When Ozempic And Wegovy Fail To Work- Why GLP-1 Drugs Aren’t The Magic Bullet For Everyone
Ozempic and Wegovy have received a lot of publicity as revolutionizing treatment options for obesity. Both medications form a class of GLP-1 receptor agonists, which mimic a hormone in the body called glucagon-like peptide-1 and are involved in the regulation of appetite and blood sugar. Indeed, in initial clinical studies, the majority of those on the drugs lost 15% to 22% of body weight, hence much optimism. For most patients, these medications are underwhelming for about 20% of patients due to minimal weight loss or other challenges.
Take a closer look at why the weight loss drugs may not work for everyone, together with what options exist when they don't deliver the expected outcomes.
While GLP-1 receptor agonists have produced phenomenal responses in a majority of patients, it remains a reality that these drugs work differently for different people. Here's why:
1. Genetic and Hormonal Variability
Weight loss medications interact with complex systems in the body that differ from person to person. Genetics, hormones, and individual brain responses to energy regulation play significant roles in determining how a person responds to drugs like Ozempic and Wegovy.
2. Underlying Medical Conditions
Other conditions, such as sleep apnea, may be prevalent and prevent or delay the achievement of weight loss goals. Prescription drugs like antidepressants, steroids, or contraceptives are other medications that can nullify weight loss medication benefits.
3. Unrealistic Expectations
Often, they come to these medications with enormous hopes; expecting the promised rapid and dramatic weight loss. Progress creates disappointment if it has not stalled. In patients who rigidly follow recommended lifestyle modifications, frustration and disappointment are most common.
For most patients, the effectiveness of GLP-1 receptor agonists is evident within a few weeks of treatment. Weight loss typically begins within a few weeks of initiating therapy and tends to increase with dosage. However, some patients respond very little, if at all, despite strict adherence to their regimen.
For nonresponders, this can feel like a dead end. However, understanding the unique complexities of obesity is essential. This condition stems from brain dysfunction, and the pathways that contribute to weight regulation differ among individuals.
When Ozempic or Wegovy doesn’t yield desired results, there are still many paths to explore:
For example, some patients who don't respond well to one GLP-1 receptor agonist might find success with another drug in the same class. Newer medications, such as Zepbound, target other hormone pathways and seem promising even for those not responsive to earlier drugs.
While there is much to say about newer drugs, older treatments can still be useful and work for some patients. One can also seek the help of a medical provider specializing in obesity treatments in order to identify the best alternatives.
Diet, exercise, sleep, and stress management continue to be integral components of any weight loss program. New changes may be small but can make an enormous difference in one's health and success.
It is a complex disorder, and most patients should receive a multidisciplinary treatment. Collaboration with an obesity-aware doctor may mean access to tailored treatment plans, ranging from psychological support all the way to metabolic testing, and many others.
For others, side effects like nausea, vomiting, or diarrhea hinder them from continuing with these drugs. These symptoms often reduce as the body becomes accustomed, but for some, they might be severe enough to stop treatment altogether. In those instances, alternative drugs or procedures become vital to find.
Another largely unexplored area relates to GLP-1 drugs' long-term effects on the brain's regulation of hunger and satiety. Although GLP-1 drugs suppress appetite and can lead to effective weight loss, emerging research suggests that they may also affect brain reward mechanisms, changing the way patients experience foods.
This aspect could prove of paramount significance in the future treatment of obesity. Perhaps GLP-1 receptor agonists do indeed affect and rewire the brain's reward pathways and will thus provide sustained benefits beyond discontinuation. However, more research is required to understand this phenomenon fully.
While for many, Ozempic and Wegovy have revolutionized obesity treatment, these are certainly not a one size fits all. Nonresponders need not lose hope- alternative strategies and medications abound. A consultation with an obesity expert healthcare provider is essential to put together a comprehensive, tailored treatment plan.
The route toward effective weight loss may be challenging, but with the evolution of obesity medicine and a better understanding of individual needs, there is a path forward for everyone.
Credit: Canva
A two-year-old boy from Bristol, UK has died from a rare heart disease, known to mostly affect children with only flu-like symptoms, on January 8.
Hudson Martin had been diagnosed with Kawasaki disease when he was seven months old and was placed on lifelong medication including aspirin and blood thinners to reduce the risk of clots. Since then, he had been living a normal and happy life, according to father Damien Martin.
