Friday, September 29, 2023
Mitochondrial Health

How Does GLP 1 & Ozempic Affect Metabolic Health & Do They Work? | Dr. Rob Lustig & Dr. Casey Means

Medications, such as Ozempic, Wegovy, and more, have become increasingly popular for weight loss. These drugs are glucagon-like peptide 1 (GLP-1) receptor agonists, and they mimic a hormone that, among other things, tells the brain a person is full so they eat less. But are they safe, and do they help improve metabolic health? Dr. Rob Lustig and Dr. Casey Means discuss these weight-loss drugs and their effects on the body, and why such medications likely won’t solve the obesity crisis, for which the food industry is culpable.

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📍What Rob Lustig, MD, & Casey Means, MD, discuss:
00:00 — Intro
06:24 — The mechanisms of action for weight-loss medications
09:07 — Dr. Casey Means shares her perception of the popularity of GLP-1 medications
13:19 — GLP-1 RAs lead to fat loss but also muscle loss
19:50 — Do GLP-1 RAs improve metabolic health?
22:29 — Dr. Lustig discusses the high cost of GLP-1 RAs
29:37 — Dr. Lustig makes the case for fixing the food problem
37:39 — How can patients use GLP-1 RAs as a jumpstart?
46:15 — Dr. Lustig shares his concerns about the use of GLP-1 RAs in children


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Transcripts & Show notes:
Robert Lustig, MD:
Metabolical by Robert Lustig, MD:


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26 thoughts on “How Does GLP 1 & Ozempic Affect Metabolic Health & Do They Work? | Dr. Rob Lustig & Dr. Casey Means
  1. Cocaine & Meth are safe and effective as weight loss drugs…

    The GLP-1 drugs come with the same FDA Black Box warning for cancer as Cigarettes. They are safe and effective…

    "They are loosing = amounts of muscle and fat" Thank you for sharing this inconvenient truth about this safe & effective treatment.

  2. I have type 2 diabetes. I started taking Ozempic in April. My A1C improved significantly since taking it. I lost 45 lbs and only 8 lbs from my goal weight and no longer being overweight. I eat a plant based whole food diet because that's what my body craves. I walk every day and swim when I can. My doctor decreased my blood pressure meds. In September I will decrease Ozempic from .5 to .25. Ozempic works for me. I'm in Canada and Ozempic is covered. Sandra

  3. It is a radical treatment perhaps warranted by severe metabolic issues like high BMI, high H1A etc. I was put on it at .25mg and instructed to eat — if I can — starting with protein and then non startchy veggies and no white or starchy foods. Definitely no sugary things. I am 5' 8" and started at 212 lbs and now am 153 lbs. My face is emaciated looking, I've had to get physical therapy to rebuild muscle needed for balance and motion and my vocal cords have been stripped down so my voice is often a hoarse raspy whisper. My gut struggles to eject waste almost getting me into the ER several times. Yes; It worked at killing my urges to eat sugary things, but frankly what saved me was the warning to change what I eat!!!!! Stop the sugar!!! But now I have at age 80 the task of rebuilding from the loss of muscle and the loss of vocal cord tissue. Will my gut return to normal? I have trouble speaking; it's a good thing I learned to touch type! I could have done this in a slow measured less damaging way by adopting a low-carb (not necessarily high-fat) regimen. The way to lose fat is to burn it; not muscle.

  4. 49:43 Social justice issue?
    What is that supposed to mean?
    Someone who is deprived of this drug may be in better shape than the supposed privileged.
    A good insurance plan can kill you.
    Good insurance allows you to load up on every drug under the sun and never fix the root problem.

    I didn't hear anything about exercise.
    Any of these studies should have an arm of a one hour brisk walk as a placebo.
    If a drug can beat that you might have something.
    But only if the drug taker could keep up with the brisk walker after some time.

  5. As a nurse I’m glad you questioned how this works because I still don’t quite understand, I wonder why people don’t suffer hypoglycemia if they aren’t a diabetic and does it improve metabolic health. The people who I see that take it still eat poorly.

  6. I was on mounjaro for 3 months helped me kick my soda & sugar addiction andlost 15 lbs. But it did help me eat less, been off it for 8 months lost another 10lbs. My cmg monitor helps me accountable to my dr. and myself. I’m still working on my diet and exercise but my A1C numbers are coming down.

  7. My Dr has recently suggested that I switch to Ozempic for my type 2 diabetes because I would probably lose more weight. She has come to realize that I do a lot of research on stuff and it takes me a long time to come to a point where I am willing to "pull the trigger" on a new/additional medication! Then I come upon this video. My answer will be "No". I am focusing on, and putting more effort into my diet. I have also come to realize that I have been chronically stressed for my entire life (long story that most people don't want to hear) and I just turned 59! I can feel the detriments of the stress and I know that if I don't get it under control, it will kill me!

  8. I do not believe there is one medicine has no side effect. Most of the meds are only treating the symptom without fixing the problem. IF + low carb is the, by far, the best solution to address obesity problem.

