Can Healthy Sustainable weight Loss be Achieved with GLP-1 Inhibitors Like Wegovy or Zepbound?
Injectable weight loss medications like Wegovy (Semaglutide) and Zepbound (Tirzepatide) have initiated a significant wave of weight loss success for many in need. Sustainable weight loss involves long-term lifestyle and dietary changes combined with a consistent exercise routine. With the proper monitoring and dosing, a safe level of weight loss can be achieved with injectable weight loss medications such as Tirzepatide and Semaglutide. It’s important to understand the potential side effects before starting and to have the proper guidance from a medical doctor.
Who Should be using GLP-1 Weight Loss Medications?
While GLP-1 inhibitors have shown clear benefits for treatment of obesity with BMI (body mass index) over 30, there is no clear guidance or long-term research information regarding healthy individuals who only want to lose 5-20 pounds. For overweight individuals who also have diabetes or high blood pressure, GLP-1 inhibitors has been shown to reduce the risk of stroke, heart disease, blood sugar control, and even liver health.
How Long Should I be using Injectable Weight Loss Medications?
Dosing duration is variable depending on co-existing health problems and weight challenges. Ideally, long-term use of GLP-1 medications should be limited due to potentially devastating side effects such has thyroid cancer, stomach paralysis (gastroparesis) and even blindness. Patients should be well-aware of any potential side effects and have informed consent with a qualified health professional.
Should you be using Compounded Versions of Wegovy or Zepbound?
In December 2024, the FDA declared that Zepbound was no longer in short-supply and in February 2025, the shortage of Wegovy also ended. Therefore compounding pharmacies have since been prohibited from legally distributing generic versions of Wegovy and Zepbound. Despite that, many online platforms, medical spas and weight loss clinics are still providing generic versions.
Compounding pharmacies ignoring ethics and legalities often mix generic GLP-1’s with Vit B12, Vit D, or other ingredients. There are quality & consistency issues: Compounded or imported GLP-1 may not meet FDA standards for purity, potency, or stability, increasing the risk of under- or overdosing. Patient safety risks include incorrect dosing or contamination can lead to serious side effects, including vomiting, pancreatitis, thyroid issues, hypoglycemia (low blood sugar), bacterial contamination, or vitamin toxicity, among other things.
What is a healthy rate of weight loss?
Typically a healthy rate of weight loss is 1-2 pounds per week for most people. This may vary depending on your overall weight.
What are the dangers of losing weight too fast?
Extreme dieting or medications such as Wegovy (Semaglutide) and Mounjaro (Tirzepatide) may lead to rapid weight loss. However with proper monitoring and dosing, rapid weight loss can be avoided. Losing weight too quickly can pose several risks to your health. Here are the key concerns:
Nutrient Deficiencies:
Rapid weight loss often involves extreme calorie restriction, which can lead to inadequate intake of essential nutrients such as vitamins, minerals, and proteins which then has cascading effects on muscle mass, facial volume, hair density, skin elasticity, and metabolism.
Muscle Loss:
Extreme calorie restriction forces the body to use muscle protein for energy, leading to muscle breakdown. Rapid weight loss diets often lack adequate protein, which is essential for maintaining muscle mass. Losing muscle mass will decrease your overall strength and slow down your metabolism.
Hair Loss:
Rapid weight loss can be a physical stressor, which can disrupt the normal hair growth cycle, leading to a condition known as telogen effluvium, where hair prematurely enters the shedding phase. Quick changes in diet and weight can alter hormone levels, impacting hair growth and potentially causing hair loss.
Loose Skin:
Losing weight too quickly can result in loose, sagging skin, as the skin doesn’t have enough time to adjust to the body’s new shape.
Facial volume loss:
Quick weight loss leads to a significant reduction in facial fat, which can make the face appear gaunt and less youthful. Along with fat, there is also loss of muscle mass in the face, contributing to a hollowed appearance. The skin has insufficient time to adjust to the smaller contours of the face, resulting in loose and sagging skin.
Gallstones:
Quick weight loss increases the risk of developing gallstones, which are hard deposits of cholesterol in the gallbladder that can cause pain and digestive issues.
Metabolic Slowdown:
A significant reduction in calorie intake can slow down your metabolism, making it harder to maintain weight loss and potentially leading to weight regain.
Dehydration:
Rapid weight loss can lead to dehydration, especially if it is achieved through extreme diets or excessive sweating.
Electrolyte Imbalance:
Losing weight too fast can disrupt the balance of electrolytes in your body, leading to symptoms like fatigue, muscle cramps, and irregular heartbeats.
Mental Health Issues:
Rapid weight loss can contribute to mental health problems such as anxiety, depression, and eating disorders due to the stress and pressure of maintaining extreme diets or exercise routines.
