LEVELS – A Whole New Level

#226 - How do weight-loss medications affect metabolic health? And will Ozempic and other GLP-1s actually solve the obesity crisis? | Dr. Rob Lustig & Dr. Casey Means

Aug 17, 2023
Dr. Rob Lustig and Dr. Casey Means discuss weight-loss medications like Ozempic and how they affect metabolic health. They delve into the mechanisms of action for these drugs, their potential benefits and limitations, and the high cost associated with them. The podcast also addresses the need to address the food industry's role in the obesity crisis, concerns about using these medications in children, and the importance of individualized treatment. Additionally, they discuss the impact of tracking glucose levels, optimizing metabolic health, and the importance of education and support for long-term success in weight loss.
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INSIGHT

How GLP‑1s Cause Weight Loss

  • GLP-1 agonists mimic satiety by acting on brainstem GLP-1 receptors and reduce food intake.
  • Semaglutide (Ozempic/Wegovy) and newer drugs cause substantial weight loss by lowering appetite, not correcting metabolic root causes.
ANECDOTE

From Gila Monster To Wegovy

  • Semaglutide came after earlier GLP‑1 drugs derived from Gila monster peptides like exenatide (Byetta).
  • Novo Nordisk increased dose to create Wegovy for weight loss after observing modest weight effects with Ozempic.
INSIGHT

GLP‑1s Cause Muscle Loss Too

  • DEXA studies show GLP‑1 users lose roughly equal amounts of muscle and fat.
  • Losing muscle alongside fat resembles starvation and threatens longevity, especially in older adults.
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