The Science behind Wegovy and other new GLP-1 weight loss meds.

The Science behind Wegovy and other new GLP-1 weight loss meds.

Everyone wants the secret to weight loss, and drugs are often seen as an easy shortcut, though they may provide significant consequences. 

One drug that many of my patients have asked me about lately and which has been making headways across the media is the rise of injectable GLP-1 agonists for weight loss. 

However, only two GLP-1 agonists, Wegovy and Saxenda, have been approved by the FDA for weight loss, while many GLP-1 agonists are primarily used to regulate blood sugar levels in diabetes patients. 

With that said, there are many questions surrounding this new class of drugs. Do GLP-1 agonists work for weight loss? Can non-diabetics take these weight loss injections? 

Let’s dispel the mystery behind GLP-1 agonists and determine whether these injections are right for you and your weight loss journey. 

What Are GLP-1 Agonists?

GLP-1 agonists mimic the same function as glucagon-like peptides, which are hormones secreted in the intestines that increase insulin levels and suppress glucagon secretion. 

Insulin helps cells absorb glucose to power your body, while glucagon is a hormone responsible for raising blood sugar levels. Unfortunately, people who struggle with diabetes have higher insulin resistance which allows glucose to build up in the blood leading to hyperglycemia. Hyperglycemia can lead to several adverse outcomes, including increased hunger and thirst. 

How Do GLP-1 Agonists Work?

GLP-1 agonists mimic the secretion of glucagon-like peptides, which have shown promise in the suppression of glucagon and the increase in insulin resistance. GLP-1 agonists also delay stomach emptying to prevent glucose spikes and reduce hunger over time. 

Additionally, glucagon-like peptide 1 may possess anti-inflammatory properties, which may be one reason it helps with insulin resistance. Due to theories that chronic adipose tissue inflammation leads to insulin resistance, GLP-1 may also lower insulin resistance via other mechanisms. 

Every GLP-1 agonist works differently. All but one GLP-1 agonists have to be taken by injection, and as mentioned above, only two are approved for weight loss: Wegovy and Saxenda, from the Danish healthcare company Novo Nordisk . 

Generally, we divide GLP-1 agonists into short-acting or long-acting drugs, which impact the body slightly differently. 

For example, short-acting GLP-1 may delay stomach emptying, which can help reduce glucose levels after meals. On the other hand, long-acting GLP-1 agonists work by stimulating greater insulin production in the pancreas to help absorb glucose more easily into the body’s cells. 

Aside from helping people who struggle with diabetes, regulating blood sugar levels can also control hunger and thirst to prevent overeating. 

Additionally, the positive effects of losing weight with GLP-1 agonists have been shown to also improve cardiovascular health and cholesterol levels. 

For this reason, there is some optimism that GLP-1 agonists can be useful as weight loss products.

How Do GLP-1 Agonists Work for Weight Loss?

GLP-1 agonist injections may effectively curb hunger in patients by delaying the emptying of food from the stomach and into the small intestine. In turn, people who take GLP-1 agonists will feel fuller for longer after a meal.

Additionally, GLP-1 agonists can also prevent overeating associated with hyperglycemia by regulating blood sugar levels.

The non-Brand names of the two GLP-1 agonists that are currently approved for weight loss are Liraglutide (brand name Saxenda) and Semaglutide (brand name Wegova). 

Both are long-acting agonists taken via subcutaneous shots, with Semaglutide administered weekly and Liraglutide administered daily. While both have shown some effectiveness for patients, there are some risks and downsides. 

How Safe Are GLP-1 Agonists?

Early clinical trials of Semaglutide have shown the GLP-1 agonist is relatively safe, with a majority of adverse events considered mild. The most common side effects reported were nausea, GERD, flatulence, abdominal pain, diarrhea, constipation, fatigue, headache, and other gastrointestinal symptoms.

Do GLP-1 Agonists Cause Hypoglycemia?

One common concern many people have is whether GLP-1 can work too well and cause low blood sugar levels (hypoglycemia). 

