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.
Credits: Assignment
A one-year-old baby from Uzbekistan rom suffering from a rare genetic liver disorder and was saved by his father who donated a part of his liver. The child was suffering with Alagille syndrome. The timely intervention of the doctors as well as father stepping in saved the child from a life-threatening disease.
Right after birth the child got jaundice, while it is common for newborns, and appears two to three days after birth, it often resolves in one to two weeks. However, this was not the case with him. The baby required neonatal intensive care. When he was of just two months, he was diagnosed with biliary atresia, a condition that blocks the normal flow of bile from liver. The baby underwent a Kasai procedure, which is a surgery performed in infancy to help restore bile flow.
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However, his condition continued to worsen. The baby suffered from persistent jaundice, severe itching, poor weight gain, delayed growth and pale stools. All of these symptoms indicated progressive liver failure.
This is when the family sought help from specialized liver care in India. Upon a careful assessment, a serious heart ailment too was detected in the baby. The investigation confirmed that the baby had Alagille syndrome.
As per the National Institute of Health, Alagille syndrome is a multisystem autosomal dominant disorder with a wide variety of clinical manifestation. Johns Hopkins Medicine says it is an inherited condition in which bile builds up in the liver because there are too few bile ducts to drain the bile. This causes liver damage.
This is caused by JAG1 gene mutation and could be passed from parent to child. If the child has one parent with Alagille syndrome, the child has 50% chance of developing the condition. Its rarity makes it appear in one out of 70,000 babies.
Upon the case review, it was identified that only a liver transplant could save the child's life, this is when his father stepped in.
Dr Ajitabh Srivastava, Director HPB Surgery and Liver Transplant, Max Super Speciality Hospital, Patparganj, whose team led the transplant said, "“Infants with prolonged jaundice are commonly evaluated for biliary atresia, for which the Kasai procedure is an early surgical treatment aimed at restoring bile flow and delaying the need for liver transplantation." However, he noted, rare conditions like Alagille syndrome could also mimic biliary atresia in early infancy.
"In such cases, the Kasai procedure may not provide lasting benefit because the underlying problem is genetic rather than structural and in fact the wrong procedure (Kasai) worsens the condition of the child. As the liver disease progressed despite early surgery, a timely living donor liver transplant became the only life-saving option," the doctor explains.
The transplant has been successful, noted Dr Srivastava, and the child is on a "steady path to recovery". The doctor especially pointed out how early diagnoses could save lives even from the rarest of the rare diseases.
Credits: Canva
Air quality has long been linked to lung and heart diseases, but its role in infertility among both women and men often goes unnoticed. In recent years, researchers have begun to better understand how long-term exposure to high levels of air pollution, especially in Indian cities, may harm fertility and reproductive health. Prolonged exposure can damage reproductive cells, interfere with hormone balance, and increase the risk of pregnancy-related complications. While pollution is not the sole cause of infertility, it adds to existing reproductive challenges and can worsen underlying problems.
We got in touch with Dr. Suchithra Reddy, Senior Consultant - Infertility Specialist, Rainbow Children’s Hospital, Sarjapur Road who helped us know more about the same.
Male reproductive health appears to be particularly affected by sustained exposure to polluted air. Fine particulate matter, especially PM2.5, has been closely associated with lower sperm count, reduced motility, abnormal sperm shape, and increased DNA damage in sperm cells. Dr Reddy said, “These changes are largely driven by oxidative stress and chronic inflammation, which directly affect the seminiferous tubules where sperm are produced. In addition, heavy metals present in polluted air may disrupt testosterone levels, a hormone essential for proper sperm development and maturation.”
Air pollution can also negatively influence female fertility. A broad review of existing studies shows that exposure to common air pollutants around the time of conception can reduce the chances of successful pregnancy and raise the risk of miscarriage. Dr Reddy said, “Pollutants frequently found in urban environments, such as PM2.5, nitrogen dioxide, and polycyclic aromatic hydrocarbons, have been shown to impair ovarian function and interfere with embryo implantation.”
Beyond conception, polluted air is linked to a higher likelihood of pregnancy complications, including preterm birth and low birth weight. This is thought to occur because pollutants can limit the supply of oxygen and nutrients to the developing fetus, leading to adverse outcomes.
Studies have shown that air pollution exposure can disturb estrogen and progesterone levels and alter hormones involved in ovulation, such as FSH and LH. These changes may result in reduced ovarian function, poorer egg quality, irregular menstrual cycles, and a higher risk of miscarriage. Together, these disruptions directly affect ovulation, implantation, and early pregnancy health.
