The drugs Wegovy, Ozempic, and Mounjaro have been grabbing headlines for their impact on weight loss and diabetes management. These medications are considered breakthroughs because they target pathways linked to both obesity and diabetes. But what’s interesting is that these drugs actually mimic natural compounds produced in your gut, known as incretin hormones.
What led to the development of these drugs?
It turns out our bodies naturally make versions of them, and they play a vital role in regulating metabolism and blood sugar. While it’s not a shock that nutrients in our food influence these hormones, what might surprise you is that the trillions of microbes in our gut are major players in this process.
These medications, along with their natural counterparts, offer us a glimpse into the root causes of metabolic diseases. By understanding how gut health, hormones, and diet intertwine, we’re entering a realm of potential innovations in treating metabolic issues and promoting overall well-being.
What is the colonic break?
In the depths of your lower gut, specialised bacteria get to work on the components of food that your body can’t digest – think fiber and polyphenols, those plant elements that often get stripped away in processed foods. These bacteria transform these components into molecules that play a key role in controlling your appetite and metabolism. One of these molecules is GLP-1, which just so happens to be a natural version of the Wegovy and Ozempic drugs.
These gut-produced hormones, including GLP-1 and others like PYY, play a vital role in managing blood sugar levels through interactions with the pancreas. But that’s not all – they also communicate with your brain, signaling when you’ve had enough to eat. This prompts your stomach and intestines to ease up on the speed of food movement along the digestive tract, giving your body the time it needs for proper digestion. This system even has its own name: the colonic brake.
How do Wegovy and Ozempic replicate the colonic break?
Medications like Wegovy and Ozempic stimulate the colonic brake, acting downstream of food and microbes with molecules much like GLP-1. Studies have showcased their efficacy in weight loss and blood sugar control.
Taking it a step further, Mounjaro combines GLP-1 with a second hormone analogue, GIP, derived from the upper gut. Research suggests that this combination therapy surpasses the effectiveness of GLP-1-only treatments like Wegovy and Ozempic in promoting weight loss.
These drugs complement extreme measures such as gastric bypass surgery, especially in cases of severe metabolic disease. Procedures like gastric bypass might operate similarly to Wegovy and Ozempic by diverting digestion in parts of the gastrointestinal tract, exposing gut microbes to less digested food. This, in turn, may prompt the microbes to stimulate gut cells to produce GLP-1 and PYY, effectively regulating appetite and metabolism.
Notably, patients have witnessed substantial improvements not only in weight and blood glucose but also in critical cardiovascular outcomes like strokes and heart attacks. The use of new incretin-based medications, including Wegovy, Ozempic, and Mounjaro, is supported by medical guidelines to manage the interconnected metabolic conditions of diabetes, obesity, and cardiovascular disease.
The downside
While incretin-based therapies, like Wegovy, Ozempic, and Mounjaro, may seem like close-to-magic solutions, they do come with some potential downsides, particularly in the gastrointestinal department. Side effects such as nausea, vomiting, diarrhea, and constipation are not uncommon, directly tied to the drugs’ mechanism of slowing down the gastrointestinal tract.
More severe albeit rare side effects include pancreatitis and irreversible gastroparesis, involving inflammation of the pancreas and paralysis of the stomach.
It’s noteworthy that these medications can contribute to a loss of healthy lean muscle mass, not just fat, especially in the absence of regular exercise. Additionally, significant weight gain often occurs after discontinuing the drugs, prompting questions about the long-term effects and whether a smooth transition back to relying solely on lifestyle measures for weight management is feasible.
As with any medical intervention, a balanced consideration of both the potential benefits and side effects is crucial. Individuals exploring these therapies should engage in open discussions with their healthcare providers to make informed decisions tailored to their specific health needs and goals.
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