Fortunately, GLP-1 agonists have not been shown to cause hypoglycemia in normoglycemic patients, meaning that it is currently considered by doctors to be safe to take whether you are diabetic or not. However, the risk of hypoglycemia largely depends on individual risk factors and should ALWAYS be discussed with your doctor. 

Are GLP-1 Agonists Worth It for Weight Loss?

This leads us to our ultimate question: are GLP-1 agonist shots worth the risks? 

One study from the New England Journal of Medicine found that patients who took Tirzepatide ( a GLP-1 agonist not approved for weight loss) enjoyed a 20% greater weight production than placebo groups who had not taken the drug. 

Similar findings have also found that Semaglutide helped patients shed around 15% of their total weight. 

However, while these drugs may come with mild side effects, these drugs are generally not recommended for anyone under a BMI of 30. 

Furthermore, many of these drugs are:

  • Highly expensive
  • Not covered by insurance
  • Require daily/weekly injections

While GLP-1 agonists are highly effective for people struggling with Type-2 diabetes, there may be better alternatives for regular people trying to lose weight.

Time-restricted eating, getting more sleep, and following a steady diet can be more effective and provide better long-term benefits than relying on GLP-1 injections.

Like so many other products, once patients stop using the product, the weight returns. So while GLP-1 agonists have shown effectiveness for weight loss in short-term trials, patients should wait for long-term data to see if GLP-1 agonists can help stabilize people’s weight long-term without a rebound. 

Remember, GLP-1 agonists, are effective because they suppress hunger. Therefore, adjusting eating schedules and consuming fewer calories is all achievable without spending thousands on injections with potentially serious side effects. 

Takeaways

GLP-1 agonists offer great promise in the treatment of diabetes and have been shown to be effective in helping patients struggling with obesity. However, GLP-1 agonists can be very expensive and have a host of side effects. 

Adjusting your diet, activity level, and when you eat will all prove more effective and stable at helping you lose weight over the long term. 

FAQs

Can Non-Diabetics Take GLP-1 Agonists?

Early findings indicate that GLP-1 agonists are glucose-dependent, meaning they only suppress glucagon and increase insulin in response to increased glucose. In sum, non-diabetic patients should be able to take GLP-agonists without the risk of hypoglycemia. 

Does Insurance Cover GLP-1 Agonists?

Unfortunately, no major insurance carrier covers GLP-agonists, meaning all costs must be paid out of pocket. 

Is There a Natural Alternative to GLP-1 Agonists? 

Studies have found that products like berberine, curcumin, soybeans, wheat, resveratrol, cinnamon, and several other natural ingredients found in complex carbs may boost GLP-1 activation.  

Always speak to your physician before considering or taking any new medication or supplement. 

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Dr. Kulka

Dr. Kulka is a board-certified family medicine physician with 20 years of clinical experience. Placing an emphasis on improving wellness and avoiding illness, Dr. Kulka has a passion for educating people about their health, weight loss options, and specific medical concerns in an easy-to-understand way.

If you, like so many people, struggle to be consistent with your healthy diet and exercise routine, or feel overwhelmed and unsure where to start on your journey to a healthier lifestyle, check out our Seriously Simple Steps to Health and Wellness program.

The Ultimate Complex Carbs List for Healthy Eating

Complex Carbohydrates

The Ultimate Complex Carbs List for Healthy Eating

Thanks to fad diets like Keto and Atkins, carbs have gotten a bad rap over the years. 

 

However, carbohydrates are an essential macronutrient of any diet, as the average nutritionist recommends at least half of your diet should include carbohydrates.

 

Not only do carbs produce glucose required for energy and exercise, but they also aid digestion, manage cholesterol, and influence how full you feel after every meal. 

 

Nevertheless, there are healthy and unhealthy carbs, which you need to be aware of if you are on a diet program or trying to lose weight.

 

This article will explore the benefits of complex carbohydrates (i.e., good carbs) and provide a complete list of good carbs and ways to incorporate them into your diet. 