Fatigue and Weakness:
Extreme dieting and fast weight loss can lead to general fatigue, weakness, and a decrease in energy levels, affecting your daily activities and overall quality of life.
Rebound Weight Gain:
Quick weight loss is often not sustainable, and many people regain the weight they lost (and sometimes more) once they return to their regular eating habits.
For these reasons, health experts typically recommend aiming for a gradual weight loss of about 1-2 pounds per week, which is more sustainable and poses fewer health risks.
What’s the best way to lose weight?
Sustainable weight loss involves maintaining healthy lifestyle and dietary habits combined with a consistent exercise routine. Those who need a boost, often resort to injectable weight loss medications.
How can Emsculpt NEO or Strength Training help with Healthy Weight loss?
Emsculpt NEO effectively increases muscle mass and strength, contributing to a toned and sculpted appearance. The radiofrequency energy component helps reduce stubborn fat to enhance overall body contour. Emsculpt NEO is non-invasive, with no downtime, only 30 minutes per session making it a convenient and time-saving addition to a weight loss program. Emsculpt NEO works synergistically with diet and exercise, accelerating results and boosting metabolism.
How does increasing muscle mass improve metabolism and contribute to weight loss?
Muscle mass improves metabolism and contributes to weight loss in several key ways:
Increased Basal Metabolic Rate (BMR): Muscle tissue is metabolically active and burns more calories at rest compared to fat tissue. This means that the more muscle mass you have, the higher your BMR, which is the number of calories your body needs to maintain basic physiological functions while at rest.
Higher Caloric Expenditure: During physical activity, muscles require more energy, resulting in a higher caloric burn. This is true for both resistance training and everyday movements, making weight management more efficient.
Enhanced Post-Exercise Caloric Burn: Building muscle through strength training causes your body to continue burning calories even after the workout is finished, a phenomenon known as excess post-exercise oxygen consumption (EPOC).
Improved Insulin Sensitivity: Increased muscle mass improves the body’s ability to respond to insulin, which helps regulate blood sugar levels more effectively. Better insulin sensitivity reduces the likelihood of fat storage and aids in maintaining a healthy weight.
Fat Utilization: Having more muscle mass shifts the body’s energy utilization towards burning fat, especially during periods of calorie restriction or weight loss efforts.
Support for Healthy Hormone Levels: Muscle mass helps maintain balanced hormone levels, including those that regulate metabolism and appetite. This hormonal balance supports sustained weight loss and prevents metabolic slowdown.
By enhancing metabolic rate and increasing the body’s efficiency in burning calories and utilizing fat, muscle mass plays a crucial role in both weight loss and long-term weight management. Emsculpt NEO is FDA cleared for treatment of 10 body areas to include: abdomen, arms (triceps, biceps), obliques (flank region), thighs (anterior, medial, lateral, posterior), buttocks, and calves.
When should I consider weight loss medications?
If dieting and exercise has been unsuccessful, you might consider an alternative approach. Weight loss medications like Semaglutide (Wegovy) or Tirzepatide (Mounjaro or Zepbound) can be considered under specific circumstances:
Body Mass Index (BMI) Criteria:
Adults with a BMI of 30 or higher (obese).
Adults with a BMI of 27 or higher (overweight) with weight-related health conditions such as type 2 diabetes, hypertension, or dyslipidemia.
Failure of Lifestyle Changes:
Individuals who have not achieved significant weight loss or sustained weight loss with diet and exercise alone.
Those who have made serious efforts at lifestyle modifications without the desired results over a reasonable period.
Presence of Comorbid Conditions:
Patients with obesity-related health issues such as type 2 diabetes, cardiovascular disease, obstructive sleep apnea, or non-alcoholic fatty liver disease, where weight loss is critical for improving health outcomes.
Health Risks of Obesity:
Individuals whose obesity poses a significant risk to their health and well-being, potentially leading to severe medical complications.
At Rejuve Medspa, Dr. Kaplan can help you determine if weight loss medications are appropriate for your specific situation, ensuring a comprehensive approach to weight management. The decision should not be taken lightly. Awareness of the potential risks is important. Medical clearance with laboratory monitoring will be required.
How much weight loss can I expect with Semaglutide or Tirzepatide?
Semaglutide and tirzepatide have shown significant potential for weight loss in clinical studies. Here is an overview of the expected weight loss with each medication:
Wegovy (Semaglutide)
Clinical Trial Results:
In the STEP (Semaglutide Treatment Effect in People with obesity) trials, participants taking semaglutide (Wegovy) achieved an average weight loss of around 15% of their initial body weight over 68 weeks.
Some participants experienced weight loss of up to 20% or more.
Dosing and Duration:
The typical dosing for weight loss starts at a lower dose and gradually increases to the full dose of 2.4 mg once weekly.
