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.

Why Weight Loss Drugs May Not Work

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.

Why it is Important to Identify Non-responders

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.

Alternative Treatment Options

When Ozempic or Wegovy doesn’t yield desired results, there are still many paths to explore:

1. Switching to Another GLP-1 Drug

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.

2. Use of Older Medications

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.

3. Lifestyle Changes

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.

4. Medical Management of Obesity

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.

Why Side Effects of Weight Loss Drug Ozempic May Be a Barrier

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.

Long-term effects of Ozempic or Wegovy on the Brain

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.

In today’s hyper-connected world, access to health information has never been easier. Yet, ironically, the ability to understand and apply that information remains one of the biggest barriers to better health outcomes.

This is where health literacy comes in, not just the ability to read a pamphlet or follow a doctor’s prescription, but the broader skill of accessing, comprehending, and using health information to make informed decisions for oneself, one’s family, and one’s community.

While definitions vary, there is consensus that health literacy is multi-dimensional. It involves confidence, critical thinking, and practical skills, knowing when to seek care, how to evaluate health claims, and how to follow treatment correctly. In essence, health literacy is the foundation of preventive care and treatment adherence, and its absence can be devastating.

The Challenge of Low Health Literacy in India

The scale of the problem in India is stark: nearly 90 percent of Indians have low health literacy. This gap directly affects patient outcomes, from delayed diagnoses and poor compliance with treatment to preventable complications and higher healthcare costs.

Several factors explain this reality:

• Low literacy levels: A significant proportion of the population cannot read or interpret basic medical instructions, leading to mismanagement of conditions.

• Poverty and affordability: For millions living on less than INR 100 a day, awareness alone is not enough when healthy choices remain unaffordable.

• Gender and cultural barriers: Women often have lower access to information and autonomy in health decisions, particularly around reproductive and maternal health.

• Distrust in healthcare systems: Overcrowded facilities and inconsistent care erode confidence, driving many to informal or unverified sources.

Low health literacy doesn’t just harm individuals; it amplifies inequities and strains the entire healthcare ecosystem. It also worsens misinformation, as people turn to social media or word-of-mouth for guidance, often encountering unverified or unsafe advice.

Blockbuster drug Ozempic, known for treating type 2 diabetes and obesity, has a surprising side effect. A new study published in The Lancet Psychiatry showed that the GLP-1 receptor agonists might prevent worsening of depression and anxiety.

People with diabetes or obesity are generally more likely than the general population to suffer from depression and anxiety. It is because both diabetes and obesity increase the risk of mental ill-health, and vice versa.

The findings showed that people with diabetes using semaglutide had a substantial decrease in hospitalizations and sick leave due to mental illness, including less worsening of depression, anxiety, and self-harm.

“Our findings suggest that GLP-1 drugs, particularly semaglutide, might contribute to better mental health in people with diabetes and obesity, but since this was an observational study, controlled clinical trials are needed to confirm the results,” said Jari Tiihonen, specialist physician and professor at the Centre for Psychiatry Research, Karolinska Institutet.

What Did The Study Find?

The research, led by an international team from Griffith University, the Karolinska Institutet, and the University of Eastern Finland, tracked Swedish national registers between 2009 and 2022.

It included 95,490 people, of which GLP-1 receptor agonists were used by 22,480 individuals during the follow-up period.

Semaglutide was associated with a decreased risk of worsening

• depression
• anxiety
• substance use disorder
• self-harm.

Patients using semaglutide experienced a 42 percent lower risk of hospitalization for mental health issues during periods of use, compared to periods when they were not taking the drug.

More specifically, the risk reduction was 44 per cent for sickness absence or hospital care due to depression, 38 per cent for anxiety disorders, and 47 per cent for substance use.

Also read: Can Weight Loss Jabs Surge Divorce Rates? What Experts Are Saying

The team also found some benefits with Liraglutide. The drug was associated with an 18 per cent lower risk of sickness absence and hospital care due to psychiatric reasons.

How Does Semaglutide Work?

