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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Screening for all men is "likely to cause more harm than good", says the UK National Committee. This recommendation is based on a clinical trial called Transform, which is now filling gaps in the evidence on how screening could be safely rolled out to other groups.
As of now, as per the recommendation, men who are between the ages of 45 and 61 should be screened every two years, if they have specific genetic mutations called BRCA variants.
As per the clinical study and the Cancer Research UK, of the 1000 men who get screened between the age of 50 to 60 for PSA test or the prostate-specific antigen test, around 100 have a positive PSA test. Of them, 34 have a positive MRI and receive a biopsy. Then only 28 are diagnosed with prostrate cancer. Of those 28, 10 are offered active surveillance, 13 are offered surgery or radiotherapy, and 4 need surgery or radiotherapy, while 1 need any other treatment.
However, the Cancer Research UK notes that while 1000 men are screening, and 28 diagnosed, only 2 lives could be saved, with 20 being over diagnosed, this means they have a slow-growing tumor that does not need treating, and of them 12 men will receive treatments that do not benefit them, rather harms them. These harms come in forms like being unable to control your bladder, or maintain an erection.
While experts say it is, patients are disappointed. Sir Chris Hoy, a terminal prostrate cancer patient says he was "disappointed and saddened" by the new recommendations as BBC reports.
However, Prof Freddie Hamdy, who is a urological surgeon in Oxford tells BBC: "The diagnosis of prostrate cancer in a healthy man is hugely disruptive event, with potential to affect quality of life, very significantly, for many years."
"It cannot be done lightly, men need to be really well counselled and informed before the 'snowball' starts. Before you know it, you are on the operating table having your prostate removed – and we see examples of that all the time," he said.
The screening committee’s decision is not final. It marks the beginning of a three-month public consultation period, after which the committee will reconvene and present its final recommendations to ministers in England, Wales, Scotland, and Northern Ireland. Each nation will then make its own decision on prostate screening.
England’s Health Secretary Wes Streeting said he supports screening “if backed by evidence” and promised to review the data “thoroughly” ahead of the final guidance expected in March.
Reactions to the draft recommendations have been sharply divided. Cancer Research UK welcomed the consideration of screening for men with faulty BRCA genes and agreed that, for most men, screening could currently do more harm than good.
But others strongly disagreed. Sir Chris Hoy said he was “extremely disappointed and saddened,” calling the BRCA-specific recommendation “a very small step forward” that falls short. Sharing his own experience, he emphasised that “early screening and diagnosis saves lives.”
Prostate Cancer UK CEO Laura Kerby also expressed being “deeply disappointed,” saying the decision will “come as a blow” to tens of thousands of men.
Prostate Cancer Research criticized the move as “a serious error that ignores modern evidence,” calling it a missed opportunity for Black men and those with a family history.
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Many people struggle to fall asleep because their minds race with worries about the next day or even old memories. To stop this mental chatter, some try complicated breathing exercises or relaxation hacks. However, a simple neuroscience trick involving temperature might help you drift off instantly.
Neuroscientist Kyle Cox suggests that you can fall asleep in seconds simply by placing something cold on your forehead when you go to bed. He explains that this method has been backed by sleep clinics and can be highly effective.
Researchers have learned that the temperature right on your forehead controls whether your brain stays active or decides to rest.
When the front part of your brain, called the frontal lobe, gets cooled down by even a little bit, just one degree, it automatically tells your body to start producing the chemicals needed for sleep.
The cold also quickly slows down all that busy mental chatter because the part of your brain that handles thinking (the prefrontal cortex) literally cannot work as hard when it is being cooled down.
A 2018 study published in the Sleep Journal also found similar results through a device that that cooled the forehead temperature as a treatment for insomnia. The device improved things like the time it took to fall asleep compared to the patient's own baseline sleep and the time it took to enter different stages of light and deep sleep (NREM Stages 1 and 2).
The two-night treatment helped patients fall asleep faster according to most PSG measurements and was safe. The researchers recommend more studies to see if this treatment works for the longer-term management of insomnia.
If you struggle with sleep, the NHS (National Health Service) says that often the best cure is to change your daily sleep habits. If you stick to a healthier routine, your insomnia usually gets much better over time.
Go to bed and set your alarm to wake up at the exact same time every day, even on weekends. This helps set your body's internal clock.
Start relaxing at least one hour before you plan to sleep. This could mean taking a warm bath, listening to calm music, or reading a physical book.
Make your bedroom a perfect place for sleeping. It should be as dark and quiet as possible. Use heavy curtains, blinds, or even an eye mask and earplugs if needed.
Exercise is great for sleep, but do it regularly during the day, not right before bed.
Check that your mattress, pillows, and blankets are supportive and cozy so you can easily relax once you lie down.
To sleep better, avoid things that keep you awake. Stop smoking, drinking caffeine or alcohol six hours before bed. Do not eat a large meal or exercise intensely late at night. Avoid screens right before bed, limit daytime naps, and always stick to your regular morning wake-up time.
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Researchers have recently found that looking closely at the shape of the main buttock muscle, called the gluteus maximus, gives important clues about a person's health. This muscle shape reflects key changes linked to how we age, our lifestyle choices, and medical problems like diabetes.
This new study, done by a team at the University of Westminster, is unique because, unlike older research that only measured how big the muscle was, the team used advanced 3D mapping to show exactly where and how the muscle shape was changing.
These shifts, either the muscle shrinking (atrophy) or becoming inflamed, are connected to things like being frail, the amount of time someone sits each day, fat storage and diabetes risk.
the research analysed a large dataset, looking at over 61,000 MRI scans taken from the large U.K. Biobank health database.
Along with the MRI images, the dataset also included detailed information on 86 different factors for each person, including their medical history, body measurements, and what kind of lifestyle they led.
By putting all this data together, the team was able to figure out which specific factors were strongly linked to changes in the shape of the buttock muscle over time.
The analysis revealed strong connections between muscle shape and certain health factors:
People who were considered fitter, meaning they reported doing more vigorous physical activity and had a stronger hand grip, tended to have a greater gluteus maximus shape. This often means the muscle was larger and more defined.
On the other hand, factors like getting older, being generally frail (weak), and spending many hours sitting were all linked to muscle thinning or shrinkage. This suggests that a lack of use and the natural process of aging reduce the muscle's size and fullness.
A very important discovery was that the gluteal muscles don't change in the same way for men and women, especially when they are dealing with a disease. For example, men who were considered frail showed more shrinkage (thinning) in their gluteus maximus compared to women who were also frail.
When the researchers examined Type 2 diabetes, the difference was even more noticeable: diabetic men showed clear muscle thinning (reduced muscle mass), while diabetic women often showed enlarged muscle mass.
This larger appearance in women is likely due to fat building up within the muscle tissue, rather than the muscle itself growing stronger. These differences strongly suggest that the body's biological response to diseases like Type 2 diabetes may be completely different between men and women.
The researchers conclude that the shape of the buttocks, rather than simply its size, is more closely connected to fundamental metabolic changes happening in the body. Because the gluteus maximus is one of the largest muscles in the body, its health plays a crucial role in overall metabolic health.
These findings suggest that tracking gluteal muscle shape could potentially become a new way to monitor metabolic health and disease risk.
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