Semaglutides, weight loss, and the new weight loss medicines that everyone is talking about.

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Every physician and every overweight patient have struggled with achieving effective weight loss that was effective for most people, until now! Almost simultaneously 6 weight loss drugs hit the market approved by the FDA for different uses. The only drug approved for just weight loss is called Wegovy, a once-a-week injection that causes loss of appetite as well as a feeling of fullness when only a fraction of volume of an American meal is eaten. It also works by limiting the hormone glucagon that dumps stored blood sugar into the blood when blood sugar levels get low, and it decreases the craving that many overweight patients complain of. The majority of overweight people have been eating a high carbohydrate diet filled with sugared soda, bread, pasta, cereals, candy, cake, cookies, chips, crackers etc. This is the average American diet, and it is killing us!

Years of eating this diet has made us fat and insulin resistant, as well as malnourished. Humans need food for fuel, and we have made it into entertainment! We need a varied diet of proteins, fats, and carbs. Our genetics dictates how much of each group we need; however, the one size fits all mentality of the FDA and the US government has led citizens to believe that cereal and bread is the basis for diet because America grows grain and sells it to our citizens…it is a diet based on GNP not our metabolism. Simply said this has left most children and adults obese and fatigued because they are not getting the right nutrition from their food intake. Now we have to work backward, and the insurers of this country will not pay for the drugs we need to reverse the process.

The drugs above are all variations of the generic name Semaglutide. The only drug that is different is Mounjaro or Tirzepide. It is more effective for treatment of diabetes and obesity, however Ozempic and the only oral version, Rybelsus, are also effective for both Diabetes and weight loss. We generally prescribe Wegovy for weight loss without diabetes, and we can try to get it approved by insurance for weight loss. However, this is generally not approved.

The requirements for insurance to pay for these drugs for weight loss includes:

1. BMI over 30
2. Two other illnesses that are associated with being overweight, eg hypertension, heart disease, prediabetes.

Even with these requirements fulfilled they usually don't pay for it! The price is $ 1,500 for one month! Three months is around $4,500. This is prohibitive for everyone.

To solve this access problem, Dr Sullivan has contacted several compounding pharmacies who will make the drug for weekly self-injection at a much lower price! The price is $540 for 3 months compared to $4,500. We have been recommending this avenue when we cannot get the drug paid for. The only difference is that patients must draw up the small amount of semaglutide in an insulin syringe and inject themselves with a needle instead of a "pen".

This is the way we have been accessing this medication for our patients and we have seen unbelievable results! People who could never lose weight are losing and very obese patients who did not have the staying power to continue dieting to get appreciable weight loss are now approaching ideal weight.

The only people who cannot take this medication are those with a history of a specific type of thyroid cancer or a disease of the endocrine system called MEN II. You know it if you have one of these rare problems. Others love to eat so much that limiting their intake is a problem for them.

Special Cases: Those people who genetically are "never full", or "always hungry", this is the drug for them to make them feel full for the first time in their life….. Obesity from never feeling full or always hungry is genetic.

Dr. Maupin:

"I never understood those kids and adults who had to eat 24-seven or who could eat 2-3 plates of dinner. .I just had never walked in their shoes until I was pregnant…At that time in my life being 118 lbs and 5-3 when I got pregnant I never could catch up by eating enough calories to feed both of us. I felt full at the beginning of a meal but was always hungry, so I had to eat every 30 or 40 minutes. I was hungry all the time! It literally ruled my life, and it made me think about food all the time. I felt like I was in a prison of low blood sugar restricting my activities. NOW I understand how terrible a genetic albatross having the "never full" or "always hungry" is! Except for pregnancy, I know that inherited genetics make some people always hungry, and others never feel full, and my heart goes out to them. These GLP-1 drugs work well for people with these genes. PS. I was thrilled to deliver my daughter, and it was both the happiest day of my life to see our beautiful baby, but I was also so relieved not to be hungry anymore!"

If you have this genetic issue, then this classification of drug is for you! You will be able to get to ideal weight and you will have to stay on a maintenance dose to keep your weight at ta healthy level. How do you go off these meds when you have reached your ideal weight? We have our patients decrease their dose per week until they start to be able to eat reasonably. Sometimes we can't get our patients off the medication completely, but the cost is much lower because a 3-month dose will now last 3-6 months.

We like to team up Testosterone pellets with semaglutide treatment for older women to make sure they don't lose muscle instead of fat. The T-pellets help patients become lean, and preferentially lose fat, not fat and muscle.

What you can do with the medications to make them work faster, more effectively:

• Exercise daily for 45 minutes or more—normal life activity is not exercise! Walking briskly means you can't talk and walk at the same time.
• Eat a low carbohydrate (know what that means), NO SUGAR, high protein diet with a lot of vegetables and fruits of every color 3 times a day. Snacks can be veggies, nuts, cheese, yogurt, eggs, and or fresh fruit. No baked goods, no crackers, bread, junk food or fast food.
• High protein diet means eating as many grams of protein as your weight in lbs if you are active. Eat ½ of that in protein if you are not actively exercising that day.
• A delicious protein powder that actually tastes good is Phormula #1. I like the mint ice cream sandwich flavor….I can eat that as a meal substitute blended with fruit 3 meals a day.
• Drink filtered water and lots of it! At least 64 fl oz a day.
• No alcohol
• If you want to lose weight in certain spots like your waist or your thighs, I use the EmSculpt fat destroyer with skin tightening.

For those of you who have had trouble with your weight or have had trouble losing it and keeping it off, then BioBalance Health Weight Loss program is for you!