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.
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If you think that injections of botulinum toxin -- commonly known as Botox -- are only used to make skin wrinkle-free, you may be mistaken.
A new study led by US researchers has shown that Botox injections can act as a “rescue therapy” to treat conditions such as finger ulcers, digital ischemia, and gangrene that are difficult to manage with standard therapies.
Finger ulcers (or digital ulcers) are painful open sores, while acute digital ischemia causes the fingers to become extremely painful, cold, and sometimes pale or bluish in color. Gangrene is the dangerous death of body tissue (necrosis), often turning skin black, green, or purple.
These debilitating complications, often associated with conditions like lupus, rheumatoid arthritis, systemic sclerosis, or bacterial infections, are caused by reduced blood flow to the fingers and heal poorly.
Botox injections, which work by reducing blood vessel constriction and improving circulation, may help achieve complete healing of lesions in more than 85 percent of such patients, according to a study recently published in JAMA Dermatology.
“These new findings are particularly important because therapeutic options remain limited for the cutaneous and vascular manifestations of systemic sclerosis and other autoimmune diseases,” said Dr. Netchiporouk, a scientist in the Infectious Diseases and Immunity in Global Health Program at the Research Institute of the McGill University Health Center.
Netchiporouk noted that the available vasodilator and immunosuppressive treatments are generally administered intravenously.
In contrast to Botox injections, these are also costly, minimally effective, and associated with significant adverse effects.
Also read: Botox Helped Her Burp: How Injectables Changed A 25-Year-Old's Life
The study also described the case of a 50-year-old man with a rare autoimmune disease that caused joint pain and digital necrosis (gangrene).
While traditional medications helped reduce his pain, he was forced to stop working, and the condition severely impacted his quality of life.
However, after receiving botulinum toxin injections, his pain was relieved, and sensation improved within 24 hours, and the necrosis began to improve within two weeks.
“This treatment has become an important tool, especially for patients with autoimmune vascular diseases that result in serious health consequences and for which there are few therapeutic options,” Netchiporouk said.
Also read: Why Regulatory Clarity Is Important for Safe Aesthetic Procedures in India
The study, based on a systematic review and individual patient data meta-analysis of 30 published studies and one unpublished case involving 119 patients, found that only a few patients experienced adverse effects.
These were generally mild and short-lived, most commonly temporary muscle weakness or pain at the injection site.
“Our results show that botulinum toxin can improve blood circulation in the fingers and treat serious complications such as ulcers or gangrene, offering a safe and easy-to-administer alternative,” said Dr. Catherine Zhu, a dermatology resident at the McGill University Health Center.
Zhu added that the injections can be easily administered by rheumatologists and dermatologists in outpatient settings, reducing reliance on intravenous therapies that require hospitalization and increasing overall healthcare costs.
Importantly, in most cases, a single injection session was sufficient to achieve the desired response.
“Botulinum toxin can offer significant benefits with a favorable safety profile. It deserves further study to develop standardized protocols and optimize outcomes,” said Dr. Netchiporouk.
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Even after being preventable and curable, tuberculosis (TB) retains its status as one of the deadliest infectious diseases more than 140 years after Robert Koch announced the discovery of Mycobacterium tuberculosis (Mtb) on March 24, 1882.
A major challenge is that millions of people carry it without knowing, and current tests often miss it. This is known as latent TB infection, where bacteria exist in an inactive state in the body.
While you do not feel sick, the infection can progress to active, contagious TB disease.
Ahead of World Tuberculosis Day, on March 24, scientists at the Indian Council of Medical Research-National Institute for Research in Tuberculosis (NIRT) in Chennai, reported developing an advanced blood test that can find TB even when it's hiding, and before it gets serious.
In the study, published in the Lancet journal eBioMedicine, the researchers explained about detecting circulating cell-free Mtb DNA in the plasma of individuals at high risk of developing TB disease via a dual target-based digital droplet PCR (ddPCR) assay.
The test was targeted at adults without a clear diagnosis of TB (asymptomatic or clinically diagnosed TB).
