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Posted on Friday January 26, 2024 in Metabolic Health
By Juliette Martin, Nutritional Therapist
Over the past few months, a family of medications called GLP-1 agonists, often referred to as the ‘skinny jab’ has captured widespread media attention. Endorsed by celebrities including Oprah Winfrey and Elon Musk, these medications, initially designed for individuals with type 2 diabetes -notably Liraglutide, marketed as Saxenda and Semaglutide, known under the name of Ozempic – are being promoted as a miracle solution for weight-loss.
How do they work?
The drug mimics a naturally occurring hormone called glucagon-like peptide 1 (GLP-1). When food reaches the small intestine, hormones including GLP-1 are released which in turn enhances insulin secretion in the pancreas, slows gastric emptying and suppresses hunger by inhibiting the release of glucagon, a hormone involved in hunger regulation. Effectively, when using these injections, your body sends a signal to your brain that you are full, reducing your overall food intake.
By significantly reducing portion size, many individuals have successfully managed to lose weight fast and keep their blood sugars more stable.
Weight loss but at what cost?
Although research is still very much in its infancy for the use of GLP1-agonists with non-diabetics, what is clear is that these drugs do not come without a myriad of risks, as one would expect with any novel ‘miracle’ drug promising quick results. Some individuals report having experienced concerning side-effects and the long-term effects are unknown. Common symptoms include gastrointestinal issues such as nausea, constipation, diarrhea and heartburn. Concerningly, cases of pancreatitis, bone loss, psychological distress and thyroid cancers have also been reported.
A recent study revealed that a year after withdrawal, those patients taking GLP-1 agonists regained two-thirds of the weight loss [1]. In addition, their improved blood pressure, cholesterol, blood sugar levels reverted back to their pre-trial levels, highlighting the potential drawbacks associated with GLP-1 agonists in the long-run.
Aside from the potential health risks, the financial cost of around £2,400 per year as well as the maximum two-year usage suggests these drugs may only offer a short-term solution at best.
The importance of sustainable weight-loss
While reducing portion sizes is beneficial, it’s crucial to emphasize that GLP-1 agonists are not a substitute for a healthy diet. If an individual predominantly consumes processed foods and saturated fats, the potential harm to metabolic health could outweigh the benefits.
Success stories have often involved healthy habits such as long walks, batch-cooking, and including protein at every meal for enhanced satiety. When individuals regained their ‘baseline’ hunger levels, they were better able to sustain the positive results. Ideally, this should be done within a supportive medical framework involving a comprehensive medical history, examination, and psychological, dietetic, or nutritional support.
For those considering alternative pathways to weight loss, GLP-1 agonists are by no means a definitive solution. Personalised nutrition which targets potential drivers such as blood sugar dysregulation can contribute to a more sustainable approach to weight management.
Here are three tips to encourage weight loss without the risks:
1) Include protein at every meal.
Foods rich in protein including fish, legumes, poultry, eggs, beans, nuts and seeds are key to help with promoting feelings of satiety and ward off any sugar cravings. It is thought that this happens due to a combination of an increased secretion of satiety hormones including GLP-1 and improved glucose regulation.
2) Eliminate snacking
Snacking on processed foods contributes to blood glucose fluctuations and leave you more prone to overeating. Focusing on whole, nutrient-dense foods and well-balanced meals can help in achieving and sustaining a more consistent energy level throughout the day.
3) Prioritise a good sleep routine
There is a very close connection between sleep, hormonal regulation, metabolic health and weight management. Poor sleep can reduce glucose tolerance and insulin sensitivity whilst increasing the levels of ghrelin – the hunger-stimulating hormone-, and decreasing leptin levels – the hormone which controls satiety. Studies have shown that individuals with poor sleeping patterns tend to consume 300-400 calories more.
Weight gain is a multifaceted issue and while GLP-1 agonists provide a quick fix for some, they come with associated risks and limited long-term effectiveness. A more personalised and holistic approach, taking factors such as sleep, physical activity, stress management and diet into consideration is likely to be more effective in the long-run for sustainable weight loss.
The idea of predicting a heart attack may have once seemed like science fiction, but it is rapidly becoming a reality. With the advent of advanced imaging techniques and artificial intelligence, we are now able to detect the early signs of coronary heart disease and intervene before a heart attack occurs. This represents a major shift in the way we approach cardiovascular care, moving from a reactive model to a proactive one.
Is is increasingly obvious that not everyone with raised coronary inflammation and elevated risk of heart attack simply has a raised LDL Cholesterol- in fact there appears to be a mixed bag of risk factors associated with high coronary artery inflammation, including raised LDL, raised LP (a), raised Homocysteine, hypertension and dysregulated glucose. Our metabolic health assessment is therefore designed to offer a comprehensive dive into known contributory causes, the latest and most controversial of which is 'glucose dysregulation', the principle topic of this article.
For patients who have been diagnosed with an acute coronary syndrome, requiring bypass surgery or stent, or have CT Angiography and or raised FAI.
Ultimately, the approach to cardiac CT screening is highly individualized, reflecting the diverse presentations and risk factors among patients. By employing a sophisticated pre-consultation process, cardiologists can tailor their assessment and management plans to best suit each patient's unique needs, enhancing the precision and effectiveness of cardiac care.
There are two main reasons left atrial thrombus forms then detaches to cause embolic stroke. The first is that during atrial fibrillation or flutter, a thrombus may develop in the left atrial appendage, which does not move as much as it does when in sinus rhythm. The likelihood of this occurring in any given year is low, correlated to the CHA2DS2-VASc score. The second reason is not related to CHA2DS2-VASc score
Lp(a) testing is advised for individuals at high risk for cardiovascular disease, including those with a prior stent or bypass operation, coronary syndrome or heart attack as well as anyone with a family history of coronary heart disease, high FAI (coronary inflammation) or high risk patterns on Cardiac CT angiograms. In our practice, Lp (a) is offered as part of our comprehensive Metabolic Health assessment (MHA1).
A new high quality MRI scanning service launched today by VCL and available at SCVC.
Throughout your life your blood pressure will be largely determined by your genetic makeup, BMI, what you eat and any medications you take. If your parents have or had high blood pressure, the odds are that you will, one day develop it too, so if you are fortunate enough to live into old age it may well end up causing you some issues. So lets be warned!