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The Truth About Ozempic: A Dietitian’s Advice.

One of the hottest topics of discussion in recent times has been the rise of Ozempic and its cousins Wegovy, Moujaro and Rybelsus for weight loss.

With its impressive track record of improving blood sugar control, promoting weight loss, and potentially reducing the risk of cardiovascular complications, it’s no wonder that Ozempic has achieved widespread attention. Many individuals have experienced life-changing results with this medication, leading to a surge in its popularity.

These medications have revolutionized the treatment landscape, offering new hope for individuals struggling to manage their metabolic health. However, it’s not a one-size-fits-all solution. I want to talk about what you should consider before starting a GLP-1 receptor agonist (GLP-1RA).

 In this post we’ll cover:

  • What are GLP-1RAs and how do they work?
  • Updates on supply and cost
  • Illegal sales market
  • The drawbacks and safety risks
  • Nutritional considerations
  • My opinion

Understanding GLP-1 Receptor Agonists: What Are They and How Do They Work?

These drugs mimic the action of a hormone our body produces naturally, called glucagon-like peptide 1 (GLP-1). GLP-1 is naturally produced in our gut in response to eating food and helps to lower blood sugars, slow gastric (stomach) emptying and increase satiety. However, in individuals with conditions like type 2 diabetes and obesity, the production or effectiveness of GLP-1 may be impaired.

Generally speaking, after a person eats a meal, their blood sugar starts to rise. Then, their body responds by secreting insulin to lower their blood sugars. GLP-1 receptor agonists help the body to produce more insulin to lower blood sugars. 

These drugs also help slow the movement of food from the stomach into the small intestine. As a result, you may feel full faster and longer, so you eat less. This could result in losing weight.

GLP-1 receptor agonists, like Ozempic, work by binding to the same receptors as our natural GLP-1, and enhance its effects.

Most GLP-1RAs are taken via injection either daily or weekly.

Here are some of the more popular options currently on the market:

  • Tirzepatide (Mounjaro®) – weekly injection
  • Semaglutide (Ozempic®, Wegovy®) – weekly injection
  • Semaglutide (Rybelsus®) – taken by mouth once daily
 
These drugs are indicated for use by people managing type 2 diabetes or obesity as an adjunct to diet and exercise. They have been proven to: 
 

Updates on supply and cost

1. According to Health Canada: 

Novo Nordisk has advised Health Canada that the following shortages of Ozempic (semaglutide) have been resolved as of Feb, 2024. Eli Lilly has advised Health Canada that it expects shortages to end by July, 2024.

“Both companies are making efforts to increase manufacturing capacity to be able to meet demand.”

2. According to the National Community Pharmacists Association (NCPA):

In a recent survey by the NCPA, nearly all (90%) of pharmacy owners and managers said they would stock the class of medications used in the treatment of type 2 diabetes and obesity, but nearly all of those (96%) said they are experiencing shortages or backorders of GLP-1 agonists.

3. According to the NHS on March 20, 2024:

“The NHS continues to face supply issues with glucagon-like peptide receptor agonists (GLP-1 RAs, or GLP-1 analogues), a range of drugs used for managing blood glucose levels in people with type 2 diabetes. 

The global shortage in supply is partly due to a surge in off-label prescriptions of the drug semaglutide being issued for weight loss, which is exceeding supply.”

Depending on where you live and your insurance coverage, these medications could cost upwards of $1000 per month.

 

Illegal selling market

These shortages, plus the lack of insurance coverage when prescribed for weight loss, have created yet another online scam industry – with websites illegally selling them at deep discounts, without the need for a prescription.

The National Association of Boards of Pharmacy has identified more than 35,000 websites illegally selling these drugs, with new ones popping up daily, each with the potential to cause harm.

Illegally purchased GLP-1 agonists may be adulterated, contaminated, improperly stored and transported, ineffective, or unsafe. In many cases, the active ingredient in illegally purchased Ozempic or Wegovy isn’t the base form of semaglutide that’s used in the approved drugs. Instead, compounders may be using salt forms of semaglutide, including semaglutide sodium and semaglutide acetate, which don’t act the same.