He told Bristol Live: "You’d never know anything was wrong from pictures or videos. He bounced off everything. He loved climbing, dancing, music, he was a proper daredevil."
But days before his third birthday, he suddenly collapsed while playing at home. Despite being given CPR by paramedics for an hour, his heart did not restart and he passed away.
“They did absolutely everything they could,” Damien said. "His heart just wouldn't come back."
Also known as mucocutaneous lymph node syndrome, Kawasaki disease causes inflammation in the walls of small to medium-sized blood vessels that carry blood throughout the body which can damage to the heart and blood vessels, mostly in children younger than five years old.
When this happens, the heart doesn't work as well to pump blood to the body and could burst (coronary artery dilation and aneurysms). It also causes swelling in the lymph nodes and mucous membranes inside the mouth, nose, eyes and throat.
Apart from a 102.2 degrees Fahrenheit (39 degrees Celsius) fever that can last for five days, children with Kawasaki may also experience some or all of the following symptoms:
It remains unknown what causes Kawasaki disease in children and if it affects adults.
Diagnosis involves ruling out other diseases that cause the same symptoms which include:
While this non-contagious disease can be treated with a mixture of antibodies given through the veins (intravenous immunoglobulin) and aspirin, it remains uncurable. Doctors may also advice steroids if intravenous immunoglobulin is not effective.
After receiving treatment for Kawasaki disease, most children recover fully and long-term follow-up care remains unnecessary. However, children who have suffered through aneurysms or other complications related to the disease will need lifelong monitoring with a cardiologist.
Credits: AI Generated
Cases of scabies, a highly contagious skin condition caused by microscopic mites, continue to remain higher than normal across England this winter, according to the latest surveillance data. Recent findings from the Royal College of General Practitioners’ Research and Surveillance Centre indicate that scabies has been spreading more widely than expected over the past few months, with infections steadily increasing through autumn and winter.
Overall, reported cases have stayed above the usual five-year average, with the sharpest rise recorded during the final four months of last year, particularly across northern regions of the country. With scabies infections continuing to climb, concerns are growing around which treatments are safe to use, especially when it comes to children.
Scabies is caused by a microscopic parasite known as Sarcoptes scabiei. This mite burrows into the top layer of the skin to lay its eggs, triggering severe itching and a red, spotty rash that often becomes more intense at night. Although the mites are too small to be seen easily, measuring less than half a millimetre, the body reacts to their saliva, eggs, and waste, leading to an allergic response.
Scabies spreads through prolonged skin-to-skin contact and can affect people of all ages. According to the NHS, it is most commonly transmitted through close household contact, including between partners, family members, people living together, and during sexual activity.
UK Health Security Agency surveillance data shows that scabies cases reported through sexual health services remained relatively stable before the COVID-19 pandemic, but numbers began rising sharply from 2022 onwards. Diagnoses increased from 3,393 cases in 2023 to 4,872 cases in 2024, marking a 44 per cent rise.
Both the UKHSA and the British Association for Sexual Health and HIV (BASHH) suggest several reasons could be driving the surge:
Experts also caution that the actual number of cases is likely much higher, as the available data only reflects diagnoses made in sexual health settings.
Ivermectin is an oral antiparasitic medicine used to treat scabies by paralysing the mites. It offers a systemic alternative to topical creams and is often considered in cases that are widespread, severe, or involve institutional outbreaks. Because the drug does not kill scabies eggs, a second dose is usually required after seven to fourteen days to target newly hatched mites.
According to the Centres for Disease Control and Prevention, ivermectin is generally well tolerated, improves treatment compliance compared to creams, and has been widely used in mass drug administration programmes, though repeat dosing is important due to its limited effect on mite eggs.
Despite its broad use in programmes targeting conditions such as river blindness, intestinal worms, and scabies, ivermectin has traditionally not been recommended for children weighing under 15 kilograms, largely due to limited safety data. However, researchers revisited this concern following a systematic review and meta-analysis that suggested the drug could be safe even in children weighing as little as 11 pounds.
