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Angela Fitch’s household historical past of weight problems caught as much as her at age 40, when she was pregnant along with her first little one.
As a doctor and weight problems medication specialist, Dr. Fitch knew the approach to life levers to tug—and he or she had the monetary means to yank them laborious.
After giving start, she lifted weights with a coach twice per week. She sweated by way of one Peloton exercise after one other and tracked her meals consumption on MyFitnessPal.
However, for the following decade, Dr. Fitch misplaced (and regained) the identical 5 to 10 kilos. Her blood stress crept upward. Then got here a sleep apnea analysis.
As her fiftieth birthday neared, Dr. Fitch determined to take the recommendation she gave her sufferers. She went on remedy. (And, she misplaced 30 kilos.)
Within the years since, Dr. Fitch has often stopped her meds. For just a few months, she maintains her outcomes.
Finally, nonetheless, the dimensions climbs again. For now, she’s determined that she’ll be on remedy long-term.
In case you’re a coach, how does this story land with you?
Does it…
… Make you are feeling upset? Does this look like a narrative of somebody “giving up” or “not attempting laborious sufficient”?
… Encourage you with a way of awe? That fashionable medication has found out learn how to deal with yet one more power illness?
… Deliver up questions? Like questioning in regards to the results of being on remedy—probably long-term? (Or if weight reduction is even that related—as long as an individual is maintaining a healthy diet and exercising usually?)
Dr. Fitch is now president of the Weight problems Drugs Affiliation and chief medical officer of Known Well, a major care and weight problems medication observe in Needham, Massachusetts. No matter how you are feeling about her story, it illustrates what can initially look like an inconvenient fact for these of us within the well being teaching trade:
Habits change by itself isn’t all the time sufficient.
For many individuals with weight problems, semaglutide (Ozempic, Wegovy, Rebelsus), tirzepatide (Mounjaro, Zepbound), and different glucagon-like peptide-1 receptor agonists (GLP-1 RAs) function worthwhile instruments that make vital and lasting weight reduction doable.
However for well being coaches, these medication can look like an existential risk.
You would possibly surprise:
‘Who wants a diet coach or a private coach when individuals can get sooner, simpler, and extra dramatic outcomes with medication?’
Nevertheless…
Folks want well being coaches now greater than ever.
On this story, we’ll clarify why—and present you learn how to flip “the golden age of weight problems medication” into an enormous profession alternative.
With fats loss, there’s no such factor as an “simple method out.”
To handle diabetes or deal with most cancers, most individuals think about it regular and pure to mix way of life behaviors with prescription medication.
Nobody would inform somebody with most cancers, “You’re on chemo? Approach to take the simple method out!”
Nevertheless, that’s what many individuals with weight problems hear after they point out remedy or surgical procedure.
For many years, a lot of society hasn’t considered weight problems because the illness that it’s.
As a substitute, individuals have seen it as a willpower drawback.
The treatment: “Simply strive tougher.”
Nevertheless, somewhat than motivating individuals to succeed, this “treatment” usually encourages them to surrender. (Extra importantly, the willpower idea isn’t primarily based on science.)
In actuality, individuals with weight problems probably have as a lot willpower as anybody else.
Nevertheless, for them, fats loss is tougher—due to genetics and physiology, together with social, cultural, behavioral, and/or environmental components that work in opposition to them.
Why is it so troublesome to lose fats?
Think about life 150 years in the past, earlier than the invention of the auto. To get from level A to level B, you needed to stroll, pedal a bicycle, or experience a horse.
Meals was usually briefly provide, too. You needed to expend energy to get it, and meals would simply fulfill you (however not go away you feeling “full”).
In the present day, nonetheless…
“We stay in an obesogenic atmosphere that’s crammed with low cost, highly-palatable, energy-dense meals [that make overeating calories easy, often unconsciously], and numerous conveniences that scale back our bodily exercise,”
says Karl Nadolsky, MD, an endocrinologist and weight reduction specialist at Holland Hospital and co-host of the Docs Who Lift podcast.
