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Considering Weight Loss Injections? A Balanced Perspective
Are you contemplating using new weight loss injections for yourself or a family member? The allure of significant results from these medications might be strong, particularly if you’ve experienced a long-term struggle with weight management. Seeing friends or colleagues endorse these treatments could further fuel your interest. However, are these weight-loss jabs the right choice for everyone seeking to manage their weight?
Glucagon-like peptide-1 (GLP-1) agonists, their medical designation, undeniably mark a major advancement in obesity treatment, holding the potential to revolutionize the lives of numerous individuals.
Research indicates these weight management drugs might also contribute to reducing the likelihood of cardiovascular conditions, renal impairment, cognitive decline, and support addiction therapy.
However, there is concern regarding the fervent rush to acquire semaglutide (marketed as Ozempic and Wegovy) and tirzepatide (known as Mounjaro). This demand has fostered an unregulated environment, especially online, where individuals can easily purchase and self-administer these potent medications without proper medical consultation or dietary guidance.
A three-step strategy for safe utilization of weight-loss injections, addressing concerns about unsupervised use.
Prior to his passing, concerns were raised regarding the sustainability of weight loss achieved with these drugs.
He noted, ‘Evidence suggests that upon discontinuing the medication, appetite returns, and weight regain is common. Without concurrent lifestyle modifications, the lost weight is often regained, primarily as fat.’
Furthermore, these injections are not universally suitable. Some individuals find the associated adverse effects – including nausea, diarrhea, constipation, and vomiting – challenging to endure.
Links have also emerged between these drugs and potentially serious complications like bowel obstructions, acute pancreatitis, gallstones, and even thyroid cancer.
Another significant consideration is that a substantial portion of weight lost through these injections, ranging from 25% to 40%, can be lean body mass, primarily muscle.
Subsequent weight regain typically manifests as fat unless a dedicated effort is made to rebuild muscle mass through adequate protein intake and resistance training. Maintaining muscle is crucial as it aids calorie expenditure and is essential for balance, particularly as we age. Therefore, determining if weight-loss injections are appropriate for you requires careful consideration. And for those who decide to proceed, optimizing their use to ensure sustained weight management is paramount.
A comprehensive approach, integrating weight-loss medication with dietary and lifestyle adjustments, offers the most effective and enduring outcomes.
Adopting a structured plan can empower individuals to make well-informed decisions about utilizing these novel weight-loss drugs safely and effectively, potentially leading to an enhanced quality of life.
For individuals convinced of the potential benefits, combining medication with significant dietary and lifestyle changes from the outset yields the most successful and lasting results.
This approach can be implemented using a straightforward, three-stage plan.
Concerns about the long-term implications and unsupervised use of weight-loss injections.
Stage 1: Rapid Weight Reduction
Weight-loss drugs function partly by curbing appetite. While skipping meals might seem appealing, ensuring adequate nutrient intake is crucial. Establishing healthy eating patterns early on is key to maintaining weight control after discontinuing medication. Aim for a daily intake of 800 to 1,000 calories during this initial phase.
Base your diet on a moderately low-carbohydrate, Mediterranean-style eating plan, abundant in olive oil, eggs, seeds, fruits, vegetables, legumes, and fish, alongside moderate amounts of lean meats and dairy. Research supports this dietary approach for effective weight loss, muscle mass preservation, and overall nourishment. Prioritize these key nutrients:
Protein
Consume at least 60g of protein daily, focusing on sources like fish, poultry, eggs, nuts, or tofu. Protein is vital for tissue repair, immune function, and numerous bodily processes.
Protein also promotes satiety. This hunger-reducing effect is attributed to ‘protein leverage’ – the theory that the brain signals for food until protein requirements are satisfied. This explains persistent hunger after consuming protein-deficient, processed foods. A 75g cooked chicken breast offers 22.5g protein; 100g of steak provides 25g; and 100g of lentils contains 11g, as a guide.
Fiber
A significant majority of individuals lack sufficient fiber intake, essential for healthy digestion. Aim for 30g of fiber daily by maximizing consumption of vegetables, beans, nuts, seeds, and whole grains. A 100g serving of cooked chickpeas or lentils provides approximately 8g of fiber.
Fiber promotes a balanced gut microbiota, crucial for digestion, immunity, and even mood regulation.
Adequate fiber intake can also alleviate constipation, a potential side effect of GLP-1 medications. Fiber adds bulk to stool, facilitating smoother bowel movements.