In a double-blind clinical trial, researchers assessed the safety, effectiveness, and pharmacokinetics of ivermectin in young children with scabies. A total of 240 children weighing between 11 pounds and under 33 pounds in The Gambia, Kenya, and Brazil were randomly assigned to receive ivermectin at doses of 200, 400, or 800 micrograms per kilogram alongside a placebo cream, or placebo tablets alongside permethrin cream. Blood samples were collected on days 0, 3, 7, 10, and 14 to monitor biochemical markers, drug levels, and blood health.
The findings showed that ivermectin was effective in treating scabies, with just one serious adverse event reported. This involved a temporary increase in liver enzymes, which returned to normal levels within 32 days. All other side effects possibly linked to the treatment were mild, resolved on their own, and were similar to those seen in children weighing more than 33 pounds.
“Outcomes from the Ivermectin Safety in Small Children trial will hopefully provide greater reassurance that ivermectin can be safely used in children weighing less than 15 kilograms,” said lead study author Kevin Kobylinski, PhD, an honorary visiting research fellow at the University of Oxford with the Mahidol Oxford Tropical Medicine Research Unit in Bangkok, in an ASTMH press release.
Credits: iStock
Historically too, TB was one of the deadliest diseases, which killed 1 in 7 people in the US and in Europe in the late 1800s. However, with the development of antibiotics and strong public health efforts, cases have declined significantly over the 20th century. However this is for the second year in a row that TB cases have increased in the US. The number has reached their highest levels in over a decade.
According to preliminary data from the Centers for Disease Control and Prevention (CDC), more than 10,300 cases were reported in 2023—an 8% increase from the previous year. This marks the highest number of TB cases since 2011.
Both the total number of cases and the infection rate have gone up, with 34 states reporting an increase. The rise has been observed across all age groups.
Tuberculosis (TB) is a bacterial infection that primarily affects the lungs but can spread to other parts of the body. It is transmitted through the air when an infected person coughs or sneezes. Without proper treatment, TB can be fatal.
While TB symptoms depend on the affected area, the most unique symptom is a persistent cough, which lasts more than 3 weeks. This could also be mixed with mucus and or blood, along with chest pain, night sweats, unexplained weight loss, fever, fatigue and even appetite loss.
Extrapulmonary TB could also lead to swollen glands like neck, severe back pain in the spine, and headaches, confusion, or even blood in urine. A person with active TB may experience symptoms including: a severe cough that lasts 3 or more weeks.
What makes TB unique is how it has shaped civilization, as noted The Fault in Our Stars writer John Green. His book, Everything is Tuberculosis: The History And Persistence of Our Deadliest Infection.
The book is also inspired by a young person's battle with disease, who Green had met in Sierra Leone.
He shares, "I met Henry [Reider] at a tuberculosis hospital in Sierra Leone, a boy who had been living with multidrug-resistant tuberculosis. I thought he was 9 years old, the same age as my son, Henry.”
Read: John Green’s ‘Everything Is Tuberculosis’ Explores The Disease’s Stigma And Strange Romanticization
However it turned out that the boy was not 9. He was 17. "He'd just been so stunted by malnutrition and by tuberculosis that he looked much younger.”
Reider took Green around the hospital, and as he charmed him with his way, Green could not help but notice that the disease is eating him alive. "He was already on the last line of available antibiotics," said Green. "As one doctor put it, that is the point where you put the stethoscope down here - there was very little that was believed could be done for Henry."
However, over the years, he gained access to treatments common in wealthy countries and Green stayed in touch. He slowly got invested with the diseases and the injustices that had happened. He in fact explored origin stories and found that TB led to mass migrations to Western states, underpinned the creation of Stetson hat and spurred the assassins that kicked off the World War I.
Green also mentioned that there is such an extent of the inequity that it almost gets really hard to imagine. " But since tuberculosis became curable in the mid-1950s, we have allowed over 150 million people to die of the disease. It's one of the great marks of shame in human history, I think. I had no idea about that. I had no idea that tuberculosis was even still a thing. I thought of it very much as that disease of British romantic poets. But then I met Henry at a tuberculosis hospital in Sierra Leone, a boy who had been living with multidrug-resistant tuberculosis," he said.
He also highlighted how TB patients were treated as "special souls". This disease soon became a sign of creativity and sensitivity. However, he rightly wrote that "romanticization is not a kind or generous way of treating the ill".
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