A significant portion of pollution-related fertility issues is driven by chronic inflammation and oxidative stress. Breathing in polluted air triggers widespread inflammatory responses that can damage hormone-producing organs like the ovaries, testes, and thyroid. It can also interfere with hormone receptors and disrupt communication between the brain and the endocrine system. These internal changes contribute to hormonal imbalance and impaired reproductive function. The severity of these effects varies, and not everyone exposed to pollution will experience fertility or hormonal problems.
Not all particulate matter carries the same level of risk. PM10 consists of larger particles that are often trapped in the upper respiratory tract, making them relatively less harmful. PM2.5 particles are much finer and more dangerous, as they can travel deep into the lungs, enter the bloodstream, and reach hormone-producing organs such as the ovaries, testes, and thyroid. Because of this ability to spread throughout the body, PM2.5 poses a greater threat to reproductive health than larger particles that mainly affect breathing.
There is also evidence suggesting that fetal growth and lung development may be affected, with risks becoming more noticeable at the population level rather than in individual cases.
Air pollution is one of several factors influencing fertility in India, particularly in urban areas. Although it is rarely the sole cause of infertility, reducing exposure to polluted air can improve reproductive outcomes. This is especially relevant for couples undergoing IVF and during the early stages of pregnancy, highlighting the need to view clean air not just as an environmental issue, but as an important aspect of reproductive health.
Credits: Canva
Norovirus appears to be increasing after a 57 percent jump in hospital admissions linked to the sickness bug last week. Figures from the NHS show that an average of 567 hospital beds were occupied each day by patients suffering from diarrhoea and vomiting. Although this number remains well below last winter’s peak, the sudden rise over just one week has raised concerns that norovirus infections could soon climb further.
Experts believe the return of children to school and more indoor contact following the Christmas break may be helping the virus spread.
Jason Murphy, head of pharmacy at Chemist4U, as per The Mirror, said the virus is often underestimated. “Norovirus spreads far more easily than people realise. Even a very small amount can make you ill, and it can stay on surfaces for several days. As cases continue to climb, it’s important to move beyond basic hygiene and take more focused steps to protect yourself and others. Many people think norovirus is a short-lived illness, but it’s very persistent and passes on easily.”
Murphy added that pharmacists tend to approach norovirus from two angles. “We focus on stopping it from spreading and on helping the body cope while the infection passes. There’s no treatment that kills the virus itself, but there are ways to ease symptoms and lower the risk of problems like dehydration.”
Treat it as a hard-to-kill infection – Norovirus is classed as a non-enveloped virus, which means alcohol hand gels and many everyday cleaners do not work against it. Washing hands with soap and warm water removes the virus physically, while bleach can neutralise it on surfaces.
Use the right cleaning products – Choose disinfectants that clearly state they are virucidal or effective against non-enveloped viruses. If this is not mentioned, the product is unlikely to kill norovirus.
Get bleach dilution right – Bleach needs to be mixed correctly. If it is too diluted, it will not kill the virus. If it is too strong, it can irritate the skin and lungs. Always ventilate the room well and follow the instructions on the label.
Treat vomiting as contamination – In healthcare settings, vomiting is handled as a form of airborne exposure. Clean beyond the visible mess, air out the space properly, and assume nearby soft furnishings may also be contaminated.
Create isolation at home – If possible, give the unwell person their own bathroom, towels, and bin. This mirrors hospital infection control measures and helps limit the spread to others.
Focus on rehydration – Dehydration is the most serious risk linked to norovirus. Electrolyte drinks are more effective than water alone because they replace lost salts as well as fluids.
Take fluids slowly – Sip small amounts every five to ten minutes instead of drinking large volumes at once. This helps reduce vomiting and allows the body to absorb fluids better.
Pain relief – Once fluids are staying down, paracetamol is the safest option for fever, headaches, and muscle aches. Ibuprofen should be avoided if you are dehydrated or vomiting frequently, as it can irritate the stomach and strain the kidneys.
Be careful with anti-diarrhoea medicines – Drugs such as loperamide can slow diarrhoea, but this is not always advised because diarrhoea helps flush the virus out. These medicines may be used briefly in specific situations, such as essential travel, but should not be given to children or used if there is a fever or blood in the stool.
Help with nausea – For severe sickness, a pharmacist can recommend anti-nausea treatments. If vomiting continues, a GP may prescribe medication to help control symptoms so fluids can be kept down.
Eat gently when ready – Once your appetite comes back, start with plain foods like toast, crackers, bananas, or rice. Avoid rich, spicy, or dairy-heavy foods until you feel better.
Rest as part of recovery – The immune system clears norovirus on its own. Getting enough rest supports recovery and helps prevent further complications.
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