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: iStock
Once widely known as non-alcoholic fatty liver disease (NAFLD), the common and dangerous fatty liver condition was rephrased as Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) due to its strong link to metabolic health issues like obesity and diabetes.
MASLD now includes patients with fatty liver disease linked to metabolic risk factors such as obesity, diabetes, and hypertension.
Globally, it was observed that all patients who have non-alcoholic fatty liver disease also have some associated form of metabolic dysfunction. The patients reported having either obesity, diabetes, metabolic syndrome, hypertension, or cholesterol problems.
And all these problems eventually lead to significant comorbidities later, like some people developed heart disease, while others developed complications of diabetes.
In view of these, a global consensus process in 2023 involving hundreds of experts from different countries adopted MASLD as it better reflected these underlying causes of the condition.
Also read: Lancet Study Shows Metabolic Liver Disease To Rise Over 38% By 2050: What’s Behind The Surge
MASLD is an umbrella term for liver conditions that develop in the presence of 1 or more cardiometabolic risk factors—including high blood sugar, elevated body mass index (BMI), and hypertension—but in the absence of other causes of liver fat accumulation.
The condition can be defined by excess liver fat accumulation (more than 5 per cent of liver weight) in the presence of metabolic dysfunction, independent of alcohol intake.
It encompasses a spectrum from simple steatosis to steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma.
“Initially, it was thought that having fatty liver disease without alcohol was a benign condition, but now it is recognized that, since it is associated with lots of metabolic comorbidities, it's no longer benign,” Dr. Ashish Kumar, Professor of gastroenterology and hepatology at Sir Ganga Ram Hospital in New Delhi, told HealthandMe.
He stated that whenever a diagnosis of fatty liver is present, "we should actually include other comorbidities, like obesity, dyslipidemia, which means cholesterol problem, diabetes, sugar problem, pre-diabetes, and hypertension. At least 50–70–80 percent of these patients will have one or more of these comorbidities".
Although alcohol has remained the number one risk for liver disease, MASLD seems to be rising globally, including among people who do not drink. Why?
The reasons include:
a sedentary lifestyle,
increased consumption of fast and processed food,
lack of exercise,
lack of sleep,
stressful life.
Also read: Why Regular Scans Are Crucial for Liver Cancer Patients: Doctors Explain
The experts noted that food, especially the increasingly accessible junk food or processed food, is a major culprit.
“So even if the person is not drinking alcohol, people are developing addiction to processed food, and this is causing an epidemic level of obesity and diabetes. Consequently, MASLD is also increasing, and now it is becoming the number one cause of liver disease,” Dr Kumar said.
According to Dr. Sanjay Goja, Director, Liver Transplant & HPB Surgery, Narayana Hospital, Gurugram, prevention must focus on following a healthy lifestyle like maintaining a healthy BMI, engaging in regular physical activity, and eating a balanced diet.
Controlling diabetes, cholesterol, and blood pressure is also important to prevent the risk of MASLD.
Dr Siddharth Badola, Manipal Hospital, Ghaziabad, suggested sustainable lifestyle changes such as:
Maintaining an adequate body weight: Even slight weight loss (5–10 percent) has been shown to significantly reduce liver fat and inflammation.
Follow a balanced and nutrient-rich diet: People should focus on consuming whole grains, fresh fruits and vegetables, lean proteins, and healthy fats, while limiting refined carbohydrates and processed foods.
Avoid foods with added sugar: Excess consumption of fructose, commonly found in packaged foods and sugary beverages, is a key contributor to fat accumulation in the liver.
Engage in regular physical activity: At least 150 minutes of moderate-intensity exercise per week is recommended to improve insulin sensitivity and liver health.
Manage associated metabolic conditions: Effective control of diabetes, hypertension, and dyslipidemia is essential in reducing the risk of MASLD progression.
Ensure adequate sleep and stress management: Poor sleep quality and chronic stress can negatively impact metabolic balance and liver function.
Keep your body hydrated with ample water intake and follow structured meal timings.
Credit: Canva/WHO
Women can play a major role in preventing as well as eliminating Chagas Disease, a potentially life-threatening neglected tropical disease that affects 8 million people globally and causes 10,000 deaths every year, according to UN agencies.
