I want to start this post off by saying I have been reading and researching a lot about these new weight loss drugs and the jury is still out about the long term effects of using them. Having said that, they seem to be extremely powerful and helpful for many people, albeit cost prohibitive.
Ozempic (semaglutide) is the most well known drug on the market currently so we will use it for the purposes of this post, but know there are other drugs in the same category and even more that are slightly different (and may even be more effective) still emerging.
In the past, traditional weight loss methods (diets) focused on the thermodynamic equation of energy in vs energy out and these methods typically rely heavily on caloric restriction and require immense amounts of will power and are often accompanied with feelings of deprivation.
The difference with Ozempic is that it focuses on affecting the brain's reward center and retraining your brain to not crave food. It does this mainly by helping the body control blood sugar and regulate insulin (this is why it was originally only approved for patients with Type 2 diabetes) but it also simulates a hormone called GLP-1 which slows the stomach's emptying and signals our brain that we feel full sooner or just aren't hungry to begin with.
The reason this type of drug is so popular is because the results it yields are quite substantive. Normal weight loss interventions/diets will typically see a weight loss of 5-7% of the person's body weight. With Ozempic, the numbers are far greater- closer to 15-18%, which in a 200lb person is the difference between losing 10lbs vs 30lbs.
People using the drug also mention a reduction in other addictive and dopamine dependent behaviors such as alcohol consumption and/or online shopping. So it obviously works on the brain's reward system beyond food. Another unexpected benefit is its relation to improving cardiovascular health in some patients- this effect is being studied further.
As with most weight loss interventions, if you stop taking the drug, you run the risk of putting the weight back on and long term effects of the drug have not been studied yet given its fairly new emergence in the market. Typical side effects are GI distress and nausea and it can lead to some more serious issues with the pancreas. Doctors typically have patients titrate up on the drug over a period of time to help alleviate some of these symptoms. Another important factor to mention is that the weight loss tends to be equal parts fat tissue and lean tissue. Ideally, we want to hang onto as much lean tissue as possible for a variety of reasons, so the ratio being 1:1 is not ideal, and can actually be counterproductive in the long run.
Doctors tend to restrict the use of these drugs to obese patients and those with Type 2 diabetes and the drugs have not been tested yet in leaner people looking to lose a few pounds. I'm sure that's coming though.
As with any new "miracle" weight loss intervention, it needs to be taken with a grain of salt and a pound of caution, but for some it seems to be quite effective and helpful in reducing body fat and the accompanying health risks that come with obesity.