Obesity is a global health problem today. There is not a single benefit from being obese. Today, one in eight people on the planet is obese (1 billion total count) and around half a billion more are children ages 5-19 years of age. Since the 1990’s, obesity numbers have doubled, and with it, diabetes, hypertension, heart illnesses and cancers have also risen in numbers. They are directly related after all. 

Therefore, it was no surprise that when an Obesity-reducing “miracle” drug was announced, people everywhere were ecstatic! 

Initially, it was Ozempic © that came out in 2017, produced by the Danish NOVO-NORDISK company. Its main target population was the diabetic adult patients at the time. In 2022, LILLY followed with Mounjaro ©, for the same purpose of treatment. Both drugs give a sense of “enhanced fullness” and thus make a person eat less, and lower blood sugar. 

Recently, a more obesity-targeted approach by the two companies have resulted in the production of WEGOVNY © by Novo Nordisk and ZEPBOUND © by Lilly. The U.S. FDA organization has deemed Ozempic and Mounjaro as drugs for treating diabetes type 2 (“adult diabetes”) and not obesity in general. However, since Wegovny is currently in short supply everywhere, doctors are giving Ozempic in its place. 

The mechanism of action of these drugs is basically mimicking a natural protein called GLP-1. In normal days, when a person eats, GLP-1 is produced by the stomach sending a message to the brain saying “I’m full, stop eating”. What Ozempic does is that it pretends to be GLP-1, goes to the brain, and makes us feel very-very full. In addition to GLP-1, Mounjaro also contains another “fullness” protein called GIP, thus making it a little stronger and more expensive drug. 

The good news: All of the above actually work in reducing weight. The average weight loss is 15% of your total weight at start after 2 months with Ozempic, and loss of 22% of total weight after 2 months with Mounjaro. Meaning that a 150 kg person will lose ~20kg in 2 months with minimal effort, no exercise, no special dietician; or ~30 kg loss with Mounjaro. 

The bad news:

1- The main one are the side-effects during treatment: severe nausea, vomiting, diarrhea, constipation, stomach pain, fatigue and headache. These symptoms are stronger in the beginning, and varies between patients. Because of this, the first thing effected is the hydration, because patients don’t feel like drinking or eating much. People using any of the above must always keep proper hydration ongoing, even if they do not feel like it. 

2- You can not take these for longer periods of time than designated. This means that a 150 kg person cannot take Ozempic for months and months until he/she is 80 kgs, while doing no other effort like exercise. 

3- Another issue is that once you begin stopping the drug, appetite returns. Most people who are not informed of this issue regain 70% of the weight they lost and as quickly as they lost it. Therefore, if someone is not mentally 100% dedicated to weight loss and not prepared for that appetite increase later on, they will not benefit properly from all this scenario. Once the appetite increases again later, it MUST be followed by a dietician with proper protein-rich meals in correct quantities. 

Therefore, although these drugs give a person a “quick and easy” way to lose a few kilos, they must be followed by strict and controlled dietary and lifestyle advice to maintain that weight loss, and continue the process to an ideal weight. It is a long journey. There is no easy way to reach this ideal goal yet.