What Are Complex Carbohydrates? Understanding Carbs

Carbohydrates are composed of sugar molecules found naturally in food and broken down into glucose in our cells to power our bodies. 

 

There are two types of carbohydrates we tend to differentiate, simple and complex carbs. 

 

Simple carbohydrates consist of a single or dual sugar molecule that requires minimal effort by the body to process. Essentially, they start breaking down the moment you put them in your mouth.

 

The most common simple carbohydrates include table sugar, fructose, and other highly processed ingredients. 

 

The problem with processed foods is that they often strip the fiber and starch off the products during processing, leaving consumers with fewer nutrients. 

 

Additionally, consuming simple carbohydrates, which are often designed to taste good, can lead to overeating. They can also spike insulin levels because they are absorbed into the bloodstream quickly and give you those classic “sugar highs” and crashes. 

 

Complex carbohydrates are composed of several sugar molecules–also known as polysaccharide molecules–which require significantly more effort by the body to break down and the intestines to absorb. 

 

Vegetables, fruits, and nuts are all forms of complex carbohydrates that contain lots of nutrients and are good for the gut. 

 

The primary difference between simple and complex carbs is that simple carbs contain very few nutrients (e.g., vitamins and minerals), and complex carbs contain lots of nutrients. And, since complex carbs are more difficult to break down, they also help us feel fuller longer. 

 

There are two types of complex carbohydrates:

 

  • Fiber: A polysaccharide molecule that cannot be digested in the stomach but is broken down in the gut. 
  • Starch: A polysaccharide molecule that normal enzymes can digest. 

 

We will talk more in-depth about starchy and fibrous carbs, but both provide immense nutritional benefits and are a healthy addition to any diet. 

The Benefits of Complex Carbohydrates

Complex carbohydrates offer tremendous nutritional value and are great for curbing cravings. 

Some widespread benefits of complex carbs for weight loss and health include:

  • Higher nutritional value than simple carbs 
  • Greater feeling of fullness after meals
  • Regulating bowel movements
  • Managing cholesterol
  • Improving gut microbiota
  • Reducing glucose and blood sugar spikes
  • Sustainable energy
  • Adding complex carbs to any diet will ensure you get proper nutrients and maintain a healthy gut biome. 

Additionally, complex carbs can be a good source of satiety if you’re trying to lose weight without piling on the calories. 

Best of all, many foods rich in complex carbohydrates are tasty and versatile, making them your ultimate pal in the kitchen

The Importance of Fiber

Before we get into the list of complex carbs, I want to focus a little more on the benefits of fiber. 

 

Incorporating fiber into a diet for weight loss or any reason is especially important because it helps us feel fuller for longer and provides significant nutritional value. 

 

There are generally two forms of fiber, which we differentiate:

 

  • Insoluble Fiber: Fiber that doesn’t dissolve in water and helps regulate bowel movements (ex., Kale, seeds, almonds.) 
  • Soluble Fiber:  Fiber that does dissolve in water and helps regulate cholesterol and insulin levels (ex., Apples, beans, berries). 

 

Both forms of fiber are fundamental and can address different needs in your diet. However, soluble fiber may be more important for addressing specific health concerns, while insoluble fiber can be a healthy snack alternative to curb cravings for longer. 

 

I’d also like to mention resistant starches, which contain soluble and insoluble fiber properties. 

 

Resistant starches are not digested by the small intestine and ferment in the large intestine, feeding the good bacteria in your gut. In addition, most resistant starches provide synbiotics and prebiotics, which, if you take probiotics, can help improve your gut microbiota.  

 

With that said, I wanted to provide a complex carbohydrate list of the best sources for these macronutrients to help you find ways to incorporate more good carbs into your diet.

List of Complex Carbs and Popular Sources

Starches

Starches are a very important complex carbohydrate, which can be a good source of iron, fiber, B vitamins, and other minerals.

Starches also help us achieve satiety and provide sustainable energy throughout the day. 

In cooking, starch can be used as a healthy thickening ingredient, most often associated with cornstarch. 

Wheat-based products, potatoes, oats, and cereals are great sources of starches that can serve as a hearty breakfast or an endearing side for any meal. 