You would possibly surprise: Why do some individuals achieve fats in an obesity-promoting atmosphere whereas others don’t?
The reply comes right down to, largely, genetics and physiology.
(Weight problems is complicated and multifactorial. As we famous above, there are different influential components, however your genes and physiology are largely out of your management, and so remedy may be one of the best device to change their influence.)
Genetically, some persons are extra predisposed to weight problems.
Some genes can result in extreme weight problems at a really early age. Nevertheless, these are fairly uncommon.
Way more widespread is polygenic weight problems—when two or extra genes work collectively to predispose you to weight achieve, particularly while you’re uncovered to the obesogenic atmosphere talked about earlier.
Individuals who inherit a number of of those so-called weight problems genes are inclined to have significantly persistent “I’m hungry” and “I’m not full but” alerts, says Dr. Nadolsky.
Weight problems genes additionally appear to trigger some individuals to expertise what’s colloquially often called “meals noise.”
They really feel obsessive about meals, regularly considering, “What am I going to eat subsequent? When is my subsequent meal? Can I eat now?”
Physiologically, our bodies have a tendency to withstand fats loss.
In case you achieve lots of fats, the hormones in your intestine, fats cells, and mind can change the way you expertise starvation and fullness.
“It’s like a thermostat in a home, however now it’s damaged,” says Dr. Nadolsky. “So when individuals lower energy and weight goes down, these physiologic components work in opposition to them.”
After shedding pounds, your intestine could regularly ship out the “I’m hungry” sign, even in the event you’ve not too long ago eaten, and even when you’ve got greater than sufficient physique fats to function a calorie reserve. It additionally would possibly take extra meals so that you can really feel full than, say, another person who’s by no means been at the next weight.
Enter: GLP-1 medication
In 2017, semaglutide—an artificial analog of the metabolic hormone glucagon-like peptide 1—was accredited within the US as an antidiabetic and anti-obesity remedy.
With the emergence of this class of medicine, science supplied individuals with weight problems a comparatively secure and accessible strategy to drop some pounds long-term, as long as they continued the remedy.
How Ozempic and different weight problems medicines work
Present weight reduction drugs work primarily by mimicking the operate of glucagon-like peptide 1 (GLP-1), which is a hormone that performs a number of capabilities:
- Within the pancreas, it triggers insulin secretion, which helps regulate blood sugar.
- Within the intestine, it slows gastric emptying, affecting your sensation of fullness.
- Within the mind, it reduces cravings (the need for particular meals) and meals noise (intrusive ideas about meals).
In individuals with weight problems, the physique shortly breaks down endogenous (pure) GLP-1, making it much less efficient. Consequently, it takes longer to really feel full, meals provide much less endurance, and meals noise turns into a near-constant companion, says Dr. Nadolsky.
Semaglutide (Ozempic, Wegovy, Rybelsus) and medicines prefer it flood the physique with synthetically made GLP-1 that lasts for much longer than the GLP-1 the physique produces. This long-lasting impact helps improve emotions of fullness, scale back between-meal starvation, and muffle cravings and meals noise.
Apparently, by calming down the mind’s reward heart, these medicines may assist individuals scale back addictive behaviors like drawback consuming and compulsive playing, says Dr. Nadolsky.
The lesser-known historical past of weight reduction medication
To know the facility of semaglutide (Ozempic, Wegovy, Rybelsus) and different GLP-1 medicines, it’s useful to know somewhat in regards to the medication that predated it.
A long time earlier than the age of Ozempic, physicians realized that a number of medication initially developed to deal with different circumstances additionally appeared to assist individuals drop some pounds.
