The Hidden Risks of New Weight Loss Medications: My Perspective as a Bariatric Surgeon
As a bariatric surgeon, I’ve spent the majority of my career focused on weight loss, metabolism, and the intricate workings of the human body. Over the years, I’ve closely followed the development and popularity of new weight loss medications like Ozempic, Mounjaro, and Wegovy. These injectable drugs have been widely praised for their ability to help people shed pounds quickly, but as someone deeply committed to understanding human physiology, I believe it’s important to look beyond the surface. There are significant aspects of these medications that both patients and physicians need to understand more fully. In this blog, we dive into the risks of weight loss injections.
How These Medications Work
These injections use a synthetic form of a naturally occurring peptide called GLP-1 (Glucagon-Like Peptide 1). In a healthy person, GLP-1 functions as a neurotransmitter, playing a critical role in regulating appetite, metabolism, and blood glucose levels. However, when we inject high levels of synthetic GLP-1 into the body, we’re essentially using a neurotransmitter as a hormone—a practice that can have unintended consequences.
The Paradox of Weight Loss Response
One of the paradoxes I’ve observed with these medications is that those who seem to lose the most weight are often the people who have the least amount of weight to lose. Conversely, individuals who are severely obese or have significant metabolic issues often don’t respond as dramatically. This is concerning because it suggests that these medications may be more effective in people who are metabolically healthier, yet it is precisely this group that may be at greater risk for severe long-term side effects.
Muscle Loss and Stomach Paralysis: The Hidden Dangers
In my clinic, we’ve seen firsthand the side effects associated with these injections, particularly muscle loss and a condition called gastroparesis, or partial paralysis of the stomach. On average, 40-50% of the weight lost through these medications comes from muscle, not fat. This is alarming because muscle mass is crucial for overall health and longevity.
Gastroparesis is another serious issue I’ve encountered in patients who stop taking these medications. Some individuals experience persistent nausea, vomiting, and an inability to eat, all of which stem from the stomach’s inability to contract and empty properly—a direct result of the paralysis of the stomach muscles.
The Role of the Vagus Nerve and Autonomic Nervous System
To understand why these side effects occur, it’s essential to look at the role of the vagus nerve and the autonomic nervous system. The vagus nerve is responsible for many involuntary functions in the body, such as digestion, heart rate, and blood pressure regulation. In healthy individuals, there is a balance between the sympathetic (fight or flight) and parasympathetic (rest and digest) branches of the autonomic nervous system. However, in conditions like obesity and diabetes, this balance is often disrupted, leading to an overactive sympathetic system and a weakened parasympathetic system.
When these weight loss injections bypass the normal physiological pathways, they exacerbate this imbalance. The medications increase dysfunction in the autonomic nervous system, which could explain why some patients experience muscle loss, stomach paralysis, and other severe side effects.
Long-Term Consequences and the Need for Caution
I’m deeply concerned about the long-term consequences of using these medications, especially in younger, healthier individuals who are using them primarily for weight loss. I speculate that when these injections are discontinued, patients may face a decline in cognitive function, increased insulin resistance, and a worsening of their overall metabolic health—potentially leaving them in a worse state than before they began the treatment.
It’s important to note that the studies conducted on these medications have primarily involved patients with significant metabolic diseases like diabetes and heart disease. Extending the use of these drugs to individuals without such conditions—simply for weight loss—may carry unforeseen risks.
Why Bariatric Surgery Offers a Better Solution
As a bariatric surgeon, I often compare the effects of these medications with bariatric surgery, which I believe offers a more sustainable solution for weight loss. Unlike the injections that bypass the vagus nerve, bariatric surgery often restores its function, promoting a return to normal physiology. This difference likely accounts for the superior and more lasting results we see in patients who undergo surgery compared to those who rely solely on medication.
Final Thoughts
In the current craze surrounding these new weight loss injections, it’s crucial to take a step back and consider the long-term implications. While the promise of quick weight loss is enticing, both patients and physicians must weigh the potential risks against the benefits. Understanding the full physiological impact of these treatments is essential to making informed decisions that prioritize long-term health over temporary results.
If you’re interested in learning more about weight loss, metabolism, or bariatric surgery, we invite you to visit my YouTube channel, Idaho BMI, where I delve deeper into these topics.
https://www.youtube.com/@idahobmihome
View our videos on the risks of weight loss injections here:
https://www.youtube.com/watch?v=BvIMCyHPpDI
https://www.youtube.com/watch?v=62B2C5I2zFQ