Everyone's talking about it: Ozempic® and GLP-1 drugs
In recent years, Ozempic® and other drugs belonging to the GLP-1 class have become ubiquitous topics of conversation. Originally developed to treat type 2 diabetes, these treatments are now attracting a great deal of interest for their remarkable weight-loss effects, offering new options for people battling obesity. But what are GLP-1 drugs and how do they work? Let's decipher their mechanism, their history, and what they represent for weight and health management.
What is a GLP-1 drug?
GLP-1 (glucagon-like peptide-1) drugs are treatments initially developed for type 2 diabetes. The very first of these drugs, retratutide, was approved in 2005. Liraglutide (Victoza®, Saxenda®), the first to be approved, was developed by Novo Nordisk in 2010. Since then, other options such as dulaglutide (Trulicity®), semaglutide (Ozempic®, Wegovy)®, tirzepatide (Mounjaro®, Zepbound®), and soon retatrutide, have become available for their effect on glycemic control and weight loss.
GLP-1 mechanism of action
GLP-1 drugs work by mimicking a hormone naturally produced by the intestine after a meal. They influence metabolism in several ways:
Triggering insulin release: Insulin enables the body to use glucose in the blood, preventing sugar levels from becoming too high.
Blocking glucagon secretion: By reducing the secretion of glucagon, a hormone that increases blood glucose levels, GLP-1s limit the amount of sugar released into the bloodstream.
Slower gastric emptying: slower digestion releases less glucose into the bloodstream, promoting more stable blood sugar levels.
Increased feeling of satiety: GLP-1 acts on the brain to prolong the feeling of satiety, helping to reduce the amount of food consumed.
Type 2 diabetes and obesity: closely linked conditions
Type 2 diabetes and obesity are two common chronic diseases in North America, often interconnected and influenced by genetic predisposition and lifestyle. Obesity generally precedes type 2 diabetes and is a major risk factor for its development. Moreover, significant weight loss in diabetic patients can often lead to remission of the disease.
Obesity, in addition to type 2 diabetes, also increases the risk of developing other serious conditions: heart disease, stroke, certain types of cancer, osteoarthritis, sleep apnea, and much more. From this perspective, GLP-1 drugs, by promoting weight loss, provide a solution not only for diabetes management, but also for the prevention of many health problems.
Other obesity treatment options
Historically, options for sustainable weight loss have been limited and often risky. Bariatric surgery, while effective, carries risks, and restrictive diets are difficult to maintain over the long term. In contrast, GLP-1 drugs, combined with lifestyle modifications such as diet adjustment and increased physical activity, offer a less invasive and more sustainable alternative for many patients.
Why are GLP-1 drugs so popular now?
The popularity of GLP-1 drugs can be explained by their efficacy. Since the arrival of liraglutide (Victoza®, Saxenda®) in 2010 for diabetes (and in 2014 for obesity), these treatments have continued to evolve:
- Semaglutide (Ozempic®, Wegovy®): Available since 2017, it is less expensive than liraglutide, and, with weekly injections (unlike liraglutide's daily injections), delivers an average weight loss of 15%.
- Tirzepatide (Mounjaro®, Zepbound®): Approved in 2022, this drug acts on both GLP-1 and GIP receptors, offering an average weight loss of 25%.
- Retatrutide (coming soon,
Several studies have also shown that these revolutionary treatments can reduce the risk of other conditions such as kidney disease, Alzheimer's and alcohol dependence, thus improving patients' overall health. Research continues in this field.
Disadvantages and side effects of GLP-1 drugs
Despite their effectiveness, these treatments have certain drawbacks. They are costly and, as with any chronic disease, require long-term treatment. The most common side effects, though mostly temporary, include nausea, stomach ache and constipation. Temporary hair loss and sagging skin are also possible after-effects of weight loss. Patients with a family history of thyroid cancer are advised not to take these drugs, however, recent studies show that these treatments are not associated with an increased risk of thyroid cancer. Remember, only a physician can help you determine whether this type of medication may be indicated for you.
Who can benefit from these medicines?
These drugs are recommended for people with a BMI over 30, or for people with a BMI between 27 and 30 in the presence of a weight-related condition, such as hypertension, type 2 diabetes, or sleep apnea. Medical follow-up is required to assess individual needs and rule out any underlying causes of weight gain, such as thyroid problems.
Ozempic and Aesthetic Surgery
It's important to note that cosmetic surgery is not a substitute for weight loss. Procedures such as liposuction target specific areas of subcutaneous fat, not visceral fat.Abdominoplasty and redraping of the arms, thighs and breasts are effective for removing excess skin after weight fluctuation or loss (or pregnancy). In general, "body contouring" surgeries are recommended once weight has stabilized, and the patient is healthy.
When it comes to facial changes following weight loss, it's true that fat loss in the face contributes to an aged appearance, regardless of how the weight loss was achieved. In fact, facial fat loss occurs naturally with age. In some cases, facial contouring with fat transfer (lipoinjection) can be considered, while in others, fillers or biostimulators (Sculptra®) can be used to attenuate volume loss.
Thanks to GLP-1 drugs, weight and obesity management is now more accessible and effective. However, such an approach must always be carried out under medical supervision. These drugs are available by prescription only, usually from the family doctor, but some telemedicine (online) options are available for patients who don't have easy access to their doctor, or who don't have one. And it's always advisable to consult a healthcare professional when embarking on a weight-loss program, to ensure that the process is safe and effective.
Together, with the necessary support, a path to health and well-being is within your reach.