These included:
- Qsymia, which pairs phentermine (an older weight reduction medication) with the epilepsy medication topiramate
- Contrave, which mixes the antidepressant bupropion (Wellbutrin) with naltrexone, used to deal with addictions
- Metformin, a diabetes medication
Nevertheless, weight reduction from these older medicines was modest, serving to individuals to lose (and preserve off) round 5 to 10 % of their physique weight.1 2 3
Round 2010, liraglutide (Victoza, Saxenda) was accredited by the FDA to deal with diabetes. Like Ozempic and different newer weight reduction medicines, liraglutide mimics glucagon-like peptide-1 (GLP-1), however it’s much less efficient than the newer medicines.
Why does Ozempic get all of the credit score?
Ozempic has grow to be the Kleenex of weight reduction medicines—a reputation model individuals toss round as if it’s generic.
This fame is at the least partly earned: Dr. Fitch says that semaglutide (Ozempic, Rybelsus, Wegovy) additionally works extra successfully than liraglutide, its GLP-1 predecessor.
“Semaglutide is 94 % much like our personal GLP-1,” she says, “They’ve been in a position to make it nearer and nearer to the GLP-1 our our bodies make.”
It additionally lasts longer than liraglutide, and extra of it reaches the mind.
Nevertheless, newer meds outperform Ozempic. (See the desk within the part under.)
And there are different medicines—out there orally somewhat than by way of injection—coming. These drugs will probably be simpler to mass produce, which can drive down prices and make GLP-1 medicines much more accessible to extra individuals.
So, though Ozempic is the present reigning model of the burden loss drug world, it could be ousted in time.
The rising effectiveness of weight reduction medication (particularly together with way of life modifications)
Researchers measure a weight-loss medication’s success primarily based on the share of people that attain key weight reduction milestones.
For instance, most individuals begin to see well being advantages after dropping 5 % of their weight—and remission from illness after dropping round 20 %.
Because the chart under exhibits, weight reduction medicines have grow to be more and more efficient at serving to individuals to succeed in each milestones.
Drugs | % of people that lose 5% of their weight | % of people that lose >20% of their weight |
---|---|---|
First-generation weight reduction medicines (Qsymia, Contrave, Metformin) 4 5 6 | 53-80% | 10-20% |
Semaglutide (Ozempic, Rybelsus, Wegovy) 7 8 | 86% | 32% |
Tirzepatide (Mounjaro, Zepbound) 9 10 | 85-91% | 50-57% |
Retatrutide (not but FDA accredited) 11 12 | 92-100% | 80-83% |
How do weight reduction drugs examine to conventional interventions?
Prior to now, weight reduction interventions have targeted on way of life modifications like calorie or macronutrient manipulation, train, and generally counseling.
Relatively than pitting way of life modifications in opposition to weight reduction medicines or surgical procedure, it’s extra useful to consider all of them as instruments.
Because the graph under exhibits, the extra weight reduction instruments somebody makes use of—together with teaching—the extra vital the outcomes.13 14 15 16
Fats loss usually comes with highly effective well being advantages
For years, the medical neighborhood has informed of us that dropping 5 to 10 % of their physique weight was adequate.
Partly, this message was designed to right-set individuals’s expectations, as few lose way more than that (and preserve it off) with way of life modifications alone.
As well as, this modest weight reduction additionally results in measurable well being enhancements. Lose 5 to 10 % of your whole weight, and also you’ll begin to see blood sugar, ldl cholesterol, and stress drop.17
Nevertheless, dropping 15 to twenty % of your weight, as individuals are inclined to do after they mix way of life modifications with second-generation GLP-1s, and also you do way more than enhance your well being. You may go into remission for a number of well being issues, together with:
- Hypertension
- Diabetes
- Fatty liver illness
- Sleep apnea
Meaning, by taking a GLP-1 medication, you would possibly have the option ultimately to cease taking a number of different medication, says Dr. Nadolsky.
Consultants suspect GLP-1s could enhance well being even when no weight reduction happens.
“The medicines appear to supply additive advantages past simply weight discount,” says Dr. Nadolsky.