Since nearly all complex carbohydrates contain fiber of some kind, I wanted to outline a list of foods that contain starches, which you should experiment with in your diet.

  • Oats
  • Durum wheat
  • Buckwheat 
  • Einkorn
  • Cereals
  • Sweet potatoes
  • Bread
  • Bulgur
  • Emmer
  • Kamut
  • Pasta
  • Rice
  • Spelt
  • Rye

Recipe Ideas and Additions

  • Opt for whole grain cereals and oatmeal instead of sugary cereals for breakfast.
  • Make sweet potato fries as a side to any meal. 
  • Use brown rice as a side or base for grain bowls or other healthy meal options.
  • Experiment with homemade pasta to consume less processed ingredients. 

Whole Grains

You’re probably inundated with products that list whole grains on a daily basis, but what are whole grains? 

Whole grains are derived from cereals, grass-like plants, such as wheat and oats, and some non-grass plants, such as quinoa.

A whole grain is anything that contains all of the grain plants and is not refined or stripped of any of its three parts (bran, germ, and endosperm). 

Whole grains can help reduce your risk of heart disease, high blood pressure, and diabetes.  Some of the most popular sources of whole grains include:

  • Millet
  • Bulgur
  • Farro
  • Oats
  • Rice
  • Quinoa
  • Barley
  • Kamut
  • Sorghum

Recipe Ideas and Additions

  • Opt for whole wheat or whole grain bread for sandwiches. 
  • Replace traditional pasta with whole wheat pasta that’s much more fibrous. 
  • Substitute white rice for brown rice. 
  • Add brown rice, quinoa, farro, or millet as a side or the main dish for your next meal. 
  • Look for whole grain cereals at the store (Be sure to read the label for added ingredients!)
  • Substitute all-purpose flour with buckwheat or millet (account for added leavening times).

Vegetables

Next up are vegetables, which should be a staple of any diet. 

In terms of consuming healthier vegetables, I highly recommend growing your own–gardening is a great hobby to get into. Additionally, I recommend sourcing locally grown vegetables at farmer’s markets that are more nutritious.

Vitamins, like Vitamin C, are photosensitive and will deteriorate with age and light exposure. As with many nutrients, the fresher you harvest your fruit or vegetable, the more nutrients it will pack. 

In terms of eating raw and cooked vegetables, I recommend incorporating both. Raw vegetables contain higher fiber content, although they may be harder to digest for people with gut issues. Furthermore, cooked vegetables may allow for more bioavailable nutrients, which are easier to digest and absorb. 

Fortunately, almost every vegetable on this list can be served hot or cold, as a side, or herb. 

  • Spinach
  • Lettuce
  • Carrots
  • Peas
  • Mushrooms
  • Squash/zucchini 
  • Alliums (onion, garlic, leeks)
  • Asparagus
  • Swiss chard
  • Fennel
  • Cauliflower
  • Broccoli
  • Peas
  • Peppers
  • Parsnip
  • Beats

Recipe Ideas and Additions

  • Roast vegetables with oil and sea salt for a healthy snack.
  • Use natural herbs from a garden or store instead of dried herbs. 
  • Add steamed vegetables as a side with any dish.
  • Make a salad with any leftover vegetables in your garden or refrigerator.
  • Make soups and chili using vegetables.
  • Experiment with veggie-based noodles in place of pasta.
  • Add vegetables, like spinach, peppers, or asparagus, to omelets and quiche.
  • Shave vegetables like asparagus for easy digestion and use the shavings as a salad garnish.  
  • Top sandwiches and wraps with cooked vegetables like broccoli rabe. 
  • Combine vegetables like carrots and celery with sauces for a snack.
  • Juice vegetables like carrots, ginger, or celery for a healthy tonic. 
  • Create a casserole using several different vegetables.  

Fruits

It hardly seems necessary to talk about the benefits of fruits, but fruits contain several vitamins and minerals, including vitamins A and C. 

Furthermore, fruit is highly fibrous and can serve as a good snack to help curb cravings if you feel hungry.

