Recently I got to go on live radio to discuss GLP-1 drugs like Ozempic. The show possibly came about as a publicity move for the bariatrics department, but they tapped me to balance things out. Around the studio table sat a bariatrician, who performs gastric sleeve and bypass surgery, and her dietician colleague who helps patients qualify for and then succeed with the gut wrenching procedures. Next to me sat a professional actor who shared her struggle with weight, and had started a GLP-1 three months back. The first month she was perennially nauseous, but now she felt great. There are a few things I didn’t have a chance to say on the air:
1. The actor mentioned obtaining her GLP-1 from Hers, an online prescriber. These digital dispensaries are an understandable response to dysfunction in healthcare, but they are riskier than going to a doctor who knows you and can devise a safe plan. There is no requirement with Hers to do blood work before starting meds, or at regular intervals during treatment. Since GLP-1s often cause vomiting and diarrhea, patients risk developing electrolyte derangements and kidney injury. Checking labs can actually make the difference between life and death.
This is why when you sign up for Hims/Hers, you must submit that “..IN NO EVENT SHALL HIMS & HERS BE LIABLE TO YOU…FOR ANY…CONSEQUENTIAL DAMAGES, PERSONAL OR BODILY INJURY, EMOTIONAL DISTRESS, OR WRONGFUL DEATH…” Deeper into the fine print, they seem to contradict themselves, but qualify that, “HIMS & HERS SHALL BE LIABLE ONLY TO THE EXTENT OF ACTUAL DAMAGES…NOT TO EXCEED U.S. $1,000.”
Still, Hims and Hers have found themselves at the center of several class action lawsuits for alleged fraud. Telehealth pill mills may be convenient, but they make GLP-1s even more dicey than they already are. I would venture that it’s worthwhile to discuss eligibility for a new medication with your doctor, who can then monitor your response to it.
2. The surgeon argued that lifestyle medicine doesn’t work, citing a longitudinal study of contestants from “The Biggest Loser” reality show. Since most of them regained their weight years later, she suggested, diet and lifestyle must not be a sustainable solution. Let’s explore this. First, the sample size was fourteen people. Second, there was no ongoing lifestyle intervention between the end of the show and the six-year mark when contestants were reevaluated. Did anyone expect these individuals, who underwent a nationally televised crash diet, to succeed in maintaining the weight loss six years later, without support?
For those less into reality TV, numerous studies demonstrate a strong link between diet and sustainable weight loss.
Here is a review of plant-based dietary interventions involving over 10,000 people. And here’s another featuring 19 different plant-based trials.
Large population studies like EPIC and Adventist Health 2 have indicated a direct relationship between plant-based diet and normal weight. And this randomized trial demonstrated the efficacy of a plant-based diet for weight loss at 1 and 2 years with ongoing education.
3. Finally, I missed my chance on the panel to commemorate the 1975 hit “Magic” by Pilot, which has been irredeemably ruined in Novo Nordisk’s ad that goes, “Oh, Oh, Oh, O-zemp-ic!” I like to think that if Pilot frontman David Patton understood the shortcomings of GLP-1s, he would not have sold the rights to his soul.
herbivores.life 