Hydration is also vital during this stage. Fat metabolism naturally leads to fluid loss, so increase your fluid intake by 1-1.5 liters daily, through water or herbal tea, or more with increased physical activity.
Weight-loss drugs suppress appetite but ensuring nutrient adequacy is paramount, emphasizing dietary control and balance.
Dehydration can induce fatigue, irritability, headaches, and exacerbate constipation, a known side effect of GLP-1 drugs. Maintaining physical activity is crucial throughout all phases of this plan.
To prevent muscle loss, which can be challenging to regain, incorporate both strength training and aerobic exercise. Aim for at least two strength training sessions per week (30-60 minutes total weekly) and 150 minutes of moderate aerobic activity weekly.
Strength training can vary based on age and fitness level, encompassing free weights, gym machines, resistance bands, or structured group fitness classes.
High-intensity circuit training (HICT) effectively combines strength and aerobic exercise, offering full-body benefits. Search ‘seven minute workout’ online for accessible routines.
Stage 2: Discontinuing Injections
As you approach your desired weight, consider gradually decreasing your GLP-1 medication dosage. Consult your physician to create a suitable tapering schedule. Consider these practical tips:
● As medication reduces, you may re-experience ‘food noise’ – internal urges prompting snacking or overeating.
Increased vigilance helps prevent reverting to previous habits. Joining a weight loss support community (like the Fast 800 online forum) can be beneficial.
● Emphasize nutritious, satisfying Mediterranean-style meals, meeting daily protein and fiber goals to control hunger effectively.
● Intermittent fasting, like the 5:2 method, can be beneficial, creating periods of fat-burning.
Choose two days weekly for calorie restriction to 800-1,000 calories, and consume larger portions on other days, adhering to the Mediterranean style diet.
Fasting days are effective for fat reduction. Time-restricted eating, extending your overnight fast to 12 hours, enhances fat burning as the body transitions to this mode after this duration.
● Regular self-weighing is recommended. Monitoring weight closely facilitates prompt intervention for minor weight gains. Implement additional ‘fast’ days if weight starts to increase.
● Initial motivation is often high due to reduced food noise and weight loss progress. However, clarifying long-term motivations upon medication cessation is key.
Motivations could include reducing or discontinuing diabetes medication (under medical supervision) or achieving fitness for activities like playing with children.
Research at Newcastle University showed type 2 diabetes remission possible through weight loss.
Long-term weight maintenance correlates with improved physical and mental well-being, effective goal setting, regular exercise, and supportive relationships.
Stage 3: Sustained Success
Discontinuing or reducing GLP-1 medication is a desirable goal post target weight achievement. By this point, healthy eating and exercise habits should be ingrained. Consider these further tips for long-term success:
● Remove sugary treats and processed convenience foods from kitchen storage to minimize temptations.
● Avoid self-recrimination for occasional dietary lapses. A University of Canterbury study (2014) linked ‘guilt’ associated with consuming restricted foods, like cake, to poorer dietary control and reduced weight maintenance success.
● Prioritize consistent, quality sleep. A Danish study indicated individuals regaining weight after 2st (13kg) loss with liraglutide (a GLP-1 jab) were linked to poor sleep quality.
Key Questions Before Starting Injections
Consider these six crucial questions before committing to weight-loss injections:
- Am I prepared for potential side effects like nausea, constipation, vomiting and diarrhea?
- Am I comfortable using a medication without extensive long-term safety data at current dosage levels? While low-dose GLP-1s have been used for type 2 diabetes for 20 years, higher weight-loss doses are newer (since 2021), lacking long-term health effect studies.
- Am I willing to potentially reduce food enjoyment?
- Is this medication suitable for me given my health history? Caution is advised for individuals with gallstones, thyroid cancer risk, or pancreatitis history. Weight-loss injections are generally not recommended for BMI under 27. (Licensed privately for BMI over 27 with weight-related complications, safety outside criteria is less established.)
- How will I ensure healthy living and weight maintenance post-treatment?
- Am I prepared for the ongoing expenses? Private prescriptions typically range from £150-£300 monthly. Long-term use may be necessary without sustained diet and lifestyle changes.
Some individuals opt for long-term low-dose maintenance to prevent relapse. Some private practices offer ‘micro-dosing’ starting with very low doses and ‘booster’ doses as needed.