‘Let food be thy medicine and medicine be thy food’, a familiar phrase from Hippocrates dating back to around 400 BC. While a few things may have changed in the world since then, this statement has never been more relevant. There is a rising ‘ tsunami’ of chronic condition diagnoses, both physical and mental. Along with these, an increasing reliance on prescription medications like Ozempic to treat and manage them. This is a distinct shift away from lifestyle medicine of old.
While medication can be life-changing and life saving it is not without it’s downsides. This is true in terms of side-effects and costs. Yet the lure of a quick fix very often outweighs these. And speaking of weight, this is where the need for a quick fix is most prevalent. In 2022 the global weight loss and weight managment market size was valued at US$ 224.27 billion. It is predicted to grow to around US$ 405.4 billion by 2030. It’s no surprise then that weight loss or anti-obesity medications, like Ozempic, have taken their place at the top of prescription pads around the world.
How does it work?
Ozempic is prescription medication traditionally used to manage blood glucose control in type 2 diabetics. The medication mimics a natural hormone in the body known as glucagon-peptide 1. (GLP-1) This is secreted in the intestine in response to the intake of food. This sets in motion a hormone-driven process that stimulates the increased production of insulin, a reduction in the amount of glucose produced by the liver and an overall slowing of digestion. Finally GLP-1 travels to the brain and activates the area that regulates fullness and hunger; essentially telling you to stop eating before you have even done so. By doing this, the medication doesn’t just lower your appetite. It affects the signalling between your gut and your brain, ultimately changing how your body responds to food.
The upside
The positive impact on insulin response and glucose control makes Ozempic a critical part of diabetes management. Poorly regulated blood glucose has several complications, including heart disease, kidney disease and stroke. Weight loss in itself supports overall metabolic health and improves numerous health markers including inflammation and blood pressure.
The downside of Ozempic
With the increased off-label use of Ozempic due to it’s newfound fame, supply issues have arisen making availability increasingly difficult for those who really need it. In addition, it’s a costly exercise with monthly dosages ranging in price from R1600 – R3000, and no associated reductions in general healthcare costs.
Coast and availability aside, side effects and sustainability are growing concerns. Early side effects may include nausea and vomiting together with heartburn and bloating. More serious side effects may include pancreatitis, gallstones, kidney issues and thyroid tumours or cancer. Studies investigating the sustainability of these medications have shown that the majority of users (68%) discontinued treatment within the first year. With the discontinuation comes weight regain, similar to the original weight lost.
The alternative to Ozempic
Since the medication works by mimicking natural hormones, it makes sense that there is natural option: real food. Food not only provides your body with energy, but it also provides it with instruction. Your body has multiple hormone pathways that respond differently to different types of food. Making the right food choices goes beyond satiating you – it literally changes how your body responds. So choosing the right foods means giving your body the right instructions.
There have been major changes in the global consumer environments over the past 40 years. The typical diet now widely adopted is low in fruit and vegetables and high in refined grains, isolated sugars and ultra-processed foods. Together, these dietary factors can alter the gut’s composition and function , essentially overriding the body’s natural hormone response to food and almost having the opposite effect to Ozempic: a blunted insulin resonse, and a poorly regulated mechanism of telling you when to stop eating.
A study done by Virta Health in the US found that people with type 2 diabetes who stop using drugs like Ozempic can avoid regaining the lost weight if they adopt a ketogenic diet. These results together with the successful weight loss and management experienced with a low carbohydrate, high fat diet suggests that reverting back to a diet more similar to our ancestors may be the quick fix we have been looking for all along.
Conclusion
Ultimately there is no doubt that the short-term weight loss associated with Ozempic is powerful and significant, but it’s not a lifelong solution for your weight or your health. For this you need to adopt a sustainable approach that trains your body to appreciate the fuel you’re providing it. This is what will set you up for a lifetime of healthy weight.