Potential Drawbacks

  • They are a long-term medication, not a temporary quick fix. Stopping the medication can result in weight gain. 
  • All but one GLP-1RA must be taken by injection.
  • Potential injection site reactions and erythema.
  • Some common side effects include nausea, vomiting and diarrhea which usually improve as you continue using the drug.
  • Low blood sugar (hypoglycemia) risk, usually only when being taken with another blood-sugar-lowering drug.
  • GLP-1RAs are not recommended if you have a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia. Lab studies have linked these drugs with thyroid tumours in rats. But until more long-term studies are done, the risk to humans isn’t known.
  • Not recommended for those who have had pancreatitis.
  • Should be avoided in patients with gastroparesis or inflammatory bowel disorders.
  • Small potential for high-risk adverse events.

Nutritional Considerations

When losing weight, the goal is to lose fat mass and retain lean body mass (LBM). The faster weight comes off, the more difficult it can be to maintain lean body mass – and the loss of LBM can result in a slower metabolism. 

For anyone starting a weight loss journey with or without medication, you need sufficient nutrition – especially protein – to help retain LBM. You should also be engaging in regular movement, including strength training to help maintain LBM. If you plan to start a weight loss medication, consider speaking to a Registered Dietitian to help you provide your body with the nourishment it needs to feel your best! You can book a strategy session with me online right now by clicking here. 

You can also increase your GLP-1 levels naturally to help with weight loss by consuming a diet higher in:

  1. fibre, such as fruits, vegetables, whole grains, legumes, nuts, and seeds
  2. lean protein, such as chicken, turkey, fish, shellfish, lean cuts of meat, tofu, tempeh, edamame, Greek yogurt, cottage cheese, milk, and protein powder
  3. healthy fats, like avocados, avocado oil, olives, olive oil, nuts, seeds, fatty fish, and nut/seed butter
 
If you need help meeting your fibre, protein or healthy fat needs to nourish your body well and achieve your goals, let’s work together!

My opinion

From what we know right now, these are fantastic medications for what they are intended to do and who they are intended for. Drugs go through extensive testing and can become approved for specific populations. The problem I have is that due to the celebrity status and popularity of the drug, many people are using it “off-label”. Ozempic is indicated in Canada for people with type 2 diabetes. Wegovy is indicated in Canada for people managing obesity or who are overweight plus have a weight-related comorbidity.  It is not (yet) indicated for the average teenager or celebrity to lose 10 pounds just because. This has caused some people managing type 2 diabetes, obesity and significant weight-related comorbidities (who desperately need the medication) to not always have access to it.

Lastly, before starting a GLP-1RA for weight loss, it’s VERY important to understand they are not quick fixes. You can’t just take the medication, lose the weight and then stop the medication. Your body does a variety of physiological adaptations as you lose weight and when you stop the drug, weight gain happens. Taking your medication is a lifelong thing, so be sure you are committed to that before starting. 

Weight loss doesn’t necessarily equate to health. You could take Ozempic to lose weight AND still smoke, have a poor diet, be sedentary, lack sleep, etc. Achieving good health is about more than a weight loss aid. Consider your daily lifestyle habits.

My transformation program is designed to provide high-level support and accountability to improve your diet and build better lifestyle habits. The weight loss is slower, but you don’t have to pay for a costly drug or inject yourself for the rest of your life. In my program, you’ll learn how to permanently change your habits, not temporarily fix them.

PLEASE NOTE:

I’d love to know if this was helpful to you! If you have any questions, please DM me on Instagram or comment below.  

 

All blog posts are written for general nutrition improvement and should only be used as a guide. This article is intended for educational purposes only and is not designed to diagnose, treat, prevent or cure any condition. It is not specific advice for any individual. Before adding supplements to your regimen, please speak to your healthcare professional.

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@balancewithkrista

Krista Williamson

Registered Dietitian

Hi, I’m Krista! I am a Registered Dietitian on a mission to show people how to feel better in their bodies with balance! Healthy eating shouldn’t be so restrictive + complicated. 

Eating balanced means nourishing your body and your soul so you can optimize your physical health without sacrificing your mental health.

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