Maximum weight loss is often seen after 6 to 12 months of continuous use.
Zepbound (Tirzepatide)
Clinical Trial Results:
In the SURPASS clinical trials, participants taking Tirzepatide (Mounjaro) achieved an average weight loss ranging from 15% to 22.5% of their initial body weight, depending on the dose.
The higher dose of 15 mg once weekly showed the greatest weight loss.
Dosing and Duration:
Tirzepatide dosing starts at a lower level and gradually increases to the target dose over several weeks to minimize side effects.
Significant weight loss is typically observed within the first few months, with continued benefits over 12 months or longer.
Factors Influencing Weight Loss
Adherence to Medication: Consistent use as prescribed is crucial for achieving optimal results.
Lifestyle Modifications: Combining medication with diet changes and regular physical activity enhances weight loss outcomes.
Individual Variability: Results can vary based on factors such as age, gender, baseline weight, and overall health.
Both semaglutide and tirzepatide offer substantial weight loss potential, especially for individuals who have struggled with traditional weight loss methods. It's essential to consult with a healthcare provider to determine the most appropriate treatment and to tailor the approach to individual needs.
What are the potential side effects of Wegovy or Zepbound?
Side effects may include: nausea, loss of appetite, diarrhea, vomiting, constipation, abdominal pain, dyspepsia (heartburn), headache, fatigue, bloating (burping and flatulence). More serious but less common side effects include: gastritis (stomach inflammation), gallstones, pancreatitis, low blood sugar, abdominal distention (bloating), low blood pressure and syncope (fainting), acute kidney injury, thyroid cancer, allergic reaction, necrotizing pancreatitis sometimes resulting in death.
Is Tirzepatide or Semaglutide better for weight loss?
At Rejuve Medspa, we prefer Zepbound since it has been shown to be associated with fewer side effects and less risk of potential complications. Zepbound is also very effective for weight loss at low doses, especially for those with BMI less than 30.
Is there an alternative weight loss medication?
Metformin has been widely used for many years and has a safety track record. Metformin, primarily used to treat type 2 diabetes, can also aid in weight loss through several mechanisms:
Improved Insulin Sensitivity: Metformin enhances the body's sensitivity to insulin, reducing insulin levels and decreasing fat storage.
Reduced Appetite: It can help reduce appetite, leading to lower caloric intake and potential weight loss.
Lower Glucose Production: Metformin decreases the liver's glucose production, which helps regulate blood sugar levels and can contribute to weight loss.
Altered Gut Microbiota: Metformin promotes the growth of beneficial gut bacteria while reducing harmful ones. This improved balance can enhance metabolic functions and contribute to weight loss.
Increased Production of Short-Chain Fatty Acids (SCFAs): The beneficial bacteria fostered by metformin produce SCFAs, which have been shown to improve insulin sensitivity, reduce inflammation, and regulate appetite, all of which support weight management.
Metformin is not known to cause rapid weight loss. Thus the potential for hair loss, muscle loss, facial volume loss, sagging skin, gallstones, and pancreatitis are not typically associated. Unlike semiglutide or terzepatide, metformin is not linked with thyroid cancer, anaphylaxis (severe allergic reaction), Patient taking metformin can sometimes experience nausea, diarrhea, reduced appetite but this can be minimized by slowly increasing the dose. Metformin can lead to mild reduction in weight (about 5 pounds) for many people. It may be a good alternative for those wishing to wean off injectable weight loss medications such as Tirzepatide or Semaglutide. It might also be a consideration for those who prefer not to take injectable weight loss medications.
What are the most important elements of proper Nutrition and Lifestyle for sustainable weight loss?
Calorie Reduction: Avoid calorie-dense foods such as potato chips, which are easy to eat and can allow us to consume more calories than we need before we sense we’ve had enough.
Lean Proteins: Prioritize lean proteins to support healthy muscles. Good sources of protein are lean meats, beans, peas, and lentils. Most patients require around 60-80 grams of protein per day, but this may vary depending on your health conditions. Consider meeting with a registered dietitian for more individualized advice.
Fiber: Consuming whole grains, non-starchy vegetables, and fruits as part of a balanced diet, and they are also great sources of fiber.
Movement: your body regularly. Make a plan for regular physical activity, which includes strength training and stretching to promote strength, function, and weight maintenance.
Stress management: Incorporating stress management, mindfulness, and a healthy sleep pattern to support mental well-being and restoration.
Sleep: Adequate sleep supports weight loss by regulating hormones that control hunger and appetite, improving metabolism, and reducing cravings for high-calorie foods. Consistently getting enough rest helps the body burn energy efficiently and maintain healthy weight management.
Strength Training: improved insulin resistance and metabolism boost.
In summary, lifestyle, diet and exercise are more important than medication for healthy, sustainable weight management.