When I started my grand plan to lose weight and get fit I wondered if I could manage a quick hard hit and maybe get the job done in just a few months. Luckily for me I seem to have had a rush of oxygen to the brain and been able to make some long term changes which have just about settled into long term habits. Iv’e also come to realize that the lose weight/get fit is the fundamentally wrong way of looking at my health long term so iv’e recently shifted focus onto working on my metabolic health first and allowing weight loss and fitness to tag along behind. What was really wrong in my own thinking was the idea of being able to do it fast and without any consequences : now, i’m absolutely sure that slow is better and that my primary goals must be to lose visceral fat as measured by waist circumference and use the combination of exercise and protein to hang on to what muscle mass I still have at 68.
Early on I decided against the GLP-1 agonist drugs such as Ozempic, Mounjaro et al. My initial reasons for rejecting them was because of the reported side effects and that they were initially developed for the management of Type 2 Diabetes but have subsequently been used for weight loss in clinical obesity and now it seems for appearance and weight loss in already normal weight (or less) people. What seems to be emerging is that GLP-1 Agonists look successful when used in diabetes management but absolutely terrible when used as a lifestyle choice.
Since then iv’e spent a lot more time reading everything I can about GLP-1 Agonists and also trying to take in as many opposing views as I can – especially the kind of online doctors whose views I respect. I’m surprised by what I found both in the positive and the negative opinions and iv’e come to a completely different final opinion than I was at first expecting knowing my own bias against the pharmaceutical industry. I now think that GLP-1 Agonists have a place in the management of Type 2 Diabetes that presents with obesity but that acceptance comes with a huge caveat both in their use and especially when coming off them. I still totally abhor how they are being used as skinny pills by those influencers and celebrities who seem hell bent on achieving a certain appearance – what was once know as the Heroin Waif look – not only extremely thin and skinny to the point of anorexia but with so much muscle and subcutaneous fat loss that they look like corpses,
My caveat is that while they obviously suppress normal appetite and usually cause rapid weight loss that weight isn’t just body fat but always seems to come with a high loss of muscle mass which is an absolute disaster in the making when the drug is stopped, hunger rebounds and fat weight rebounds rapidly, There is a huge BUT here and that is that while fat weight always rebounds muscle mass doesn’t unless (that’s also a big UNLESS) the person involved performs resistance exercise. My doubt of course is that somebody doesn’t start resistance exercise before going on a GLP-1 – or during it – then I would suggest that it’s highly unlikely to start doing it when the drug is stopped.
The doubt behind the doubt is that most people, even gym goers, don’t seem to understand the need to perform resistance exercise consistently rather them just jiggling their tits on the treadmill, exercise bike or even outdoors running. At the age of 68 I think my body may well be past the time when I can increase my muscle mass – most experts say that what will be happening is that I should be losing muscle at the rate of 1% per year but then most older people almost certainly don’t eat enough protein or do resistance exercise. In a way i’d like to be able to go back to the gym but I can do the work just as effectively at home.
Doctor Alex talks about the Ozempic Trap.
Afterword.
I know that I have a rather dark view on anything to do with the pharmaceutical industry but in the case of GLP-1 agonists I think that something truly awful is about to happen and that it could become a medicine driven catastrophe that will shorten people’s lives. I suspect it will go like this : a person decides to start taking a GLP-I Agonist to help them lose weight and initially they are successful except that unknowingly they are losing muscle mass. Then lets say that that they stop the drug and their hunger rebounds, the weight comes back quickly and then overshoots except that the muscle mass doesn’t because they have never taken up simple resistance exercise. Lets then roll it forward a while and they notice that they are overweight (maybe obese) once again and they are advised to go back on the GLP-1 Agonist. The cycle repeats and once again they eventually have to come off the drug only this time their muscle loss is even more pronounced and they are starting to lose strength. mobility and balance – in short they are developing sarcopenia and their body has had to down regulate to keep pace with their reducing muscle. The end point would be what we used to call ‘off legs’ and is most often a shortcut to death – my suspicion is that serial use of GLP-1 Agonists will soon be leading to sarcopenia, patients off legs and dying early.
Have a nice day Y’Awl
Dirty Wet Dog, the great adventure. 