I spent two glorious winter weeks visiting my aunt in Florida, in one of those ‘active senior’ communities that has me counting down the days until I’m 55.

On the shuttle ride back to the Orlando airport on Friday, a woman asked what I do for a living.

“I’m a nutritionist and I work with middle aged people on their gut health.”

“What’s the number one thing people can do to lose weight? I’m prediabetic and my doctor said losing weight will help.”

Truth be told, her answer was in her question. Weight is often a symptom of prediabetes, not a cause (although excess weight has many other causes).

The shuttle driver then mentioned that his wife’s doctor had her on Ozempic and she started gaining a bunch of weight, so she had to stop.

Can of worms, opened, Reader.

I’m a gut health person. Weight loss isn’t my lane. But clients and strangers keep asking me about this. So, here’s my take.

What is Ozempic and GLP-1?

GLP-1 drugs mimic a hormone that your body naturally secrets after eating. They were approved by the FDA in 2022 as a treatment for diabetes. (That’s super-recent!)

Then people noticed they were less hungry and lost weight.

This happened because these drugs:

• Slow gastric emptying
• Inhibit the release of glucagon, a hormone that raises blood sugar
• Stimulates insulin production, which moves glucose into cells for us
• These two buddies are in a feedback loop to regulate your blood sugar

My concerns about Ozempic and other GLP drugs

Gastroparesis: Slow gastric emptying gone too far is called gastroparesis, which is paralysis of the stomach muscles and nerves. As a gut specialist, people have come to me with gastroparesis and they’re miserable! Eating makes them feel sick an it’s difficult to be properly nourished.

​Digestion is a north to south process, and when the stomach isn’t able to do its job efficiently, I worry that there will be a cascade of digestive and nutritional issues over time.

This is just one of the digestive issues that have cropped up. Others include increased risk of gallstones and pancreatitis.

Surgery danger under anesthesia: Fasting is required when you go under general anesthesia because it’s dangerous to inhale any of your stomach contents, which can happen if you vomit while you’re lying there. In a conscious state you avoid this because your instinct is to sit up or roll over to vomit.

Delayed gastric emptying poses the risk that even while you’ve followed your doctors instructions on how long to fast, food may still be in your stomach.

Malnutrition: When you can’t eat as much, every single bite matters. Just like I’ve seen with gastric bypass surgery, people can have a difficult time eating enough protein and fat.

Everything you’re physically made of is protein, fat, minerals, and some water. Without enough of these things, you can’t produce enough healthy new cells, or run the necessary repairs, which leads to physical degeneration.

Sarcopenia, aka muscle loss: Losing muscle is one of the hallmarks of aging degeneration. Middle-aged people like me are strength training to combat this to increase the years that we’re able to live able-bodied and active. With GLP-1 drugs, this is a side effect of the decreased eating.

Blindness: Reports began surfacing about an increase in what’s been a rare eye condition known as NAION. This eye condition happens when blood flow in the optic nerve is reduced, which leads to sudden blindness that cannot be reversed.

Advancing diabetes can lead to vision loss, but is this risk worth it for those who are not diabetic? It’s considered a rare side-effect at the moment, with the risk being 1 in 10,000, but a second study has come out recently confirming the findings of the first, so this is in the news again. It hasn’t been peer reviewed yet.

Delayed absorption of psychiatric medications: This is very scary to me and I’m not seeing anyone talking about this study, which came to the conclusion, “This study using the WHO database found a signal of semaglutide-associated suicidal ideation, which warrants urgent clarification.”

With delayed gastric emptying comes alterations in the absorption of medications.

It often takes a lot of trial and adjustment to stabilize a person’s mental health with psychiatric medications and there are online reports of serious destabilization happening when people are on Ozempic and psychiatric medications together.

The study found that the 45% increased risk of suicidal ideation from taking Ozempic alone became a 345% increase in those who were already taking SSRI antidepressants.

Pharmaceutical dependency: GLP-1 drugs are designed to be taken forever, which keeps you dependent upon one of the most unethical industries. These medications are a goldmine for them!

I’m highly suspicious of the marketing hype, which mimics past weight loss drug “breakthroughs” that were later pulled from the market.

And I can’t forget that 20 years ago pharma reps had doctors and patients convinced that that new opioid medications were non-addictive. We’ve seen the tragic way that played out.

Is there potential for using GLP drugs?

Yes. And I want to tell you a bit about that, and provide you with all the things I’d try before GLP-1 drugs. This letter is just getting lengthy though, Reader, so I’ll save those for next week.

Coming back to the group of elders who were in that airport shuttle ride with me – I’m feeling particularly cautious. Muscle loss in particular is a hallmark of rapid aging and predisposes them to falls and enhanced bone loss.

My short answer to the pre-diabetic woman who asked, “What’s the number one thing people can do to lose weight?”, was to lower her carb intake and get a continuous glucose monitor.

Her body can show her how it responds to different meals and stressors, and the real-time data can motivate her to make changes to balance her blood sugar naturally, without the risk of these side effects.

Warm wishes,

Jenn

​Body Wisdom Nutrition​

P.S. I’ll be opening up space for two new one-on-one clients in March. If you’re interested, register for my upcoming Gut-Curious Zoom Call on March 4^th, so we can get to know each other first.