  9. Mounjaro was the only thing that could help me reverse diabetes and get back onto a healthy, nutritious, Keto/Intermittent fasting lifestyle. I’ve lost 70 lbs in 7 months and am halfway there. Yeah, I don’t eat as much, but I don’t eat any processed foods or sugar-poisoned junk. I’m also not starving. No longer being obsessed with food and being freed from compulsive eating is worth double the price I pay each month. Frankly, I’m saving money since I don’t order all my meals from Door Dash anymore. I’m walking and have more energy than I’ve had in decades. My arthritis pain is gone even during allergy season. I actually have more muscle mass. I don’t plan to be on this drug after I get to normal BMI and metabolic panel numbers (A1C is just on the high end of normal) but it has helped me get back on track after the metabolic mess I was in before I started it. FYI: I’m not having any side effects and I just recently stopped taking Nexium and have had to decrease my blood pressure meds. I’m not a Hollywood starvlet and I use the coupon EliLilly offers, so I pay $570 a month. A lot less than the $2000 a month I used to spend on the crap carb/sugar-loaded meals I used to eat. Mounjaro has been a lifesaver for me.

  10. Another doctor is crapping on a miracle drug. The benefits of GLP-1 medications speak for themselves. The weight loss is close to what can be achieved by surgery. Diabetics are on insulin for life so staying on a GLP-1 on a maintenance dosage is fine with me. Down 35 pounds in 22 weeks. A1C down from 7.6 to 5.4 and blood pressure down 170/100 to 128/69 and blood sugar down from 140 to 90. My two full blood panels look amazing. My diabetes is now in full remission. I think the blood tests speak for themselves. Everything in medicine is a risk/benefit analysis. I am only on 5 mg of Mounjaro and don't see a need to increase. I have not experienced any side effects. Also a much lower risk of cardiovascular events. So why is the doctor against a medication that seems to be so effective? Nothing previously was ever this effective. It's not a stimulant like Fen-phen. All weight loss involves muscle loss. Some recent research shows that the amount of muscle loss is no where near as high as the doctor stated. Also no known cancer in humans and only 2 cases of gasto parisis. Again risk/reward. So what does the doctor say about people that are morbidly obese what about all of the risks of being morbidly obese. How good is being morbidly obese ? Regarding cost it new and the pharma has a right to make money as more people take it like all drugs the cost will come down. So the doctor would say "if you just ate more healthy and exercised you could control your weight." If it was that simple then why does it not work. Morbidly obese people have food noise and their brains scream eat and they never feel full. Mounjaro stops the food noise and makes many feel full. Also gastric bypass surgery also causes muscle loss. There is also a belief that after being on this medication for a few years your metabolic system may reset. Clearly more research is needed.

  11. 0:00: 🔎 Dr. Lustig discusses the limitations of glp-1 agonists as a solution for metabolic dysfunction and obesity.

    6:08: 👩‍⚕ The use of GLP-1 agonists like Ozempic and Wegovy can lead to weight loss by stimulating insulin secretion and activating satiety signals in the brain.

    11:19: ⚠ Taking ozempic and magovi for weight loss can lead to muscle and fat loss, as well as various side effects.

    17:25: 📉 Tracking glucose and optimizing metabolic health through lifestyle changes can help prevent chronic diseases and maintain stable weight.

    23:20: 👥 The use of medications for obesity is seen as a Band-Aid solution that does not address the underlying metabolic dysfunction and can lead to other problems.

    28:19: ❌ The speaker discusses the limitations and potential risks of using medications like Ozempic and Mokobi for weight loss and diabetes management.

    33:34: ⚠ The medication ramanabant, which suppresses reward and food intake, led to major depressive disorder and suicide in some patients.

    38:21: 👥 The speaker agrees that medications can be useful in jump-starting weight loss and building self-efficacy, but only if used in conjunction with a comprehensive lifestyle program and medical supervision.

    43:55: 😡 Dr. Lustig criticizes the use of drugs like Metformin and Ozempic in children with obesity and emphasizes the need to fix the toxic food environment.

    49:21: 👥 The speaker discusses the issue of relying on medications and surgery instead of fixing the food system to address weight problems in children.

    Recap by Tammy AI

  12. Where do bodybuilders/ people who regularly strength train fit into this? Would regular strength training and a high protein diet spare muscle tissue ?

  13. We know that insulin inhibits lipolysis which is the process in which fats are broken down and burned for energy.

    If these GLP-1 drugs inhibits appetite while raising insulin, the affected person is not getting any energy from foods that they eat because they're not eating and they're not getting enough energy from their body fat either because lipolysis is inhibited.

    Therefore, if the affected person's body is not getting enough energy and is still losing weight, that means it's burning lean/muscle mass instead of fat to make up the difference because it's been put in a position where it can't burn fat.

    This to me makes a lot of sense as to why people using these drugs are experiencing these effects.

    In which case, fasting is still the best method because it reduces appetite naturally while keeping insulin low, allowing it to be possible for the body to burn fat for energy without compromising lean/muscle mass.

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