The Ozempic Revolution Has Some asterisks

The weight-loss drugs Wegovy and Zepbound, which are prescribed to combat obesity, are considered by many to be miraculous, and attempts are being made to tailor foods to suit the needs of its users. However, many people do not lose weight after taking the drug and, in fact, report not experiencing any change. Side effects include hair loss, low blood sugar, and severe gastrointestinal distress, which push people to stop taking the drugs. Severe side effects are uncommon, but cases do exist. A component of the drugs, GLP-1, works by binding to receptors that suppress appetite and regulate insulin, but those receptor "locks" can vary due to genetic differences, and some keys simply do not fit. Additionally, some people metabolize the drugs too quickly or slowly, leading to ineffective or toxic levels, respectively. These drugs only work on people who have obesity driven by dysfunction in the GLP-1 pathway, and for many, it is not effective. However, alternatives such as stacking the drugs or switching to another GLP-1 can be attempted, and bariatric surgery may be a good option. The competition for these drugs is steep, and new drug candidates are expected to have fewer side effects and be more effective. The complexity of obesity means that a one-size-fits-all treatment is unrealistic, and many options are likely to become available in the future.

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