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.
Chronic stress can take a toll on sperm count. (Photo credit: iStock)
Many men believe that as long as they feel healthy, active, and free from major illness, their fertility remains intact. While men do not have a sudden fertility cut-off like women, age still plays an important role when it comes to male fertility. Currently, a large number of men wish to start families later in life, often thinking their good health guarantees easy conception and fatherhood. They often neglect the age factor, even though it is linked to hormonal imbalance, stress, and genetic issues. A large number of men are unaware of their fertility health and continue to suffer. However, even in the absence of visible health problems, older men may face unexpected fertility challenges. Dr Madhukar J Shinde, Fertility Specialist at Nova IVF Fertility, PCMC, Pune, answered this for Health and Me.
Read more: The Overlooked Role of Men in IVF: Why Their Silent Strength Is Key to Fertility Success
Decline in sperm quality: Various studies have confirmed that as men age, sperm count, movement, and shape can slowly decline. Even if the numbers appear normal, DNA damage in sperm increases with age, which can reduce the chances of successful fertilisation.
Men must stay in touch with a fertility consultant who can design an appropriate treatment plan. The expert will evaluate them thoroughly and suggest lifestyle modifications such as a well-balanced diet, exercise, stress management through meditation, and medication for conditions such as diabetes, hypertension, and cholesterol. Awareness helps men take informed steps towards parenthood, even later in life. Certain pre-medications, including antioxidants advised by a fertility consultant, may significantly help in reducing DNA fragmentation, which contributes to poor sperm function. Therefore, men should prioritise their reproductive health, stay informed, and not suffer in silence.
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High blood pressure (BP) has become a public health problem that is driving cardiovascular diseases like heart attacks and strokes globally. While medications are important to keep hypertension under control, lifestyle changes and healthy practices are also crucial.
Several global health guidelines recommend regular physical activity, but adhering to exercise programs daily becomes a challenge for many people. But in the overtly busy schedules, sparing 10 minutes for an exercise regimen can be easier than travelling to the gym.
A large randomized clinical trial, published in the Journal of the American College of Cardiology (JACC), has proved that a traditional Chinese mind-body practice — baduanjin — may help lower blood pressure, that too, without any equipment.
Baduanjin is a slow, structured movement, focused on deep breathing and meditation.
Importantly, the clinical trial proved that the ancient Chinese technique could lower BP as effectively as brisk walking.
In people practicing baduanjin, BP reductions were seen after three months and were sustained for one year.
"Given its simplicity, safety, and ease with which one can maintain long-term adherence, baduanjin can be implemented as an effective, accessible, and scalable lifestyle intervention for individuals trying to reduce their blood pressure," said Jing Li, Director, National Center for Cardiovascular Diseases in Beijing, China.
Baduanjin is a standardized eight-movement sequence that integrates aerobic, isometric, flexibility, and mind-body components.
It has been in practice for centuries and commonly performed in community settings across China. The routine typically takes 10–15 minutes and requires no equipment and only minimal initial instruction.
Because it is low- to moderate-intensity, it is considered safe and accessible for many adults.
Also read: Cardiovascular Diseases Lead As India’s Top Killer: US Cardiologist Points Out Risk Factors
A team of Chinese researchers led the first large, multicenter randomized trial to look at the impact of baduanjin on blood pressure.
They followed 216 participants, aged 40 years or older, across seven communities to determine changes in 24-hour systolic BP from baseline to 12 and 52 weeks.
Compared to people indulging in self-directed exercise, practicing baduanjin five days a week reduced
Notably, the benefits were sustained even without ongoing monitoring, a key challenge for many lifestyle interventions that struggle to maintain long-term adherence outside structured programs.
"Baduanjin has been practiced in China for over 800 years, and this study demonstrates how ancient, accessible, low-cost
approaches can be validated through high-quality randomized research," said Harlan M. Krumholz, Editor-in-Chief of JACC and the Harold H. Hines, Jr Professor at the Yale School of Medicine.
"The blood pressure effect size is similar to that seen in landmark drug trials, but achieved without medication, cost, or side effects. This makes it highly scalable for community-based prevention, including in resource-limited settings," they added.
Also read: AHA Cholesterol Guidelines 2026: How Indians Can Improve Heart Health
How To Practice Baduanjin
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Back pain is a common problem seen among middle-aged men and women, especially those sitting for prolonged hours. The pain experienced is mainly due to poor posture, lack of physical activity, obesity, and stress.
However, for some, the pain occurs in the mid-back, indicating a far more serious problem. While it may appear like chronic back pain, it may actually signal the risk of spinal tuberculosis, which can creep in silently, according to doctors.
If left untreated, the dangerous infectious disease can lead to paralysis and spinal deformity.
“If your back pain persists for months, it is localized, or if it worsens with cough/breathing, don’t ignore it; seek expert evaluation,” said Dr. Sudhir Kumar, a neurologist from Apollo Hospitals Hyderabad, in a post on social media platform X.
Dr. Kumar also shared the case of a 55-year-old man suffering from back pain for four months.
The man’s blood tests, nerve conduction studies, and MRI (neck and lower back) appeared normal. Yet his pain did not go away. He found no relief with painkillers, muscle relaxants, and rest.
Notably, his pain increased while coughing and taking deep breaths.
“That is not a random symptom. Pain that increases with coughing is suggestive of spinal nerve root irritation or compression. This immediately shifts thinking from “muscle pain” to spine pathology,” said Dr. Kumar. The expert advised an MRI of the dorsal (thoracic) spine, which suggested spinal TB.
The “MRI dorsal spine showed involvement of D8–D9 vertebrae, disc edema and paravertebral collection. These findings were suggestive of Spinal Tuberculosis,” said the neurologist, popularly known as the Hyderabad doctor.
Unlike lung TB, where prolonged fever or coughs are a key risk factor, Dr. Kumar just had persistent back pain and no fever, weight loss, or any such “typical TB symptoms”.
“This is why Spinal Tuberculosis is dangerous. It can be silent and slow, and the diagnosis can be easily missed, until it causes paralysis and spinal deformity,” Dr. Kumar said.
Tuberculosis of the spine is also known as Pott’s disease, and is named after Sir Percival Pott, who described it in 1779.
Also called tuberculous spondylitis, it is a severe form of skeletal tuberculosis where the Mycobacterium tuberculosis bacteria infect the vertebrae — typically spreading from the lungs to the spine via the blood.
Unlike routine back pain, pain due to spinal TB is persistent, progressive, and does not respond to usual rest or medication.
Early identification is crucial to prevent complications such as spinal deformity or neurological damage, Dr. Manisha Mendiratta, Director & Head – Pulmonology, at Sarvodaya Hospital, Faridabad, told HealthandMe.
The common symptoms to watch out for include:
Early evaluation is key. If symptoms persist, a detailed clinical assessment should be done. Doctors may recommend:
Dr. Mendiratta urged the need for ensuring early diagnosis and complete treatment of any TB infection. Further, maintaining good immunity through balanced nutrition and rest, as well as avoiding ignoring persistent or unusual back pain, is crucial to preventing spinal TB.
The doctor also stressed the need for regular follow-ups in people with a history of TB exposure, and to never stop TB treatment midway.
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