The Wrong Approach to Weight Loss

Jeffrey I. Barke, M.D.

Would you willingly take this product given its potential side effects?

The FDA’s required package insert lists the following possibilities:

• Possible thyroid tumors, including cancer. In studies with rodents, this product caused thyroid tumors, including thyroid cancer. It is not known if this will cause thyroid tumors or a type of thyroid cancer called medullary thyroid carcinoma (MTC) in people

• Changes in vision.

• Inflammation of the pancreas (pancreatitis). 

• Low blood sugar (hypoglycemia).  Signs and symptoms of low blood sugar may include dizziness or Iightheadedness, blurred vision, anxiety, irritability or mood changes, sweating, slurred speech, hunger, confusion or drowsiness, shakiness, weakness, headache, fast heartbeat, and feeling jittery.

• Kidney problems (kidney failure). In people who have kidney problems, diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration), which may cause kidney problems to get worse.

• Serious allergic reactions include swelling of your face, lips, tongue, or throat; problems breathing or swallowing; severe rash or itching; fainting or feeling dizzy; or very rapid heartbeat.

• Gallbladder problems which may include pain in your upper stomach (abdomen), fever, yellowing of the skin or eyes (jaundice), or clay-colored stools.

Ozempic, Mounjaro, Rybelsus, and Wegovy all involve the same chemical — semaglutide  — and are made by the same company: Novo Nordisk A/S of Sweden. This chemical was originally approved by the FDA to treat type 2 diabetes but recently the FDA has authorized its use for weight loss. Post-marketing studies of these diabetic medications showed that patients lost weight while using the products. This, of course, prompted the pharmaceutical company to then petition the FDA for an expanded indication that included weight loss.

Thousands of Americans are now taking these products as a result of direct-to-consumer advertising overtly promoting its weight loss attributes. Interestingly, the US is one of just two countries that allow direct-to-consumer advertising for prescription medicines; the other is New Zealand.

These medications and their advertising are part of the problem, not the solution to weight problems.

Ozempic and the others work by intervening in three bodily functions that create the potential for very serious side effects:

1.  They delay gastric emptying which makes patients feel full after eating only a small amount of food. This can also cause severe nausea and abdominal pain.

2.  They stimulate the pancreas to produce more insulin to lower blood sugar. This can cause dangerous drops in blood sugar and can cause pancreatitis.

3.  They decrease glucagon secretion which prevents the liver from releasing stored sugar which can cause liver/gallbladder issues and low blood sugar. 

At best these actions within the body will cause moderate weight loss over several months. But, in my opinion, individuals are at an unacceptable level of significant risk when they do so. 

Yet, despite the potential risks, almost every day a patient requests to be put on one of these medications. Rarely does medical insurance cover the $1,000 or more per month cost.

Importantly, the manufacturer doesn’t indicate that when the medication is stopped, the weight “lost” comes back if habits, food choices, or behavior have not changed.

There is a better way in my view to look at nutrition and weight loss. But we have to go back to what worked 100 years ago when obesity, heart disease, and type 2 diabetes were rare. In fact, we need to do what our great grandparents did. They ate real butter and cooked with lard. They purchased meat from the farmer in the neighborhood where the cows roamed the grassy pastures. They ate the organs as well as the expensive cuts. They ate fresh eggs and rarely purchased packaged food because it was so limited. Their “ice box” held enough food for a day or two, but not much more. 

Walking was a big part of family life, an exercise that many of us skip. Hours were spent reading and talking, not staring at a screen. Bedtime was when the sun went down, not when a TV program ended. In many ways, our modern society has worsened our health despite medical advances in surgery, hospitals, drugs, and other interventions.

So, you want to lose weight? Here are the 8 best things to do to achieve that goal:

1. Manage your stress. If you are significantly overweight, definitionally you have very high stress. Without addressing your adrenal fatigue from chronic stress/mental health issues, trying to lose weight becomes a fool's errand. Seek professional counseling, meditate/pray, get into nature, but you must address the stress you are experiencing.

2. Eliminate refined sugar - read the packages, it’s in everything. It adds calories and sugar is very inflammatory causing weight gain and metabolic dysfunction when you don’t even realize it is happening.

3. Eliminate inflammatory oils such as Canola, Sunflower, Corn and Soybean oil. Instead, use Olive oil, Coconut oil, Avocado oil, and grass-fed butter or ghee.

4. Eat clean: Grass-fed meats, pasture raised eggs, raw dairy including raw cow or goat’s milk, raw honey, and fruit. You will not lose weight eating salads and vegetables. You need nutrient dense, real food.

5. Hydrate with purified or filtered water - never tap water. Drink at least 64 oz of water daily.

6. Move - at least 1/2 hour of exercise daily.

7. Prioritize sleep. Get at least 7 hours per night. A few sleep tips:

• Go to bed the same time each night

• Keep your room cool and dark

• No electronics in the bedroom (no TV, no iPad, no cell phone); instead, read a book. 

• No food at least 4 hours prior to sleep.

8. Get morning sunshine without glasses in the way. Sunlight through your eyes stimulates your pineal gland which helps with circadian rhythm and natural melatonin production.

Don’t have the time to eat properly or think that eating healthfully is too expensive? The cost of illness has always far exceeded the cost of health. Or, in the words of The Earl of Derby, Edward Stanely: “Those who think they have no time for exercise will sooner or later have to find time for illness.”