Medical Controversy
The medical controversy is mainly about 2 things:
- Side effects
- Regaining weight after stopping.
Here it is important to know which of the following things are a problem and which one of those are not.
Side effects
Beyond the severe risks, common side effects include nausea, vomiting, diarrhea, and constipation. Some studies suggest a link to an increased risk of pancreatitis and gastroparesis (stomach paralysis).
Weight regain
When patients stop taking the drug, evidence suggests they may regain about two-thirds of the weight they lost within a year, raising questions about the necessity of long-term or ongoing treatment. First, the patiënts in the study got the active drug, Semiglutide, and were then swapped out for a fake drug, which we call a placebo. A lot of the weight was returned, showcasing the chronic nature of being overweight and the difficulty getting rid of it. Mental health: There are concerns about potential mental health side effects and the risk of triggering eating disorders, as well as questions about how to appropriately diagnose and treat patients when weight loss is the primary goal.
Ozempic effect on lean mass
Critics of Ozempic, especially some notable examples outside the scientific community, have claimed Ozempic causes detrimental decreases in lean muscle mass, as well as increasing body fat relative to lean mass, even if lowering body weight. (What Ozempic Really Does To Your Body – Joe Rogan & Brian Redban). This talking point is used to showcase Ozempic’s supposed inferiority to diet and exercise (disregarding the fact that Ozempic can, per FDA guidelines, not be prescribed alone, but rather only in conjunction with diet and exercise).
Research on the topic has not been completely conclusive, though several important trends have become apparent. In obese patients, lean mass decreases as fat decreases and proportions remain relatively unchanged, with a slight favour to single-digit percent increases in lean mass proportions. Compared to other weight-loss strategies, such as caloric restriction, drugs with the same mechanisms of action as semaglutide lead to less favourable changes in lean/fat ratio, though not enough to warrant worry in most populations. Thus, if used as intended in the general population, an accelerated reduction of lean mass should not be a major concern.