Analysis signifies that GLP-1s could scale back the chance of main cardiovascular occasions (coronary heart assaults and strokes) in individuals with diabetes or coronary heart illness.18 19 20 In individuals with diabetes, they appear to enhance kidney operate, too.21
The idea is that organs all through the physique have GLP-1 receptors on their cells. When the GLP-1s connect to those receptors within the kidneys and coronary heart, they appear to guard these organs from harm.
For that reason, in 2023, the American Coronary heart Affiliation listed GLP-1 receptor agonists as one of many yr’s high advances in heart problems.
Ozempic unwanted side effects
You’ve probably heard that slowed gastric emptying from GLP-1s can result in nausea, constipation, and different GI woes.
That’s all true.
Nevertheless, for many, these unwanted side effects are manageable, particularly with the assistance of some key methods (which we’ll cowl later).
For now, nonetheless, we’d wish to hash out a selected draw back you’ve probably heard about from the media—as a result of it affords an enormous alternative for well being coaches.
When individuals take GLP-1 weight reduction medicines, about 30 to 40 % of the burden they lose can come from lean mass.22 23 24
Put one other method: For each 10 kilos somebody loses, about six to seven come from fats and three to 4 from muscle, bone, and different non-fat tissues.
This statistic has been broadcast amongst many media retailers in latest weeks as a dire warning in opposition to taking Ozempic, Wegovy, or Zepbound.
Such tales usually fail to say two vital caveats:
Caveat #1: Folks with extreme weight problems typically have extra muscle and bone mass than others.
To know why, think about you had been compelled to put on a 100- or 200-pound physique swimsuit every single day for a yr. On a regular basis actions—getting out and in of chairs, strolling to and from the mailbox, climbing steps right into a constructing—would really feel like a resistance exercise.
That’s probably partly why bariatric surgical procedure sufferers expertise a nine-year extension on their life expectancy, regardless of 30 % of their weight reduction coming from lean mass. They’ve extra muscle than common to start with, and due to this fact can safely lose some.25 26
For individuals with extreme weight problems, the well being increase from physique fats loss offsets the well being threat of muscle and bone loss, says Dr. Fitch.
That stated, there’s a caveat to the caveat: People who find themselves solely 30 kilos or so chubby could not be beginning out with muscle and bone mass to spare. Particularly in the event that they’re older, they might start their weight reduction journey already under-muscled, with comparatively low bone density. In these individuals, one other drop in lean mass and bone density can add as much as large well being issues.
Nevertheless…
Caveat #2: Muscle and bone loss aren’t inevitable.
As Dr. Nadolsky places it, “Muscle loss isn’t a purpose to keep away from treating weight problems [with medication]. It’s a purpose to do extra train.”
That is the place coaches can shine.
By displaying purchasers learn how to undertake muscle-building behaviors like power coaching, mixed with adequate protein consumption, you possibly can assist individuals offset the worst of the unwanted side effects when taking these medicines.
The yo-yo drawback
GLP-1s are costly, costing roughly $1000 USD a month. Consequently, many insurers both refuse to cowl them or restrict their protection to a yr or two.
As soon as the cash runs out, individuals are inclined to go off the meds—and the starvation and cravings return.
In the event that they’ve performed little to vary their foundational consuming habits, this places them at a big drawback. In the event that they’re not consuming slowly and mindfully and bettering satiety with veggies and lean protein, the return of starvation and meals noise will be overpowering.
That’s probably why, in a single examine, individuals who stopped taking semaglutide regained, on common, two-thirds of the burden they’d misplaced.27
Once more, right here’s one other alternative for coaches…
Use weight reduction medication as a key that unlocks way of life modifications.
Weight reduction medicines don’t render behavior-based methods out of date; they make them extra vital.
When GLP-1 medicines muffle meals noise and starvation, your consumer will discover it simpler to prioritize protein, fruits and veggies, legumes, and different minimally processed entire meals. Equally, as the dimensions goes down, purchasers really feel higher, in order that they’re extra more likely to embrace weight lifting and do different types of train.