Using the test, the team led by Luke Elizabeth Hanna from NIRT's Department of Virology and Biotechnology, found TB in the blood up to 18 months before a person was diagnosed.
They identified eight out of 10 people at risk - all before they fell sick with the infectious disease.
“The new test performed better than all existing standard TB tests combined. This test could change how we fight TB - by finding it early, treating it faster, and stopping it from spreading,” said the team in the paper.
Detection of pathogen-derived cell-free DNA (cfDNA) has been gaining much attention in recent years for the diagnosis of several clinical conditions.
cfDNA is a liquid biopsy blood test that analyzes small, non-cellular DNA fragments circulating in the bloodstream.
The team found that the advanced blood test could find tiny traces of TB in the blood - even when a person feels completely healthy.
The test works by breaking a small blood sample into thousands of tiny droplets and searching each one for TB.
The study included 46 healthy household contacts of patients with pulmonary TB who developed TB within two years of follow-up, and 92 HHCs who did not progress to TB.
Plasma was obtained and subjected to testing using a ddPCR assay targeting two Mtb-specific insertion sequences, IS6110 and IS1081.
"Our findings support the diagnostic utility of ddPCR-based detection of circulating Mtb-derived cell-free DNA in plasma of individuals at high risk for progressing to active TB several months prior to clinical diagnosis," the ICMR-NIRT researchers said.
"These findings address important unmet diagnostic needs and indicate the potential of plasma-based Mtb ccfDNA detection to contribute to improved TB case detection and progress towards the WHO End TB goals," they added.
In 2024, an estimated 10.7 million people fell ill with TB worldwide, including 5.8 million men, 3.7 million women and 1.2 million children. TB is present in all countries and age groups, according to the World Health Organization (WHO).
The WHO aims to End TB by 2035, with a 95 percent reduction in deaths and a 90 percent reduction in incidence compared to 2015.
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Down Syndrome is a common genetic disorder in which an extra copy of chromosome 21 (Trisomy 21) causes mild-to-moderate intellectual disabilities, developmental delays, and characteristic physical traits.
Every year, World Down Syndrome Day is observed on March 21 every year to raise public awareness about the condition, which deserves more than medical care.
The theme for World Down Syndrome Day 2026 is 'Together Against Loneliness,’ and it focuses on raising awareness of how loneliness disproportionately affects people with Down syndrome and other intellectual disabilities, as well as their families.
According to the UN data, the estimated incidence of Down syndrome is between 1 in 1,000 -- 1 in 1,100 live births worldwide. Each year, approximately 3,000 to 5,000 children are born with this chromosome disorder.
In India, about 30,000 babies are born with Down syndrome every year.
While Down Syndrome is not preventable, in a video post on the social media platform X, Dr. Neerja Gupta from AIIMS Delhi highlighted the importance of early detection, screening, and long-term support for better outcomes.
Dr. Gupta, Professor, Division of Genetics at AIIMS's Department of Pediatrics, also explained the causes of the condition and shared tests that can help eliminate the risks in future babies.
“Down syndrome is a common chromosomal disorder in which chromosome 21 is present in three copies instead of two. Normally, every human cell has 46 chromosomes. However, in Down syndrome, there are 47 chromosomes because the 21st chromosome is present in three copies instead of two,” she said.
Due to the increase in the number of chromosomes, the child may:
"The sooner we can catch them, the earlier we can begin the intervention, resulting in better health outcomes," Dr Gupta said.
Down syndrome can occur in three types, depending on how the extra copy of chromosome 21 is present. In all cases, chromosome 21 appears in three copies, but this can happen in different ways.
"As the mother’s age increases, the risk of Down syndrome also increases. Today, there are several prenatal tests available to detect this condition during pregnancy," the expert said.
"In this, the DNA is seen in the fetal baby's stomach through the mother's blood, to check whether the chromosomal copies are in the right number or not," she said.
The expert noted that this screening test is highly accurate, but if the results indicate a high risk, diagnostic testing of the fetus is recommended.
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