Healthy Skeptics Newsletter for August 2023

Topic

GLP-1 drugs for weight loss. Side effects and alternatives

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Topic 1. Rapid weight loss… at what cost?

Stephen Cherniske, MS
Natalie Kather, MD

Here is the press release sent to Seattle media outlets. Let’s see who picks up the story.

  1. GLP-1 agonist drugs (Ozempic, Wegovy, Mounjaro) are in the news every day. This is not a fad. According to Natalie Kather, MD, a board certified Family Medicine physician, “the failure of previous weight loss drugs was that they were poorly designed. Some relied on over-stimulating the nervous system, while others worked to prevent the absorption of dietary fat, resulting in embarrassing adverse side effects. GLP-1 agonists are true metabolic modifiers. They work by restoring the body’s ability to burn fat, and by keeping food in the stomach longer.

2. Not surprising, these drugs are being vigorously promoted, not only by the pharma companies who make them, but by a raft of internet providers with dubious credentials who offer direct overnight delivery after a “consultation” consisting of a simple questionnaire. Thus, we can expect the number of users to increase at an exponential rate. Global Market Insights reports that the market for these drugs was $22.4 billion in 2022, and this number will explode to $60 Billion by 2032.

Source: Read More Here

  1. The Problems no one is talking about

In what could be called the “Ozempic Dilemma,” research is showing that people using GLP-1 agonist drugs are rapidly losing “weight,” but much of that weight is muscle. In one study, subjects lost an average of 10.4% of their fat mass, and 7% of their muscle mass. One physician quoted in MedPage Today stated, “Almost every patient we put on this drug has lost muscle mass at a rate that alarms me.”

Source: Does Wegovy Shrink Muscle Mass

  1. Dr. Kather is sounding the alarm, because, as her biochemist husband explains, “the goal is NOT weight loss. Ask any obesity expert, and they will tell you that the only reasonable goal is fat loss while maintaining muscle mass. This is because muscle is the body’s natural weight management system. If you lose a significant amount of muscle (and 7% is a shocking amount) you are going to end up in a worse metabolic state than when you started. In effect, you will become dependent on the drugs for the rest of your life. What’s more, a decrease in muscle mass could lead to long-term health issues such as frailty, compromised physical function, and other related concerns.
  1. There is a solution, but there’s also a Catch-22.

For a fit person, exercise feels invigorating. But most overweight people have poor cardiorespiratory fitness, so exercise feels like torture. A fit person also feels great after they exercise. Overweight people generally feel like they’ve been hit by a bus. Overcoming this dilemma requires specialized training. A number of gyms in the Seattle area (Fitness Quest facilities) have programs designed specifically for the overweight individual. They understand the metabolic shift that is achieved with GLP-1 agonist drugs, and know how to optimize fat loss while maintaining – or even increasing muscle mass. What’s more, Fitness Quest has partnered with Dr. Kather and Stephen Cherniske to develop natural products – known as metabolic modifiers – that make exercise easier and more enjoyable.  These include a pre-workout supplement called KYSO™, a unique, non-stimulant beverage shown to safely and effectively improve circulation. Better circulation means more oxygen and fuel getting to working muscles, thereby improving exercise tolerance and stamina.

For detailed information about KYSO™ click here:
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*** The second issue that is rarely discussed in the media is gastroparesis: GLP-1 agonist drugs prolong the time food stays in the stomach, usually up to 3 hours, compared to the typical 45 minutes. This delay gives a feeling of fullness which discourages overeating.

However, an alarming potential side effect of this mechanism is the onset of gastroparesis – a condition characterized by the partial paralysis of the stomach. This condition can cause the stomach to be unable to empty itself in a normal fashion, leading to symptoms such as chronic nausea, vomiting, and even malnutrition in severe cases.

There are alternative approaches.

Natural Products and Intermittent Fasting

In light of the potential adverse effects associated with GLP-1 agonist drugs, it’s important to explore alternative strategies for weight management and blood glucose control. Two such strategies include intermittent fasting and the use of natural products with mild GLP-1 agonist activity.

Intermittent Fasting

Intermittent fasting, a practice involving alternating cycles of fasting and eating, is an approach growing in popularity. By restricting the eating window, this method encourages the body to utilize stored fat for energy and improve insulin sensitivity, thus supporting weight management and glucose control. The strategy that Natalie and I promote is called Kickstart. Quite simply, you stop eating at 7:PM.  By 3AM most people are in “fat-burning” mode. If you eat carbs for breakfast, this fat-burning comes to a screeching halt. If instead, you have a protein shake for breakfast, fat-burning continues. We created Timed Release Protein to satisfy hunger for 5 hours. Using this approach, you have 8 hours of fat burning, without feeling deprived or hungry. Combined with regular exercise, Kickstart will produce consistent weight loss. Once you reach your goal, using Kickstart a few times a week will help maintain your ideal weight.