In response to a 2024 client developments survey, 41 % of GLP-1 medication customers reported that their train frequency elevated since happening the remedy. Nearly all of them additionally reported an enchancment in food plan high quality, selecting to eat extra protein, in addition to vegetables and fruit.28
That is nice information, as a result of, as talked about above, way of life modifications are vital to preserving lean mass and stopping regain, ought to purchasers select to discontinue remedy.
When working with purchasers on GLP-1s, preserve the next challenges in thoughts.
Teaching technique #1: Discover methods to eat nutritiously regardless of unwanted side effects.
The slowed abdomen emptying attributable to GLP-1 medication can set off nausea and constipation.
Thankfully, for most individuals, these GI woes are inclined to resolve inside a number of weeks.
Nevertheless, in the event you’re working with a consumer who’s experiencing lots of nausea, they gained’t probably welcome salads into their lives with open arms. (Consider how you are feeling when you’ve the abdomen flu. A bowl of roughage doesn’t look like it’ll “go down simple.”)
As a substitute, assist purchasers discover extra palatable methods to eat nutritious meals. (For instance, vegetables and fruit within the type of a smoothie or pureed soup may be simpler.)
Dr. Nadolsky additionally suggests individuals keep away from the next widespread offenders:
- Large parts of any variety
- Greasy, fatty meals
- Extremely processed meals
- Any robust meals smells that set off a consumer’s gag reflex
- Sugar alcohols (like xylitol, erythritol, maltitol, and sorbitol, usually present in food plan sodas, chewing gum, and low-sugar protein bars), which may set off diarrhea in some
Teaching technique #2: Prioritize power coaching.
To protect muscle mass, purpose for at the least two full-body resistance coaching classes per week.
As well as, transfer round as a lot as you possibly can. Strolling and different types of bodily exercise are important for conserving the burden off—and will help to maneuver meals by way of the intestine to ease digestion.29 30
(Want inspiration for power coaching? Try our free exercise video library.)
Teaching technique #3: Lean into lean protein.
Along with power coaching, protein is significant for serving to to guard muscle mass.
You should utilize our free macros calculator to find out the correct quantity of protein for you or your consumer. (Spoiler: Most individuals will want 1 to 2 palm-sized protein parts per meal, or about 0.5 to 1 gram of protein per pound of body weight per day.)
Teaching technique #4: Fill your plate with fruit and veggies.
Moreover being good to your general well being, entire, recent, and frozen produce fuels you with vital vitamins that may assist drive down ranges of irritation.
Along with elevating your threat for illness, power irritation can block protein synthesis, making it tougher to keep up muscle mass.
(Didn’t know managing irritation issues in the case of preserving muscle? Discover out extra muscle-supporting methods right here: How to build muscle strength, size, and power)
Teaching technique #5: Select high-fiber carbs over low-fiber carbs.
Beans, lentils, entire grains, and starchy tubers like potatoes and candy potatoes usually tend to assist purchasers really feel full and handle blood sugar than lower-fiber, extra extremely processed choices.
(Learn extra in regards to the drawbacks—and occasional advantages—of processed meals right here: Minimally processed vs. highly processed foods.)
Teaching technique #6: Select wholesome fat.
Wholesome fat will help you are feeling full between meals and defend your general well being. Gravitate towards fat from entire meals like avocado, fatty fish (which can also be a protein!), seeds, nuts, and olive oil—utilizing them to exchange much less wholesome fat from extremely processed meals.
(Unsure which fat are wholesome? Use our 3-step guide for choosing the best foods for your body.)
Teaching technique #7: Construct resilient habits.
It could go with out saying, however the above options are simply the beginning.
(There’s additionally: high quality sleep, social assist, stress administration, and extra.)
Most significantly, purchasers want your assist to make the entire above simpler and extra automated.
And that’s the true reward of teaching: You’re not merely serving to purchasers determine what to eat and learn how to transfer; You’re displaying them learn how to take away boundaries and create methods and routines so their highway to well being is somewhat smoother.
