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.

India is only second in the world to have people with chronic kidney diseases in 2023, said The Lancet study. In 2023, China recorded 152 million patients with chronic kidney disease (CKD), while India was at 138 million.

The study, led by researchers from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, along with collaborators in the U.S. and the U.K., found that CKD was the ninth-leading cause of death worldwide, claiming nearly 15 lakh lives in 2023.

Regionally, the highest prevalence was reported in North Africa and the Middle East (18% each), followed by South Asia (nearly 16%), and more than 15% in Sub-Saharan Africa, Latin America, and the Caribbean.

In fact, senior director and HOD Nephrology at Medanta Kidney and Urology Institute, Dr Shyam Bansal says, "Chronic kidney disease is one of the fastest-growing chronic illnesses in India, mainly because diabetes and hypertension are becoming more common. Diabetes now affects about 10% of the population and hypertension nearly 25%, and together they remain the leading causes of kidney disease."

The report also highlighted CKD’s strong link to heart disease. It contributed to almost 12% of global cardiovascular deaths in 2023 and ranked as the seventh-leading cause of heart-related mortality, ahead of diabetes and obesity.

The researchers outlined 14 key risk factors for CKD, with diabetes, hypertension, and obesity contributing the most to the loss of healthy life. Dietary habits—such as low intake of fruits and vegetables and high sodium consumption, also played a significant role in raising CKD risk.

“Chronic kidney disease is both a major risk factor for other leading causes of health loss and a significant disease burden in its own right. Yet, it continues to receive far less policy attention than other non-communicable diseases, even as its impact grows fastest in regions already facing the greatest health inequities,” said senior author Theo Vos, professor emeritus at IHME.

The findings draw on data from the Global Burden of Disease (GBD) 2023 study, which tracked trends in diseases, injuries, and health risk factors across 204 countries and territories from 1990 to 2023.

Importance of Early Detection Of Chronic Kidney Disease

Importantly, the authors noted that most people with CKD in 2023 were in the early stages, highlighting the urgent need for strong screening programmes and strategies to reduce risk before the disease advances.

This is why its early diagnosis is utmost important. Dr Bansal on the need for early detection says, "“The biggest challenge is identifying people at risk as early as possible. Early diagnosis and timely control of risk factors are essential if we want to slow the progression of chronic kidney disease."

Early detection could also reduce heart-related deaths due to kidney disease and delay one's requirement for replacement therapies, which is usually sought in advanced stages of the disease.

Dr Bansal also points out that early detection could help one live a better life and also in many ways reduce the burden on the Indian healthcare system, and save cost. "We are dealing with a large population at risk, and kidney disease is complex and costly to treat. While infrastructure and specialist availability are improving, managing this growing burden remains a significant challenge," he says.

A GP has raised concern about a key sign that may show you have Covid rather than a cold or flu. Winter illnesses often look alike, which makes it hard to tell them apart, and getting the right diagnosis is important for proper care. Dr Rupa Parmar, GP and medical director at Midland Health, explained that there are certain clues that can help people understand what they are dealing with. She advised that anyone unsure should check with their doctor, as it is safer to ask than ignore a concern.

Why Breathlessness Matters

Dr Parmar noted that shortness of breath stands out as a sign of Covid. It rarely appears in a cold or flu, but it is common with Covid because the infection tends to affect the lungs and cause inflammation. The NHS also lists breathlessness as a sign linked more strongly with Covid than with flu or a cold. This symptom is also seen in conditions such as respiratory syncytial virus. In some cases, people with the flu who do not recover and worsen may develop breathing trouble if they develop complications such as pneumonia.

How Cough Patterns Differ

She added that coughs appear in all three infections, but they do not sound the same. A cold usually causes a light cough, flu tends to bring a dry one, and Covid usually causes a dry, ongoing cough. Many people with Covid cough for more than an hour or have several episodes of coughing through the day.

Loss Of Taste Or Smell As A Warning Sign

Another clue is a change in taste or smell. Dr Parmar said this sign is more specific to Covid. A sudden loss of taste or smell, or even a noticeable change, is more likely linked to the coronavirus. She explained that the pattern of symptoms often helps point to the right illness. A mild cough and sore throat usually fit a cold, a fever and strong fatigue suggest flu, and a loss of smell or taste with a steady cough point to Covid.

How Symptoms Begin And Progress

She also noted that the start of symptoms can differ. A cold tends to appear slowly, flu symptoms usually show up quickly within a few hours, and Covid can begin with mild signs that grow stronger over time. A cold mainly affects the nose and throat, while flu and Covid can cause symptoms across the body.

What To Do If You Have Covid Symptoms

Even though there are no formal self-isolation rules anymore, the NHS advises people to stay home and limit contact with others if they or their children have symptoms and either have a high temperature or feel too unwell to manage daily activities at work, school, or home. The NHS states that people can return to their usual routine once they feel well again or no longer have a high temperature.

As winter settles in, many people sense a shift in their mood. Shorter days and colder weather often leave us feeling a little dull. In some cases, this may be linked to seasonal affective disorder (SAD). Yet there may also be another explanation.

A doctor has cautioned that a very common deficiency could be the reason you have been feeling unusually low. He noted that this problem affects well over a billion people around the world.

Iron Deficiency Might Be The Reason Behind Your Low Mood

In a TikTok video, Doctor Sermed Mezher raised concern about iron deficiency. Iron is a mineral the body relies on to move oxygen through the blood and support several important processes. Dr Mezher explained as per Express, “Low iron is the most common nutritional deficiency in the world, affecting more than one billion people.” He also described how it can influence dopamine, often referred to as the “feel-good” chemical.

He added, “And its effects on dopamine go way deeper than just oxygen transport. Dopamine is made from an amino acid called tyrosine over a couple of steps, and the enzyme involved in the first step needs iron to work properly. It is no surprise, then, that in iron deficiency, studies show problems in dopamine pathways that play a part in happiness, reward, self control and social behaviour.”

The positive news is that this can usually be managed. Dr Mezher said, “Once your iron levels are restored, these pathways return to their normal state, and you can help this process by taking iron with vitamin C and staying away from caffeinated drinks for two hours before and after.”

Symptoms Of Iron Deficiency

The NHS lists several signs of iron deficiency anaemia, including:

• Tiredness and low energy
• Shortness of breath
• Heart palpitations
• Paler skin
• Headaches

If you think you may be low in iron, you should talk to your GP. A simple blood test can confirm it.

How To Boost Iron Levels?

Iron levels can be raised through the foods you eat. These options are naturally rich in iron:

• Dark-green vegetables such as watercress and curly kale
• Iron-fortified cereals and bread
• Meat
• Dried fruits like apricots, prunes and raisins
• Pulses including beans, peas and lentils

The NHS also suggests cutting back on:

• Tea
• Coffee
• Milk and dairy products
• Foods high in phytic acid, like wholegrain cereals, which can prevent your body from absorbing iron from meals and supplements

The NHS notes, “Large amounts of these foods and drinks make it harder for your body to absorb iron. You might be referred to a specialist dietitian if you're finding it hard to include iron in your diet.”

How Much Iron Does One Need?

The daily iron requirement is:

• 8.7mg for men aged 19 and above
• 14.8mg for women aged 19 to 49
• 8.7mg for women aged 50 and above

The NHS adds, “Taking 17mg or less a day of iron supplements is unlikely to cause any harm. But continue taking a higher dose if advised to by a GP.”