GLP-1 Science & Stigma
I received a comment on Instagram yesterday that touched me (https://lnkd.in/eKRwJerb). I want to talk about it.
First, let’s agree on the premise that GLP-1 receptor agonist like #Ozempic are effective for weight loss, but also come with potential side effects and socioeconomic issues. This is not a black-and-white matter, but one that deserves nuance.
To cheat on nuance only dissolves productive dialogue before it's begun.
I will also be forthright that I am not the right person to comment on the clinical utility or socioeconomic complexity with respect to these drugs. I am not an experienced clinician nor am I an economist or sociologist. But I am a scientist and a human being. Here is what I have to say:
From a biological perspective, obesity is a disease, and just like cardiovascular disease it cannot be conquered by willpower alone.
The fight is not against the mind, but against physiology.
Take the concept of "Food Noise," as one example: where a patient can't stopping thinking about food -- the idea of food nags them and nags them until this mental chatter drives them to have a snack they’ve been trying to resist.
One could misattribute "indulgence" to a "weak will," but this is harder to do when we understand the biological basis this "Food Noise" phenomenon: (Relating to pre-ingestion satiation neuron hypoactivity in the dorsomedial hypothalamus: more, here: https://lnkd.in/eKRwJerb)
Perhaps some may be put off by the medicalization of human experiences. But I for one feel it's functional. It provides a way of reframing and understanding why an intervention, like a GLP-1 receptor agonist, could - for some patients - represent more than a crutch but a catalyst for behavior change.
There are, in fact, many lessons to learn.
For example, we could ask the question: why is Mounjaro more effective than Ozempic?
When we dig into the physiology, we find that Mounjaro differentiates itself based on its ability to improve metabolic flexibility at fat cells (https://lnkd.in/eqX59xcj)
And there's much more to learn.
As another example, one could also what "root cause(s)" contribute to GLP-1 deficiency in metabolic diseases? There's now research on how microbiome shifts with Westernized diets can lead to mitochondrial in gut cells that produce GLP-1, leading to a GLP-1 deficiency and metabolic dysfunction in #obesity.
We can go on and on, but I did want to comment on the instagram comment.
I STRONGLY discourage judgement against those who use these medications along their metabolic health journey. Population health decisions and broad socioeconomic issues don't necessarily reflect on an individual's choice for themself.
GLP-1RA can – in their best form – be catalysts for life-long behavior change.
In building a metabolic health community, we can simultaneously share data & opinions, and respect that everyone has their own experience. In summary: don’t be an ***. Be human.
Qualified nutritionist, specialized in weight loss and metabolic health
2moBeyond the language and the emotions, as a nutritionist, I have to say Ozempic is the worst news ever. In a few years we'll come to realize the damage. But great piece :).