Ozempic helps weight loss by making you feel full. But certain foods can do the same thing – without the side-effects
You may have heard of the drug Ozempic used to treat type 2 diabetes and as a weight loss drug.
Ozempic (and a similar drug, Wegovy) have been the center of headlines and controversy. There is a global supply shortage, Elon Musk tweets about using it, and the US approves weight loss for teens. Oscar host Jimmy Kimmel even joked about it at movie night last week.
But how much do we really need drugs like Ozempic? Can we replace them with food as medicine?
How does ozone work?
The active ingredient in Ozempic is semaglutide, which works by causing a feeling of fullness. This feeling of satisfaction or “fullness” suppresses appetite. That's why it works for weight loss.
Semaglutide also helps the pancreas to produce insulin, which is how it helps manage type 2 diabetes. Our bodies need insulin to move the glucose (or blood sugar) we get from food inside our cells so we can use it for energy.
Semaglutide works by mimicking the action of a natural hormone called GLP-1 (glucagon-like peptide-1), which is normally produced when we detect nutrients when we eat. GLP-1 is part of the signaling pathway that tells your body that you have eaten and is ready to use the energy from food.
Read more: Ozempic helps people lose weight. But who should be able to use it?
Can food do it?
The nutrients that trigger GLP-1 secretion are macronutrients — monosaccharides (single sugars), peptides and amino acids (from proteins), and short-chain fatty acids (from fats, also produced by beneficial gut bacteria). High amounts of these macronutrients are found in energy-dense foods, which tend to be high in fat or high in sugar and low in water. There is some evidence that you can increase your GLP-1 levels by choosing foods that are high in these nutrients.
This means that a healthy diet rich in GLP-1 stimulating nutrients can boost GLP-1 levels. This could be foods high in good fats, like avocados or nuts, or lean protein sources, like eggs. Foods rich in fermentable fiber, such as vegetables and whole grains, feed our gut bacteria, which then produce short-chain fatty acids that trigger GLP-1 secretion.
That's why diets high in fat, fiber, and protein can all help you feel fuller for longer. That's why dietary changes are part of weight and type 2 diabetes management.
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not so fast…
However, it's not necessarily that simple for everyone. This system also means that when we diet and restrict our energy intake, we become hungrier. For some people, the “set point” for weight and hunger may be different.
Some studies have shown that obese people have lower levels of GLP-1, especially after meals. This may be due to decreased production or increased breakdown of GLP-1. The receptors that detect it may also be less sensitive, or there may be fewer receptors. This could be due to differences in the gene encoding GLP-1, the receptor that regulates production, or part of the pathway. These genetic differences are something we cannot change.
So, is injection an easier fix?
While both diet and medication can work, both have their challenges.
Medications such as Ozempic may have side effects including nausea, vomiting, diarrhea, and problems with other organs. Also, when you stop taking it, the feeling of suppressed appetite will start to go away and people will start to feel hungry back to their normal level. If you lose weight rapidly, you may feel hungrier than before.
Dietary changes carry far less risk in terms of side effects, but coping will require more time and effort.
In our busy modern society, cost, time, skills, accessibility and other pressures can also act as barriers to healthy eating, satiety and insulin levels.
Diet and drug solutions typically focus on individual changes to improve health outcomes, but systemic changes that reduce stress and barriers that make healthy eating difficult (such as shortening the workweek or raising the minimum wage) are more important. might make a difference.
It's also important to remember that weight is only one part of the health equation. If you suppress your appetite but keep your diet full of ultra-processed foods rich in micronutrients, you may lose weight without increasing your actual nutrition. Therefore, support for improved dietary choices is needed to achieve real health improvements regardless of drug use or weight loss.
Read more: Stop hating pasta—it actually has a healthy ratio of carbs, protein, and fat
the bottom line
The old adage: “Let food be your medicine” is catchy and often science-based, especially when drugs are deliberately chosen or designed to mimic hormones and compounds already naturally produced in the body. Changing our diet is one way of changing our health and biological responses. But these influences occur within the context of our individual biology and our unique living circumstances.
For some, the medication will be a tool to improve weight and insulin-related outcomes. For others, food alone is a logical path to success.
While science is population-specific, healthcare is individual, and decisions about food and/or medications should be made with the thoughtful advice of a healthcare professional. GPs and dietitians can work on your individual situation and needs.