Semaglutide works as a GLP-1 receptor agonist that mimics the GLP-1 hormone to regulate appetite and blood sugar. It slows gastric emptying and makes you feel fuller longer. It also signals the brain to reduce hunger and cravings, and triggers the pancreas to release insulin when blood sugar is high.

They work by increasing insulin release in a glucose-dependent manner, decreasing the liver's production of glucagon, and slowing down the emptying of the stomach, which helps lower blood sugar levels after a meal. They also act on the brain to suppress appetite and increase feelings of fullness, leading to reduced calorie intake.

Read More: Can Semaglutide Help Fight Cancer In The Brain?

In people with type 2 diabetes, notes Harvard Health, the body's cells are resistant to the effects of insulin and the body does not produce enough insulin, or both. This is when GLP-1 agonists stimulate the pancreas to release insulin and suppress the release of another hormone called glucagon.

These drugs also act in the brain to reduce hunger and act on the stomach to delay emptying, so you feel full for a longer time. These effects can lead to weight loss, which can be an important part of managing diabetes.

In the wake of a young doctor from Chandigarh accusing a well-known private hospital of unnecessarily admitting patients to Intensive Care Units (ICUs), it is imperative to understand who truly requires critical care.

In a widely shared video posted on the social media platform Instagram, Dr Prabhleen Kaur alleged that the hospital is making the patients remain admitted in the ICU for as long as possible to mint money.

The doctor did not mention the name of the hospital. And HealthandMe could not independently verify the details and the authenticity of the post.

However, the incident reignited concerns over accountability, patient safety, and standards of care in the country.

Speaking to HealthandMe, Dr. Sachna Shetty, Consultant Emergency Medicine at Jaslok Hospital and Research Centre, said that: "ICU admissions are for patients with life-threatening conditions needing intensive support".

"This includes shock, respiratory failure, neurological emergencies, cardiac issues, and multi-organ dysfunction," the doctor added.

What Is ICU? Who Needs Critical Care?

The NHS UK explains that intensive care units (ICUs) are specialist hospital wards that provide treatment and monitoring for people who are very ill.

They're staffed with specially trained healthcare professionals and contain sophisticated monitoring equipment.

Also called critical care units (CCUs) or intensive therapy units (ITUs), it is required in cases where a person is seriously ill and requires intensive treatment and close monitoring.

Most people in an ICU have problems with one or more organs. For example, they may be unable to breathe on their own. Some common reasons include:

• a serious accident
• a serious short-term condition
• a serious infection
• a major surgery.

"ICU beds are limited, reserved for those who'll benefit most. Decisions are time-sensitive, based on triage and clinical scoring. It's about who needs advanced life support, not just who looks critical. Fair use of resources is key," the doctor added.

ICU Admissions: What India’s Guidelines Say

India’s ICU admission guidelines—issued by the Ministry of Health and Family Welfare in January 2024 — clearly defines who should and should not be admitted to an ICU. According to the guidelines:

• ICU admissions must be based on the severity of organ failure and the necessity for organ support or in anticipation of a potential deterioration in the patient's medical condition.
• Hospitals cannot admit critically ill patients in ICU in case of refusal by them and their relatives.
• ICU is not recommended in cases where there is no treatment possible or available, and if the continuation of therapy is not going to make an impact on the outcome, especially survival.
• Anyone with a living will or advanced directive against ICU care should not be admitted to ICU.
• Low priority criteria in case of a pandemic or disaster situation, where there is resource limitation, should be taken into account for keeping a patient in the ICU.
• Blood pressure, pulse rate, respiratory rate, breathing pattern, heart rate, oxygen saturation, urine output and neurological status among other parameters should be monitored in a patient awaiting an ICU bed

1. patients with altered level of consciousness,
2. hemodynamic instability,
3. need for respiratory support,
4. patients with acute illness requiring intensive monitoring
5. organ support or any medical condition or disease with anticipation of deterioration.

Guidelines For ICU Discharge Criteria In India

The guidelines stress the importance of physiological parameters returning to near-normal or baseline status.

Furthermore, reasonable resolution and stability of the acute illness that led to ICU admission are essential factors.

Patient and family agreement for ICU discharge, particularly in cases where a treatment-limiting decision or palliative care is opted for, is also highlighted.