Wednesday, May 22, 2024

Semaglutide, Ozempic, and Mounjaro: The Skinny on Weight-Loss Injections

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You’ve likely heard the buzz around slimming injections, the secret behind numerous celebrity weight-loss transformations. These weekly injections, known as glucagon-like peptide-1 (GLP-1) receptor agonists, were initially used to manage Type 2 Diabetes. However, they’ve now taken the weight-loss industry by storm. Ozempic and Wegovy (Semaglutide), Saxenda (Liraglutide), and Mounjaro (Tirzepitide) injections are soaring in popularity, often delivering remarkable weight-loss results comparable to bariatric surgery. Discover what you need to know before embarking on your journey to a slimmer you.

How do Ozempic and Mounjaro work?

“These new hormone classes mainly impact gut hormones,” says Chicago, IL bariatric and lifestyle specialist Neha Shah, MD. “These gut hormones communicate hunger, fullness, and insulin secretion to the brain. With medications like these, we address the root cause of cravings, particularly for sweets. Patients often experience a profound sense of fullness they may have never felt before.”

Who can get a prescription from a Telehealth provider?

Telehealth options like Sequence, Push, or Alpha medical can diagnose and prescribe weight-loss medications without serious risks. Dr. Shah emphasizes that many Telehealth providers now prescribe these medications but cautions that they can’t replace specialist monitoring. Without support, accountability, and dietary changes, these medications won’t be fully effective. A dietician can provide a metabolic workup to uncover underlying issues like thyroid conditions, diabetes, vitamin deficiencies, or anemia. This level of analysis and support may not always be available through Telehealth.

Are the side effects hard to manage?

The main side effects include nausea, vomiting, gas, abdominal pain, bloating, constipation and bouts of fatigue, but they’re temporary. While their primary aim is glycemic control, they can elicit side effects in some individuals. Side effects can gradually improve as the body adjusts. There’s also a risk of hypoglycemia, primarily when used with other diabetes drugs like insulin or sulfonylureas, and occasional injection site reactions.

The biggest concern to note, however, is the risk of thyroid cancer. “It’s not recommended for people with a personal or family history of thyroid cancer because the medication may cause thyroid tumors in some,” notes Dr. Shah.

Does where you inject help with side effects?

There are three recommended places you can inject the medication into every week: the upper arms, the inner thighs or the stomach (about 4 inches away from your belly button). If you’re experiencing side effects often and for prolonged periods of time when injecting in the stomach, Dr. Shah says switch to your inner thigh which may help decrease nausea and upset stomach, but may delay slightly the onset of appetite suppression.

Does Mounjaro cause hair loss?

The potential link between Mounjaro, or any weight-loss medication, and hair loss has raised concerns and is subject to individual variation. Some individuals using Mounjaro and Ozempic have reported experiencing hair loss as a side effect, while others may not encounter this issue. The occurrence and severity of hair loss can vary based on factors such as genetics, dosage, and individual reactions to the medication. 

Rapid weight loss can trigger hair loss and thinning due to a stress response known as Telogen effluvium. According to New York dermatologist Doris Day, MD during this phase, around 40 percent of the hair prematurely enters the resting phase, leading to hair loss. Typically, only about 10 percent of hair is in the resting phase. “This resting phase lasts for approximately three to four months before the affected hair falls out, and new hair begins to grow, creating a time lag between the onset of stress and hair shedding,” she says.

Why are there multiple doses of each injection?

Each drug has a prescribed loading dose to begin the first four weeks. In the following months, patients will gradually increase the dosage to maintain effectiveness. For example, Mounjaro’s dosing starts at 2.5mg and goes up in increments of 2.5mg (5mg, 7.5mg, 10mg, 12.5mg, and 15mg). However, if your current dose is effective and you’re achieving weight loss, there’s no need to raise it.

Metamora, IL family medicine and obesity expert Jennah LaHood Siwak, MD suggests that lower doses often result in milder side effects. She advises against rapid increases, as long-term medication use may be necessary, and escalating too quickly may limit future options. “Generally at lower dosages, people have less severe side effects. If a dose is working for you then why increase? Also, keep in mind that the goal with GLP medications is that you may need to be on this medication long-term. If we increase you too quickly, there’s no where else to go from there.”

What is the best diet to follow while on these injections?

To reduce stomach-upsetting side effects from these injections, experts recommend boosting protein intake while reducing sugar, fat, and carbs. According to Dr. Siwak, protein helps preserve lean muscle mass, leading to a faster metabolism and increased calorie burning without weight gain. Protein also has a higher diet-induced thermogenesis (DIT) compared to carbs or fat, meaning it requires more energy to digest. Additionally, protein promotes a greater sense of fullness.

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