers had advertised. Apparently, well-controlled high blood pressure, only one pound overweight and money were in this instance enough to qualify for GLP-1 drugs. No obesity required!
Having confirmed an appointment, I put on substantive clothing and shoes, ate a large meal, and drank several cups of water just before the appointment, and then uncharacteristically downed a cream-filled pastry on the way to the medical office. That’s how I got my weight up by about 10 pounds to be one pound overweight including clothes.
The professional-sounding, warm, and helpful doctor told me that the GLP-1 drugs they used were compounded. I thought that must be a good thing, the way he said it with emphasis. It felt like Special for you.
But no one measured my height; they just asked me for it. I was weighed by the doctor himself with all my clothes and shoes on, with no correction for the added weight. I was given blood tests, but no one asked when I had last eaten, or told me in advance not to eat.
Just as an aside, I had been reading Warren Buffet’s late partner Charlie Munger’s new book, Poor Charlie’s Almanack. “All human systems are gamed,” it said. It seemed to me that both the medical staff and I were all colluding to get me to legally qualify for the lower-priced compounded GLP-1 drugs.
I was instructed to wait for the doctor to receive my specifically compounded and paid-for-in-advance order for him to inject Wegovy into my stomach in a week.
A day or two later, I received an email notice to come to the office because there was a problem with my blood test. It regarded blood sugar, but the question on the form about whether I had eaten was neither checked off, nor asked. Why would you test blood, not urine for sugar, I wondered?
Subsequently, I learned that compounding was actually not a wonderful service, custom-made for me. The process was born of an emergency measure to make up for a drug shortage.
The compounded drugs were not tested as were those made by the manufacturers. Apparently, Neither Eli Lilly nor Novo Nordisk sell their active ingredient to compounders.
I called the medical office, told them that I am actually not overweight at all, and that I do not have high blood sugar. I asked about contacting the compounding lab, but was given a runaround and, finally, my money back.
My advice: Look before you leap and think about what you will do when you stop losing weight or need to quit using a weight-loss drug because of side effects.
Without a backup plan it is likely that you will gain back the weight you have lost.
Look it up at Perplexty.ai: “The FDA has warned against using compounded semaglutide products, stating they may contain different salt forms like semaglutide sodium or semaglutide acetate instead of the approved semaglutide base form. These salt forms have not been shown to be safe and effective.”
So, here’s the rub: Since these GLP-1 drugs are only tested for weight loss for two years. Using them past the point of known safety without a safety net is foolhardy. According to Perplexity.ai, there are several clinics and medical spas in Manhattan offering compounded versions of GLP-1 weight loss drugs like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro). However, it’s important to note that these compounded versions are not FDA-approved, and their safety and efficacy are questionable.
How far can you go toward your weight goal? Everyone will plateau. No one knows where or when. Joining with others can help replace the drugs with emotional support.
At this time we have a confluence of influences: GLP-1 agonists are currently considered the most effective anti-obesity medications, even though they have often been shown to be impermanent.
Loneliness around the globe is at a high, too.
Russell’s suggestion is to embrace the time-tested techniques of daily logging of calorie input, exercise, weight and mutual sharing of this information by email with a like-minded individual, adhering to the same system.
Watch the video below of Roberta Russell presenting her findings at Columbia University Teachers College:
And visit:
for more free videos on ways, means and results.
This way you can increase your weight loss, the amount of time you keep off the extra pounds, and decrease the side effects.
You are, however in danger of finding a friend!
Roberta Russell is the founder of the World-Wide Calorie & Exercise Logging Group (www.permanentweightloss.org). She is the author of Report on Permanent Weight Loss, RD Laing & Me: Lessons in Love, and Report on Effective Psychotherapy: Legislative Testimony.
©Roberta Russell
The Plan by Roberta Russell
1. Take Charge of Your Time-limited GLP-1 inspired Weight Loss by tracking your effective behavior.
2. Learn how to substitute the power of a healing alliance for the transient chemical reaction of appetite-attenuating GLP-1 drugs. Before the drugs stop working, before they become intolerable, count how many calories you are consuming in your altered state. Share this information with a similarly courageous, like-minded buddy who wants the both of you to succeed permanently in achieving a normal and healthy weight and lifestyle
3. Figure out how to dampen your appetite with increased volume rather than drugs or increased calories. You do that by keeping track and making a transmittable record of your fully documented daily calories eaten and burned, then reliably sharing this log with another caring person.
4. The reverberating side effects of the force of the commitment of a loving sentient person are mutually transformative and regenerative. Just watch and keep notes and please do keep me in the loop. I want to know how you are doing.
© Roberta Russell, 7-14-2024