World Chagas Disease Day is observed every year on April 14 to raise awareness around the disease, and the impact it has on lives.
In a statement, the Pan American Health Organization (PAHO) and the Global Chagas Coalition urged health authorities to make women central to the fight against the disease and to empower them to make early detection, prevention, and care.
“Eliminating Chagas disease as a public health problem requires placing women at the center of diagnosis, treatment, and care strategies,” said Dr. Jarbas Barbosa, PAHO Director.
“Ensuring timely access to quality health services, particularly for women of reproductive age, is essential to prevent new infections and advance toward the elimination of congenital Chagas disease in the Region of the Americas,” he added.
Chagas disease, also known as American trypanosomiasis, is a illness caused by the parasite Trypanosoma cruzi, and is primarily transmitted by triatomine insect vectors.
It gets spread through
If left untreated, one third of infected people—including women and the children they carry—will develop life-altering heart, digestive, and even neurological conditions, and may even become fatal.
Once endemic to 21 countries in Latin America, the disease has now spread globally due to migration. It is now a global health concern with cases found in 44 countries including the US, Canada, Europe, Australia, and Japan.
World Chagas Disease Day was celebrated for the first time in 2020.
The theme this year is “Women at the heart of care, protecting the next generation” and underscores the key role women play in family and community caregiving, as well as their greater interaction with health services, particularly during pregnancy.
Chagas Disease: Role Of Women
According to the World Health Organization (WHO), about 2 million women aged 15-44 years are living with Trypanosoma cruzi infection worldwide.
Congenital transmission or mother-to-child transmission remains a major challenge, occurring in about 3–5 percent of pregnancies. However, it also provides a key opportunity for effective intervention.
The transmission cycle of the disease can be effectively broken by
“On the contrary, it represents a strategic opportunity to strengthen more equitable, accessible, and responsive health systems that recognize and respect women’s needs.”
Credit: Naga Munchett/ Instagram
The BBC Breakfast host Naga Munchetty has opened up about her experience of suffering from a painful womb condition, known as the "evil twin sister of endometriosis".
The 51-year-old Naga Munchetty explained her condition as adenomyosis, which can cause extreme pain at any time. Munchetty added that she has faced the condition even while presenting her show, The Independent reported.
Naga Munchetty said that adenomyosis has caused her severe pain since she was in her teens, and she has “become conditioned to accept” it.
“If you’re curled up on the floor screaming, sweating, flooding, passing out, vomiting, that is debilitating. But you end up normalizing that pain.”
Adenomyosis is an extremely painful condition, which affects the womb and causes the uterus to enlarge. Although it affects an estimated one in 10 women, it remains undiagnosed in most women.
It is a lesser-known but significantly debilitating gynecological disorder that is commonly mistaken for endometriosis.
Adenomyosis leads to debilitating symptoms such as
Adenomyosis occurs when endometrial cells—typically restricted to the lining of the uterus—break through the myometrium, the muscular wall of the uterus.
Endometriosis, on the other hand, happens when tissue similar to the lining of the uterus grows outside the uterus. These tissues commonly develop on the ovaries, fallopian tubes, or the pelvic lining.
In contrast, adenomyosis is inside the uterus but produces serious complications. These out-of-place endometrial cells continue to act as they would in a regular menstrual cycle, becoming thick and shedding, which leads to internal bleeding, inflammation, and intense pain.
Despite going to the doctors several times, Naga Munchetty was not diagnosed until recently, as she was led to believe the pain she was experiencing was “normal”.
No absolute cure for adenomyosis exists except for a hysterectomy, which involves the removal of the uterus. Nevertheless, several treatment options can alleviate symptoms and enhance quality of life. These include:
1. Pain Relief
Ibuprofen and naproxen, over-the-counter pain medications, are usually prescribed to relieve menstrual cramps and pain.
2. Hormonal treatment such as
GnRH agonists, such as Lupron, induce temporary menopause by suppressing estrogen production, thereby reducing adenomyosis symptoms. However, these injections can cause severe side effects, including mood swings, hot flashes, and bone density loss, making them unsuitable for long-term use.
4. Surgical Intervention
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