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In this episode of the Pharm So Hard Podcast, the hosts discuss GLP-1 receptor agonists, a class of medications used to manage blood sugar levels in patients with type 2 diabetes and to treat obesity. They provide an overview of the history and development of GLP-1 receptor agonists, highlighting their clinical superiority and various benefits. The hosts also explain the role of GLP-1s in the body, including their glucose-dependent insulin secretion and effects on gastric emptying. They discuss the impact of GLP-1s on hunger and mental health, emphasizing the reduction of food noise and improvement in satiety levels. Additionally, they differentiate GLP-1 receptor agonists for diabetes and weight loss and explore their indications and guideline positioning. Takeaways • GLP-1 receptor agonists are a class of medications used to manage blood sugar levels in patients with type 2 diabetes and to treat obesity. • GLP-1 receptor agonists have shown clinical superiority to other anti-hyperglycemic drugs, improving glycemic control, reducing weight loss and blood pressure, and providing cardio-protective benefits. • GLP-1s increase glucose-dependent insulin secretion, block glucagon secretion, and slow gastric emptying, leading to improved blood sugar control and increased satiety. • GLP-1 receptor agonists have a positive impact on mental health, reducing food noise and helping individuals make healthier food choices. • Different GLP-1 receptor agonists have specific indications for diabetes and weight loss, and their use is guided by clinical guidelines. • GLP-1 receptor agonists are FDA-approved for improving glycemic control in patients with type 2 diabetes and for the treatment of obesity. • The choice of GLP-1 receptor agonist depends on factors such as comorbidities, weight loss goals, and patient preferences. • GLP-1 receptor agonists have different dosing regimens, and the specific dose may vary based on the indication and the product. • Common side effects of GLP-1 receptor agonists include nausea, vomiting, and diarrhea, but these side effects often improve with continued use and proper management. GLP-1 agonists can cause loss of appetite as a side effect. • GLP-1s are being used off-label for conditions such as NAFLD and depression. • GLP-1s may have positive effects on bone health and blood pressure. • The high cost of GLP-1s poses challenges for patient access. Chapters 00:00 Introduction to GLP-1 Receptor Agonists 01:12 History and Development of GLP-1 Receptor Agonists 06:14 The Role of GLP-1s in the Body 09:38 Effects of GLP-1s on Hunger and Mental Health 11:17 Differentiation of GLP-1 Receptor Agonists for Diabetes and Weight Loss 11:44 Indications and Guideline Positioning of GLP-1 Receptor Agonists

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Ozempic: How It's Changing The Weight Loss Game At the beginning of March 2024, a CNN Business article was released, titled, ‘Ozempic Is Coming For Gyms. Here’s How They’re Responding.’ In that article, consumer reporter Nathaniel Meyersohn wrote that America’s gyms are beginning to adjust their strategies as more of their gym members are taking weight loss drugs. He says that Luxury gyms such as LifeTime and Equinox are acquiring weight loss clinics with doctors who can prescribe GLP-1 medications. These are drugs with a base component of #Semaglutide, which are marketed under a variety of different names such as #Rybelsus, #Ozempic and #Wegovy and have been shown to be highly effective at helping people lose weight. He also mentions that while the overall impact of GLP-1 medications are unclear at this point…gyms want to make sure they’re not left behind, as more and more people shift their hopes for weight loss onto these new medications. He mentions that JP-Morgan researchers predict that 30 million people…around 9% of the U.S. population, may be taking these GLP-1 medications by the year two thousand thirty (2030). Whereas gyms have traditionally been positioned as a major pathway to aid people in their effort to lose weight…they’ve also recognized that one of the side effects of taking these GLP-1 medications…is MUSCLE loss. Consequently, the industry is positioning itself to focus on people who are taking these medications, many of whom may require some measure of help and guidance in maintaining their muscle mass. In fact alliances are now being created between major gyms and fitness centers, to provide their members with access not only to doctors who can prescribe GLP-1 medications, but also with fitness trainers and nutrition counselors who can guide gym-members who are taking these medications…to help them build and retain muscle in the process. And though there is controversy over what the exact exercise patterns among these #GLP-1 users may ultimately be…there are certainly those in the fitness industry who are banking on this growing population to generate significant revenue for the gym industry going forward. Meyersohn states that food companies are also bracing for the impact of GLP-1, anticipating that people on these medications will buy fewer sugary snacks and drinks…and that according to JPMorgan…last year, current GLP-1 users were reported to have purchased 8% less food, including snacks, soft drinks and high-carb products, over the prior year…compared with consumers who were not on these drugs. So…are Semaglutide and other GLP-1’s the miracle drugs that these industries are anticipating them to be? In reality…it’s not entirely clear at this point. Even though many men and women have had significant weight-loss results taking GLP-1’s…a number industry insiders watching this play out, believe it’s just too early to tell. In fact, when we first opened our fitness and weight management clinic in 2006, drugs like Phentermine and Phendimetrazine were commonly being prescribed for appetite suppression, to help with weight loss. And though both of those medications are still on the market, and still individually prescribed today by many doctors…in July of 1992, the combination of Fenfluramine and Phentermine (dubbed Fen-Phen at the time), had a much less favorable outcome. Unfortunately…as has been the case for many different types of pharmaceuticals produced throughout the past century, Fen-Phen was found to have some problems. And ultimately it was taken off the market in the late 1990’s when the fenfluramine or dexfenfluramine portion of the drug was determined to have an association with the development of valvular heart disease in some patients. It took time for that problem to come to lite before an estimated 6 million patients had ultimately taken that drug combination. But in the beginning…just like we’re seeing now with Semaglutide and the GLP-1’s, many, many people believed Fen-Phen was a miracle drug and the final answer to excess weight and obesity. Now, my hope is that the GLP-1’s stand the test of time…especially where risk and safety are concerned, but the long-term safety of these medications will have to be born out in time. So if you happen to be considering hopping aboard the GLP-1 train…talk to your doctor about the pros and cons of taking these medications. I truly believe that the foundation of good health lies primarily in our diet, and how consistently optimal we feed our bodies, as well as having a focus on physical activity of some kind to maintain our fitness. Again, if you’re watching people around you who happen to be taking these medications and losing weight…and you’re considering doing the same…talk your doctor about the pros and cons, given your particular situation and medical needs. #ozempic #semaglutide #weightloss #weightwatchers #glp1 #muscle #type2diabetes #reversetype2diabetes

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