Special through 09/01/23. Buy one large (930g) Timed Release Protein and receive a FREE download of Stephen’s e-book: The Complete Guide to Intermittent Fasting.

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Natural Products with GLP-1 Agonist Activity

A variety of natural products may provide a gentler way of harnessing GLP-1 agonist activity. These natural supplements include curcumin (found in turmeric), berberine (found in several plants including barberry), resveratrol (found in grapes and berries), green tea, and cinnamon.

REF: Reference: Adv Exp Med Biol. 2021;1328:513-522. Boosting GLP-1 by Natural Products

Habib Yaribeygi, et al. PMID: 34981502 DOI: 10.1007/978-3-030-73234-9_36

And finally, of course… DHEA.

When discussing diabetes and obesity (now called “diabesity”) with colleagues, or at medical conferences, Natalie and I are (still) shocked at the glaring omission of DHEA. When we ask why it is not included in the syllabus or mentioned in any presentation, we are told that the research is “inconsistent,” and that DHEA has not been approved by the FDA for the treatment of diabetes or obesity. As I will show below, the research is conclusive, but since DHEA (being a natural molecule produced by the body) cannot be patented, there is no multi-billion dollar payout for drug companies to promote it.

We always recommend talking to your doctor regarding the use of any nutritional supplement. If your doctor is unfamiliar with the weight management benefits of DHEA supplementation, we have made my e-book, The Case for DHEA available for free at My2048.com.

https://my2048.com/shop/dhea/

If reading a 67 page e-book is too much to ask, here is an abridged case for DHEA, specifically regarding weight management.

  1. Remember that the goal is fat loss, in which case the long-term solution is one that improves insulin sensitivity and promotes muscle mass. In human clinical trials, DHEA has been shown to do both.

REFS;

  1. Villareal DT, Holloszy JO, Kohrt WM. Effects of DHEA replacement on bone mineral density and body composition in elderly women and men. Clin Endocrinol (Oxf) 2000 Nov;53(5):561-8 2. Kawano H, Yasue H, Kitagawa A, Hirai N, Yoshida T, Soejima H, Miyamoto S, Nakano M, Ogawa H. Dehydroepiandrosterone supplementation improves endothelial function and insulin sensitivity in men. J Clin Endocrinol Metab. 2003 Jul;88(7):3190-5. ↑
  2. Diamond P, Cusan L, Gomez JL, Belanger A, Labrie F. Metabolic effects of 12 month percutaneous dehydroepiandrosterone replacement therapy in postmenopausal women. J Endocrinol 1996; 150:S43-S50.
  3. Casson PR, Faquin LC, Stentz FB, Straughn AB, Andersen RN, Abraham GE, Buster JE. Replacement of dehydroepiandrosterone enhances T-lymphocyte insulin binding in postmenopausal women. Fertil Steril 1995 May;63(5):1027-31 ↑
  1. DHEA has been shown to produce beneficial effects in adipose tissue. It helps to prevent the deposition of dietary fat, and stimulates fat-burning in muscles and liver.

REF:

    1. FASEB J. 1993 Mar;7(5):414-9. Is dehydroepiandrosterone an antiobesity agent?

C D Berdanier , J A Parente Jr, M K McIntosh.

Concluding statement: “the antiobesity function of DHEA is not simply one of inhibiting fat synthesis and deposition but is one of affecting a number of pathways that contribute to the maintenance of the isoenergetic state.”

  1. Pergola GD. Adipose tissue metabolism: role of DHEA. Int J Obesity 2000; 24: Suppl 2. S59-S-63.

Concluding statement: “Regarding the action of DHEA as a fat-reducing hormone, it is possible that this hormone reduces the peripheral requirement for insulin by increasing glucose disposal, and that lower insulin levels are associated with a higher plasma ratio between lipolytic hormones and insulin, and a higher efficiency of lipolysis and loss of body fat.”

  1. Ongoing research (outside the US) has identified specific metabolic pathways that are improved by DHEA. As we learn more, the case for DHEA becomes stronger every year.

REF:

Steroids. 2012 Nov;77(13):1359-65. Fat-reducing effects of DHEA involve upregulation of ATGL and HSL expression, and stimulation of lipolysis in adipose tissue

Joanna Karbowska, Zdzislaw Kochan.

Concluding statement: “This study demonstrates that DHEA promotes lipid mobilization in adipose tissue by increasing the expression and activity of ATGL and HSL. The effects of DHEA appear to be mediated, at least in part, via PPARγ2 activation, which in turn upregulates ATGL and HSL gene expression.”

NOTE: We do not recommend taking DHEA by itself. Synergized DHEA™ combines pharma-grade micronized DHEA with DIM (diindolylmethane) and Alpha lipoic acid. The women’s formula also provides chaste tree berry extract.

For details, click this link:  https://my2048.com/alpha-lipoic-acid-ala/

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