Wegovy®, Ozempic®, MounjaroTM – Dissecting the Diabetes / Weight Loss Medication Trend
In this article, we’ll discuss a new trend that started online and has taken the social media world by storm. The trend is so popular that patients, once relying on the injections we are about to discuss, now have difficulty finding them to manage their diseases. This trend is using newer diabetes and weight loss medications, including Semaglutides like Ozempic and Wegovy, and other diabetes drugs like Mounjaro for weight loss, even if the patient does not qualify by FDA standards.
Uncovering the Truth About “Acid” Reflux
Chronic acid reflux (gastroesophageal reflux disease or GERD) is a significant and worsening condition affecting millions of Americans. As a result of the persistent obesity epidemic in the United States and worldwide, reflux has affected more and more of the population than ever before. While reflux may seem relatively benign, it can lead to far more severe consequences.
The constant wash of acid from the stomach into the esophagus can create a precancerous condition known as Barrett’s esophagus. This is where the lining of the esophagus begins to resemble the lining of the stomach. A small proportion of those with the condition will eventually develop esophageal cancer, which can be very aggressive if not caught early.
Is Agave Syrup a Healthy Sweetener Alternative for Bariatric Patients?
Agave syrup has taken the sweetener world by storm. Because it is low on the glycemic index, it has been put forth as a beneficial sweetener and is often touted as better than table sugar, honey, and maple syrup. After all, it comes from the same plant that gives us tequila! It’s the perfect sweetener, right? Not quite.
Let’s Start by Understanding What Agave Is
Agave is a succulent found in North and South America and has been used for thousands of years as a sweetener and to make tequila. It has even been explored for its potential medicinal properties. However, like many other new-to-us foods, it only arrived on the American table in the past few decades and, in doing so, has made quite a bang. While the agave plant has objective health benefits, many of these are negated and lost during the processing of the plant to convert its sap into the sweetener we use at home. For example, much like some whole fruits, the agave plant, in its simple form, has plenty of fiber, which is lost when the sap is extracted from the plant and boiled down into fructose.
What If My Insurance Doesn’t Cover Bariatric Surgery
When patients think of surgery, the first thought that pops into their minds is the cost, and rightly so. Surgery is, by any measure, an expensive proposition. When it comes to semi-elective procedures like bariatric surgery, there may not be the immediate desire to pay out of pocket, unlike more urgent surgical needs where there’s simply no choice. As such, patients quickly look to their insurance company to see if bariatric surgery is covered. The sad truth is that many insurance companies have bariatric surgery exclusions in their policies, which may vary between policies, despite being under the same parent company. The result is often frustration when patients hear that friends or family members with the same insurance company have coverage while they may not.
However, the insurance landscape is very different today than even a decade ago. Patients have more options if their insurance does not cover bariatric surgery.
Addiction Substitution After Bariatric Surgery
We know that food, particularly sugary foods, can be addictive. Some studies suggest that the addictive properties of sugar are as powerful, if not greater than some illicit drugs. It is, therefore, no wonder that it is so difficult to “just lose weight.” While many of us start a new diet with great enthusiasm and success, a few weeks or months later, this focus tends to fall by the wayside, and we eventually regain the weight, sometimes adding even more weight afterward. Of course, there are several reasons for this weight regain, not least of which are the stresses and anxieties in everyday life and a concept known as metabolic adaptation. Still, it would be fair to say that some patients suffering from obesity are also addicted to food.
Can Hormone Levels Be the Key to Maintaining Your Weight Later in Life?
The endocrine system of the human body is a finely tuned machine. Hormones secreted throughout the body regulate everything from our mood to heart rate and even how much fat we accumulate (and where). When we gain weight and add visceral or bad fat (typically around our waist), we can often throw our bodies out of balance and cause hormonal changes that affect our metabolic system significantly.
Both men and women are affected by hormonal imbalances. For example, some of the newest research on obesity and its hormonal consequences revolve around sexual function. In men, obesity can cause erectile dysfunction and infertility. In women, obesity can increase the risk of miscarriage, polycystic ovarian syndrome, and infertility. In fact, one of the most satisfying parts of our jobs is seeing couples that could not conceive before surgery do so afterward. But it doesn’t end there. Dysregulated hormones can promote the development or increase the severity of certain forms of cancer, including breast and colon. Inflammatory secretions from visceral fat can cause our joints to degrade more quickly. The list goes on…
New Bariatric Surgery Guidance Released by ASMBS and IFSO
While excess weight and obesity are some of the most researched topics in modern-day society, mainly due to the incredible rise in weight-related comorbidities, we do not often get the exciting news of new surgical guidance or suggestions from influential organizations. When they happen, it’s a big deal and something we should consider carefully. Just that happened last month when the American Society for Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) released joint guidance intended to update federal guidelines since 1991. In your research of bariatric surgery, you’ve likely come across these older guidelines, which essentially state that patients with a BMI of 35 or over with one or more obesity-related comorbidities or patients with a BMI of 40 or over regardless of comorbidities may be eligible for bariatric surgery. While these guidelines have been in place for the best of three decades, they have also limited access to bariatric surgery for millions of patients suffering from excess weight-related conditions but with no qualifying BMI. How is this possible?
Ultimately, the reason for this is the inherent inaccuracy of the BMI calculation. The BMI was never intended to be used as a measure of obesity. The larger question is, what exactly is obesity? Arbitrary BMI levels very loosely define obesity – there’s little empirical evidence behind it.
No Exercise, No Diet Weight Loss. Does It Exist?
If you’re considering bariatric surgery, you have likely tried many diet and exercise programs to get back into shape over the years. If you haven’t been successful, don’t beat yourself up. Unfortunately, for most, these programs are not effective. Many patients regain their weight, and often put on even more, after some time. Despite a lifetime of being bombarded with diet plans that claim to work, we continue to be lured into the promise of weight loss and fat-busting with little or no work. And it’s no surprise it often ends in frustration.
So, to get right to the point, fat loss and weight loss do not happen without work; no matter what road you take to get there. To lose weight, proper diet and exercise are essential. And this is also true after bariatric surgery.
Breaking Down Metabolic Adaptability to Understand Weight Loss
You may be coming off a failed diet and feeling frustration and despair as you read this. You may feel very alone now, but you should also know that millions of people are in the same position. Losing weight is not easy and doing so without help is even more challenging. We are often taught that the key to weight loss is a deficit of 3500 calories at a time (equal to the loss of a single pound). However, sometimes it feels like you’ve restricted so many more calories than that, yet the number of pounds lost has not kept up. Well, there is a reason for that, and it is called metabolic adaptability.
Recent studies have shown that your metabolism may not slow until about 60. However, just like it does each day, as you eat and exercise, it adapts. And this is one of the reasons why losing weight without a catalyst like bariatric surgery is so difficult.
Diet or Exercise: Which Is Better for Weight Loss?
Whether you are a bariatric patient or not, diet and exercise are vital components of any weight loss program. But while the concept of simple calories in versus more calories out for weight loss is true, it does not tell the whole story. Diet and exercise contribute to weight loss and improved health in different ways.
