Weight loss drugs are a hot topic these days. And personally, I’m a big proponent of weight loss drugs given I’ve lost about 100 pounds by using Tirzepatide.
They’ve completely changed the way I eat and my motivation to exercise. I was at the store yesterday, and a guy approached me and said, “You're pretty ripped for an old dude.”
I wasn’t quite sure if I should take it as a compliment or not. But that’s just from my own anecdotal experience.
I was pre-diabetic, and weight loss drugs have had an enormous difference in my life. Today, I had Dr. Mace Scott on the show, medical director of Cronos Body Health Wellness. He provided some insight into why they work so well, potential side effects, and why there’s motivation from insurance companies to keep them out of the hands of patients.
Below is an edited interview with Dr. Scott.
Tommy: Give us a general overview of these drugs. What are they doing to our bodies and why do they work?
Dr. Scott: These are just amazing drugs. We’ve seen people lose 60, 80, 100 pounds fairly easily on this medication over some time. However, I wanted to clear up something I got wrong on your show the last time I was on. You asked me how these medications work on the brain and why you felt so much better not just physically, but mentally.
My initial reaction was just that you felt better because of what you're eating. But they found these medicines cross the blood-brain barrier, meaning they react directly to your brain. These receptors are all over your body and they're finding they're doing amazing things. For example, they're neuroprotective. Research shows they can slow down the process of dementia.
They're also cardioprotective. They increase the contractility of the heart and improve your cardiac function. They can help people who have renal insufficiency and can decrease inflammation.
It’s a revolutionary drug that they have right now and they need to get it to the masses because it seems to be so safe. There are so few contraindications. And it does help people with diabetes, of course, and with obesity. But it also helps decrease potential chronic illnesses.
Tommy: What about cost-effectiveness to the health care system? Isn’t this a no-brainer?
The majority of patients are on insurance. Insurance doesn’t want to pay for it because they think about the bottom line this year. They think that if they approve this drug for everyone, they'll go bankrupt. Of course, it would benefit everyone in the future by decreasing chronic illnesses, decreasing obesity, obesity, high blood pressure, and diabetes. But that's a long-term goal, and that's a long-term projection. That's not going to help the bottom line this year, so you're seeing insurance companies pushing back
There were some insurance companies we found starting to pay for these medications. But after they realized the expense, they pulled back. So it’s all about making money.
Tommy: I work out a lot and probably wouldn’t had I not lost the weight. But one of the things you guys do is that you don't just look at it as a simple injection and that’s it. It’s part of holistic wellness, right?
Dr. Scott: It’s an approach. We offer a free nutritionist consultation with every weight loss patient for those who’ll take it. Unfortunately, most don’t. But we also have a fitness center and trainers and we'd like to try and use all of these together to help the person get better, improve their weight and change habits. And that's really important.
But I have seen exactly what you're saying. When people lose weight and they get back in shape, they find that motivation again that they lost. It's so hard to get over that hump, to get back started again with healthy eating and healthy habits.
Tommy: What about the potential side effects?
There’s a handful of people who don't do well on this medicine—very few. However, some people have issues with nausea, vomiting, and cramping.
You can get pancreatitis because this medicine reacts with the pancreas and it can cause inflammation of your pancreas. But that is not the same thing as pancreatic cancer. It's just an influence inflammation of the pancreas that will generally resolve. It just means you cannot take the medicine ever again.
As far as the long-term effects, there are no significant long-term problems other than a case or two of what's called gastroparesis, where the stomach slows down and stops moving.
But Tommy, these medicines bind to the GLP-1 receptor. There have been similar medicines out for decades, like Trulicity. So when Semaglutide came along under the name Ozempic, it was approved by the FDA for type two diabetes in 2017. It’s been used continuously by people since and its predecessors have been used for years and decades and shown to be safe. So I don't think we're going to come across some long-term issue over the next couple of decades.
Tommy: What does the drug do in your brain? Does it change the way you're wired when it comes to controlling how you eat and what you eat?
As I mentioned earlier, it binds to receptors all over the body. Primarily it affects your brain, your pancreas, and your gut. And in your brain, it slows down the cravings in the food noise you get—that craving for whatever your favorite snack is, for Coca-Cola or whatever. It calms that down so people don't think about it.