Ep. 115: Is Ozempic (Semaglutide) Right For Me?
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Obesity is the leading preventable cause of death, with about a third of North Americans classified as obese. One of the few effective treatments was bariatric surgery. Health Canada recently approved a new weight loss drug, semaglutide, also known by the brand names “Ozempic” or “Wegovy.” Experts refer to it as a “game changer” for its ability to curtail appetite and spur weight loss. In this episode, Medcan’s director of weight management, Dr. David Macklin (above left), a co-author of Canada’s national guidelines for obesity treatment, provides host Shaun Francis (above right) with a semaglutide explainer. “We’re in a super exciting stage in my field of medicine,” Dr. Macklin says. “I can safely say that 2022, for a number of reasons, will be characterized in history as the first time that we have a very effective non-surgical treatment for [obesity].”
LINKS
Book an appointment or read more about Medcan’s Weight Management program.
Learn more about Dr. David Macklin by visiting his website, or Twitter page. Watch his presentation on the brain, food and weight management.
Read the Canadian Adult Obesity Clinical Practice Guidelines, co-authored by Dr. Macklin
Read up on Ted Kyle’s posts on semaglutide in his blog, ConscienHealth
Check out some scientific research on the effects of semaglutide:
Read about the results of the SUSTAIN 6 trial: Cardiovascular Safety and Benefits of Semaglutide in Patients With Type 2 Diabetes: Findings From SUSTAIN 6 and PIONEER 6 in Frontiers in Endocrinology
Once-Weekly Semaglutide in Adults with Overweight or Obesity in The New England Journal of Medicine 2021
Semaglutide for weight loss in Canadian Family Physician 2021
The New England Journal of Medicine on tirzepatide versus semaglutide for patients with Type 2 diabetes.
INSIGHTS
Obesity is a brain condition. According to Dr. Macklin, around 70 percent of one’s risk of struggling with weight in their lifetime is conferred genetically, and it has nothing to do with willpower or dieting. “It’s a progressive condition, which makes struggling with weight more difficult over time, and it’s strongly environmentally influenced,” says Macklin. “It’s a real condition, it’s not your fault, and treatment does exist.” [3:24]
When we eat food, the GLP-1 hormone gets released from our gut. “It will travel to your brain, and it’ll create a signal saying ‘I’ve had enough,’” says Dr. Macklin. Semaglutide is about 94 percent identical to our naturally produced GLP-1, and sends that same appetite-suppressing signal to our brain to help us avoid cravings. The 6 percent difference? That’s to make sure the drug is able to circulate in the body for a full week, rather than the two minutes that it takes for our own GLP-1 to break down. [11:14]
Regaining weight is a biological urge. Our brains forever remember the most we’ve weighed, and spur our appetites to get us back to our heaviest. “If our ancestors lost weight, it wasn’t to look good at a wedding or because bathing suit season was coming. It was because the food supply was interrupted,” says Dr. Macklin. “The brain will combat weight loss by increasing appetite and decreasing metabolic rate.” When on semaglutide, the brain doesn’t fight as hard because the drug is sending the brain a signal—“I’m full.” Dr. Macklin says semaglutide “diminishes motivation and drive toward food.” [13:21]
Semaglutide is a game changer in the weight loss field. “The outcomes are quite remarkable. We’re seeing up to 21, 22% mean weight loss, lost and kept off,” says Dr. Macklin. These numbers were previously only achievable via surgery. Semaglutide is a weekly injectable medication, which many patients prefer to a daily pill, according to Dr. Macklin. “The way people describe it is, that there’s not only no discomfort, but most people say they don’t even really feel anything.” [29:50]
Lots of data and research exists on the safety and side effects of semaglutide. The most common side effects are mild nausea and mild heartburn. But being on semaglutide may have more positive side effects than negative. “If you're at risk of heart disease, and you have diabetes, just being on [semaglutide] means that you will experience a reduction in your risk of heart disease and a reduction in your risk of stroke. And those changes are independent of weight loss,” says Dr. Macklin. There is also evidence that semaglutide can lower risk of cancer, and reduce the progression of dementia. [27:11]
More safe and effective semaglutide-like drugs are coming, says Dr. Macklin. “There's another medication called tirzepatide… they copied two of these appetite hormones and bound them together and it looks like it might be even more effective in weight management.” That one is perhaps two years from the market, Dr. Macklin believes. Farther away is a medication that combines semaglutide with something called amylin. “It'll be even more effective,” he says, showing “twice the effectiveness as semaglutide… So we're now going to be approaching the numbers that people will see in a sustainable way that they see with gastric bypass surgery.” [32:30]
*LEGAL
This podcast episode is intended to provide general information about health and wellness only and is not designed, or intended to constitute, or be used as a substitute for, medical advice, treatment or diagnosis. You should always talk to your Medcan health care provider for individual medical advice, diagnosis and treatment, including your specific health and wellness needs.
The podcast is based on the information available at the time of preparation and is only accurate and current as of that date. Source information and recommendations are subject to change based on scientific evidence as it evolves over time. Medcan is not responsible for future changes or updates to the information and recommendations, and assumes no obligation to update based on future developments.
Reference to, or mention of, specific treatments or therapies, does not constitute or imply a recommendation or endorsement. The links provided within the associated document are to assist the reader with the specific information highlighted. Any third-party links are not endorsed by Medcan.