Some fruits you can find at any American supermarket and incorporate into your diet include:

  • Berries (raspberry, blueberry, blackberry, etc.)
  • Bananas
  • Apples
  • Lemons
  • Limes 
  • Pears
  • Dragonfruit
  • Pineapple
  • Coconut
  • Melons (watermelon, cantaloupe)
  • Citrus (clementine, oranges)
  • Avocado
  • Currants
  • Dates
  • Jackfruit
  • Grapes
  • Guava
  • Kiwi
  • Kumquat
  • Jujube
  • Nectarine

Recipe Ideas and Additions

  • Substitute salty snacks like pretzels with an apple or a handful of berries.
  • Combine berries with honey and lime juice for a sweet snack. 
  • Add almond butter to apples for a fun kid’s snack. 
  • Incorporate dried fruits like raisins and banana chips for greater fiber. 
  • Add fresh fruits to salads and make your own raspberry or blueberry walnut dressing. 
  • Create smoothies with fresh fruits, milk, or alternative milk. 
  • Add fruits to yogurts for a parfait.
  • Create a fruit salad for a dinner appetizer. 

Beans and Legumes

Beans and legumes are all-natural foods that are low in fat and contain several important nutrients, such as folate, iron, B vitamins, and zinc.  

In particular, beans are a great source of fiber and protein–especially if you are on a vegetarian diet. 

With that said, you can buy several different bean varieties and legumes at affordable prices in the supermarket. 

  • Black beans
  • Fava beans
  • White beans
  • Kidney beans
  • Green split peas
  • Chickpeas 
  • Lentils
  • Lupins
  • Vetches

Recipe Ideas and Additions

  • Create vegetarian soups and chilis using beans and legumes.
  • Mash up dried beans, like garbanzo beans, into a falafel. 
  • Add cooked beans to sandwiches, wraps, and salads. 
  • Puree beans for a delicious dip.
  • Form a bean patty for a vegetarian meal. 

Nuts and Seeds

Finally, nuts and seeds are considered the ultimate protein replacement for any vegetarian diet and pack a healthy punch of fiber, magnesium, vitamin E, and healthy fats. 

Depending on the nut or seed, you may even find different benefits. For example, some nuts, like walnuts, are a great source of omega-three fatty acids, commonly found in fish. Other seeds, like pumpkin seeds, contain high levels of zinc and are considered a fertility food. 

Check out the list of nuts and seeds below and experiment with adding them to different meals. 

  • Chia seeds
  • Peanuts
  • Pumpkin seeds
  • Almonds
  • Hazelnuts
  • Walnuts
  • Pistachios
  • Pecans
  • Brazil nuts
  • Macadamia nuts
  • Pine nuts

Recipe Ideas and Additions

  • Add chia seeds to smoothies for more fiber.
  • Garnish finished meals with nuts, like fresh pine nuts. 
  • Add nuts like pecans and hazelnuts to salads and dressings.
  • Add nuts and seeds to wraps and sandwiches.
  • Bake bread with plenty of seeds for added fiber. 
  • Roast pumpkin seeds for a healthy snack. 
  • Snack on nuts, like pumpkin seeds, walnuts, cashews, etc., as a healthy solo snack.

Not All Carbs Are Bad

It’s clear that carbohydrates have become the unfortunate scapegoat and boogeyman of a society addicted to processed foods and fast sugars. While simple sugars can be dangerous in excess, complex carbohydrates provide many essential vitamins and minerals that no diet should ignore. 

From complex B vitamins to magnesium and zinc, complex carbohydrates can be an excellent source of nutrition and incredibly healthy for your heart, kidneys, gut, and blood sugar. 

Experiment with ways to incorporate more complex carbohydrates into your diet, whether it’s just topping your food off with healthy nuts or opting for a tasty melon instead of a cookie. 

Over time, you’ll find that the benefits of these complex carbs and how you feel when you put them into your body will dwarf any cravings for sugary snacks and simple carbs that you’ll one day be able to refuse proudly.

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