As we wrap up January 2024, you’ve probably have heard about Ozempic and Monjauro for weight loss. You know you’ve seen celebrities and social media influencers using them and achieving impressive results. (Even Oprah Winfrey recently revealed that these drugs have helped her battle weight issues for years.) Perhaps, you know someone who is currently taking one of these medications for weight loss and has seen incredible success. While, these drugs are initially designed for diabetic and pre-diabetic people, research has shown they have a profound weight loss effect. But what are these drugs? How do they work? And what are the potential side effects?
We reached out to Dr. Shanley from SkinMD Med Spa in Norwell to shed some light on this current topic. SkinMD offers these treatments under a doctor or nurse practitioner’s care. Below, she shares her expert knowledge and explains how these drugs are transforming people’s lives.
Thank you Dr. Shanley for taking this time to chat with us! Can you explain the difference between Ozempic, Monjauro, Wegovy, etc.
Of course! So, first off Ozempic and Wegovy are the brand names of the drugs made by the pharma companies, but the active ingredient is semiglutide. Monjauro and Zepbound are the brand names, but the active ingredient is tirzepetide. At Skin MD, we use an FDA approved compound pharmacy that makes the drugs on behalf of SkinMD and are specific to you, using the active ingredients.
What do we now know about obesity and how can this medicine help?
What we know about obesity is that it’s not a willpower issue, but it’s really a hormonal imbalance issue. Some people have high naturally occurring levels of GLP1. If you have high naturally occurring amounts of GLP1, then you don’t always think about food and you don’t really crave or really even want food. However, for some people that have naturally occurring low amounts of GLP1, that is all they are always thinking about food and always craving food, etc. So, this really, really helps. I have patients who have sugar addictions, like they will eat a whole bag of candy in one sitting multiple times a day, and then they start this medication and all of a sudden that doesn’t even sound good to them anymore. The same with other impulse addictions like alcohol, coffee, even shopping.
Wait, so girl math says patients are saving money because we’re not drinking as much alcohol or buying that second (or third) iced coffee, and impulse shopping on Instagram?
Well, that actually sounds amazing! Okay, so how do these drugs work?
So, it works in three mechanisms. The first is it decreases your hunger hormones, so you feel less hunger. The second mechanism is it slows your gastric emptying, so when you eat something, it stays in your stomach longer, so you feel full faster, and you feel full for a longer time period. The third mechanism is it increases your body sensitivity to insulin. So normally, when you eat something, your insulin spikes, and insulin is a fat storage hormone, so it signals to your body to store fat. This medicine makes your body more sensitive to insulin, so you don’t have those big spikes. But the interesting thing is, you know, this medication, if you eat 1,200 to 1,500 calories on this medication, you won’t feel hungry. You’re going feel completely satiated, and that’s the success behind it.
How long do you stay on the medication and how much do your patients lose?
My patients lose anywhere from 5-15 pounds per month and the amount of time you are on the medication depends on how much weight you want to lose. We start you on the lowest dose possible, and we slowly increase the medication every month to get you up to the final dose. Then you’d stay on that final dose until you reach your goal weight. Typically, once you reach your goal weight, we would keep you on for a few more months, and then slowly wean it down to get off the medication. Some patients choose to be on this medication forever, and that looks like coming down to the lowest possible dose and taking it every 10-14 days. It’s important to remember, this medication is a tool. Some patients may need to stay on it long term to help them maintain their weight, while other patients can stop the medications. We customize each treatment plan to the individual.
So, let’s say one of our readers is interested in starting a regime with you. Can you take us through what the process looks like?
Sure, so you book a consultation with one of the doctors or nurse practitioners here at at SkinMD. We will first do an assessment to see if you qualify for the medications. We do not treat anyone who is overall healthy and just wants to lose 10 or so pounds. We treat individuals who fall in the overweight or obese category based on their BMI. If the patient qualifies, we determine which medication is best for them. We will discuss side effects and will answer your questions and concerns. From there, if the patient decides that they want to move forward, we will order the medication which will then arrive 7 to 10 days later. Once the medication arrives to our clinic, the patient will come in and meet with a doctor. We will fill 4 syringes, one taken on the same day once a week for four weeks. We typically start the patient on the lowest dose for a month to get the body adjusted and move up from there. The shot can be taken in the stomach area or thigh. The doctor will show the patient how to do this shot correctly. Medication must be stored in the refrigerator.
Now, the biggest question (next to, how much will you lose?), what are the side effects?
This medication has been FDA approved for ten years, which is a long time for medication to be out and available. As far as bad side effects that could occur, this medication could possibly make people have pancreatitis. However, I’ve never seen it happen. That is why I ask those questions about a history of pancreatitis and gallstones. If someone has a history of those things, it could make it worse. Very rarely it can cause an intestinal blockage, and that’s because it’s slowing your digestive system. In some people, very rarely, it can slow too much and cause a blockage. You would know if you had a blockage because you’d have severe intestinal, severe abdominal pain, and wouldn’t be passing any stool. So, it’s important to watch your bowel movements and report them to your doctor. But that is extremely rare, and we haven’t had any of the 1,000+ SkinMD patients on these medications experienced it. More common side affects include nausea, constipation and diarrhea. These side effects are mostly caused when the patient isn’t eating enough of the right foods or drinking enough water.
Anything else you’d like to share with our readers about these medications?
If you want a cookie, have one! If you want a glass of wine, then by all means have one…just do not overdo it. Heavy foods, binge drinking and not enough water will cause you to feel nausea and will intensify any side affects you may experience. While not mandatory, it’s important to follow our tips for success when taking this medication. They include eating a high protein breakfast within 1.5 hours of waking, consuming a minimum of 700 calories per day, drink lots and lots of water, do no consume artificial sweeteners as they can hinder your progress, and exercise 3-5 times a week.