Till Death Us Do Part, Continued

When someone starts taking one of the new weight-loss medications based on synthetic glucagon-like peptide-1, the vow appears to be more binding than marriage. As we have seen, in a large number of cases the meds only work while the person is taking them.

All people with Type 1 and some people with Type 2 diabetes can expect to be injecting insulin forever, and like any other commodity where the demand grows every year, insulin is profitable. People need insulin like zombies need blood, and it looks as if soon, people will be needing their GLP-1 medications in the same implacable way. Already, there are reports of some unsatisfactory and worrisome outcomes.

Lowered expectations

A British website lists possible reasons why people taking these drugs might feel discontented, like the weight loss is just not happening. One reason is, they expect the change to be sudden and dramatic, which it may be for some, although that is not the norm. But three of the reasons are definitely “on you”:

You’re not getting enough sleep
You don’t have the right calorie intake
You haven’t found the right healthy lifestyle changes

The piece goes on to say that in order to manage weight in the long term, a person needs to establish healthy habits, and then stick with them. It appears as if this is not a widespread accomplishment. Even if it were, these meds do not seem to reward tenacity. However conscientious the person has become about diet and exercise, no effort seems to matter. There are dismal reports of people trying hard but doomed to failure. If the patient goes off the meds, everything falls apart.

The Journal of Pharmacology and Therapeutics noted that “ongoing treatment [of Ozempic] is required to maintain improvements in weight and health.”

Reading too much into it

It appears that one of the things people have been telling each other might not be true, which is the “training wheels” notion. Those meds were never intended to be transitional. Yes, good eating habits and exercise will help the injections do their job. But a lot of evidence has piled up to say a different truth: If you go off the stuff, even your new healthier lifestyle probably won’t help. The pounds will begin to accumulate.

Evidence shows that no matter how many excellent habits of diet and exercise someone has been practicing, nothing can stop the inexorable re-acquisition of weight. If a person loses their insurance or suffers some other misfortune and can no longer afford the meds, it’s over.

Forbes writer Alyssa Northrop quotes Dr. Christopher McGowan:

GLP-1 medications [like Ozempic] are designed to be taken long-term… They are chronic medications for the treatment of chronic conditions (both diabetes and obesity).

Researcher and essayist John Mac Ghlionn wrote about Ozempic (and, by extension, any drug of the same type). If someone decides to quit the medication, “there is an incredibly high chance that he or she will put all the weight back on.” Like many others, he is concerned that Ozempic has been approved for treating obesity in children.

Imagine how much worse things could be if these medications were made available over the counter.

Your responses and feedback are welcome!

Source: “Ozempic For Weight Loss: Risks, Side Effects And More,” Forbes.com, 04/26/23
Source: “Not losing weight on Ozempic? Here’s why that might be happening,” MyJuniper.co.uk/05/08/23
Source: “Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension,” Wiley.com, 04/19/22
Source: “Ozempic, The Atlantic, and the Dangers of Anti-Exercise Rhetoric,” RealClearScience.com, 03/29/23
Image by Bruce Tuten/CC BY 2.0

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Profiles: Kids Struggling with Weight

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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