BBC Today – Anti-Obesity Drug Interview
Interview at 1:51:09
https://www.bbc.co.uk/sounds/play/m0026vv9?partner=uk.co.bbc&origin=share-mobile
BBC Today interviewed Professor Lotte Bjerre Knudsen last week to discuss anti-obesity drugs which are being ‘hailed as game-changers for the NHS and for millions of patients’. Professor Lotte Bjerre Knudsen is The Chief Scientific Advisor of Novo Nordisk, the Danish company who manufacturers Ozempic.
During this report Emma Barnett discusses the medicalisation of obesity and giving people the ability to switch of their feelings of hunger.
How these medicine work
Professor Lotte Bjerre Knudsen described the multiple effects of these medicines.
- For people with diabetes they reduce levels of glucose in the blood via insulin and glucagon.
- To help reduce body weight the medicine works mostly in the brain. Impacting appetite regulating hormones
Risk of complications
The Chief Scientific Advisor was asked about the risk of complications of these medicines and responded that this class of medicine was first marketed in 2005 and is very well described.
Concerns about thoughts of suicide and self-harm in users
The reporter asked about reports of users having suicidal thoughts and self-harming. Professor Lotte Bjerre Knudsen responded,
‘There will always be a description of side-effects with medicines when they are this widely used. There are many studies which support the safety of these medicines also when it comes to the effects that you mentioned around’ their safety.
When asked if these medicines could cause suicidal thoughts in users there was no comment.
Concern about looking at pharmaceutical solution instead of a societal solution
Professor Lotte Bjerre Knudsen’s response when asked if we should be looking at factors such as the amount of UPF we are eating instead of looking for a quick fix and if she was giving up on peoples ability to manage their own weight in the food world we live in was
Obesity is very complex, including genetic factors. It’s getting harder in the society we are living
How long should users take these medicines?
When asked about the duration of treatment with Ozempic Professor Lotte Bjerre Knudsen said ‘these medicine are proven for life-long treatment. The longest trial is around 5 years so you should expect that for most people. If you stop taking the medicine you will lose the effect.’
‘You don’t tell people to stop taking their anti-hypertensives just because their blood pressure is under control’. The Professor added some people with much more exercise or changing what they eat perhaps can stop the medicines’
Combe Grove Comment
Ozempic is a brand name for semaglutide medications produced by Novo Nordisk. Semaglutides are used in the treatment of type 2 diabetes and for weight loss in obesity. These drugs act in the same way as glucagon-like-peptide-1, GLP-1, a hormone which is released in the gut in response to eating. GLP-1 promotes the body to increase insulin secretion which reduces blood sugar levels. This action has meant semaglutide has been used for some time to treat type 2 diabetes.
At higher levels GLP-1 impacts our appetite regulating hormones in the brain and it is this action which can cause significant weight loss.
Concerns Raised on anti-obesity drugs
- Severe loss of muscle mass with new research indicating semaglutide may shrink the human heart as well as other muscles. Research published in the Lancet showed 40% of weight lost using anti-obesity drugs is lean muscle mass.1
- Weight is regained typically regained after stopping anti-obesity drugs
- Side effects such as nausea, vomiting, diarrhoea, GERD, bloating, constipation, gastroparesis, gallstones, headaches and fatigue are reported
- Neuropsychiatric issues such as anxiety, depression and suicidal ideation have been reported
- Requiring expensive on-going prescriptions
- Can be viewed as a quick-fix and do not address the root cause of obesity and poor metabolic health
Whilst anti-obesity medicines can help people to lose weight, lifestyle interventions can provide a sustainable alternative without the risk of complications. The power of making changes across The Five Roots of Metabolic HealthTM should not be underestimated. Shifts in nutrition, movement, sleep, environment and mindset can always improve metabolic health, often dramatically and rapidly. Reductions in body fat, and in particular visceral fat, is one of the markers in health which improve as Metabolic Health is rebalanced.
Focusing on lifestyle changes addresses the core roots of obesity and many other health challenges therefore negating the need for treatment with medicines. In fact de-prescription is common, with this approach helping patients to reduce or stop multiple medications when working with a health professional.
At Combe Grove we believe in empowering individuals to take agency for their health through education on the most impactful changes they can make across nutrition, movement, sleep, environment and mindset for their current life-stage. When people are told they can change their health and wellbeing. That they can improve their body composition. When individuals are given hope they feel confident and excited about making key changes and changing their health story.
Utilising a Metabolic Health approach can stimulate our bodies GLP-1 receptors providing a non-pharmaceutical alternative to anti-obesity drugs. Here are a few examples of changes across The Five Roots of Metabolic HealthTM which can help GLP-1 production.
- Prioritising protein, natural fats and fibre help trigger the release of GLP-1
- Including fermented foods such as kimchi, kefir and kombucha regularly can increase the production of GLP-1
- Taking a brisk walk after meals can help stimulate GLP-1
- Strength training and aerobic exercise can help with appetite regulation and improve insulin sensitivity helping with weight loss and blood glucose control
- Making the time for restorative sleep can ensure GLP-1 production is not disrupted
- Putting a stress management plan to balance hormones as chronic stress can interfere with the production of GLP-1
These strategies tackle the underlying causes of weight gain by restoring metabolic health. In addition to aiding weight management, they offer numerous health benefits, including enhanced mental and physical wellbeing, relief from constant hunger and cravings, and the opportunity to live a life without limitations.
Reference
- Prado, Carla M et al. Muscle matters: the effects of medically induced weight loss on skeletal muscle The Lancet Diabetes & Endocrinology, Volume 12, Issue 11, 785 – 787