That method, in the event that they do must cease taking remedy, their ingrained way of life habits (that the drugs made simpler for them to undertake) will make it extra probably that they preserve their outcomes.
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References
Click on right here to view the data sources referenced on this article.
- Hendricks EJ. Off-label drugs for weight management. Diabetes Metab Syndr Obes. 2017 Jun 10;10:223–34.
- Lonneman DJ Jr, Rey JA, McKee BD. Phentermine/Topiramate extended-release capsules (qsymia) for weight loss. P T. 2013 Aug;38(8):446–52.
- Sherman MM, Ungureanu S, Rey JA. Naltrexone/Bupropion ER (Contrave): Newly Approved Treatment Option for Chronic Weight Management in Obese Adults. P T. 2016 Mar;41(3):164–72.
- Apolzan JW, Venditti EM, Edelstein SL, Knowler WC, Dabelea D, Boyko EJ, et al. Long-Term Weight Loss With Metformin or Lifestyle Intervention in the Diabetes Prevention Program Outcomes Study. Ann Intern Med. 2019 Could 21;170(10):682–90.
- Sherman MM, Ungureanu S, Rey JA. Naltrexone/Bupropion ER (Contrave): Newly Approved Treatment Option for Chronic Weight Management in Obese Adults. P T. 2016 Mar;41(3):164–72.
- Lonneman DJ Jr, Rey JA, McKee BD. Phentermine/Topiramate extended-release capsules (qsymia) for weight loss. P T. 2013 Aug;38(8):446–52.
- Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 18;384(11):989–1002.
- Garvey WT, Batterham RL, Bhatta M, Buscemi S, Christensen LN, Frias JP, et al. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med. 2022 Oct;28(10):2083–91.
- le Roux CW, Zhang S, Aronne LJ, Kushner RF, Chao AM, Machineni S, et al. Tirzepatide for the treatment of obesity: Rationale and design of the SURMOUNT clinical development program. Weight problems. 2023 Jan;31(1):96–110.
- Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, et al. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022 Jul 21;387(3):205–16.
- Jastreboff AM, Kaplan LM, Frías JP, Wu Q, Du Y, Gurbuz S, et al. Triple-Hormone-Receptor Agonist Retatrutide for Obesity – A Phase 2 Trial. N Engl J Med. 2023 Aug 10;389(6):514–26.
- Frias JP, Deenadayalan S, Erichsen L, Knop FK, Lingvay I, Macura S, et al. Efficacy and safety of co-administered once-weekly cagrilintide 2·4 mg with once-weekly semaglutide 2·4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-c,ontrolled, phase 2 trial. Lancet. 2023 Aug 26;402(10403):720–30.
- Leung, Alice W. Y., Ruth S. M. Chan, Mandy M. M. Sea, and Jean Woo. 2017. An Overview of Factors Associated with Adherence to Lifestyle Modification Programs for Weight Management in Adults. Worldwide Journal of Environmental Analysis and Public Well being 14 (8).
- Maciejewski, Matthew L., David E. Arterburn, Lynn Van Scoyoc, Valerie A. Smith, William S. Yancy Jr, Hollis J. Weidenbacher, Edward H. Livingston, and Maren Ok. Olsen. 2016. Bariatric Surgery and Long-Term Durability of Weight Loss. JAMA Surgical procedure 151 (11): 1046–55.
- Ryan DH, Yockey SR. Weight Loss and Improvement in Comorbidity: Differences at 5%, 10%, 15%, and Over. Curr Obes Rep. 2017 Jun;6(2):187–94.
- Marx N, Husain M, Lehrke M, Verma S, Sattar N. GLP-1 Receptor Agonists for the Reduction of Atherosclerotic Cardiovascular Risk in Patients With Type 2 Diabetes. Circulation. 2022 Dec 13;146(24):1882–94.
- Lincoff AM, Brown-Frandsen Ok, Colhoun HM, Deanfield J, Emerson SS, Esbjerg S, et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. N Engl J Med. 2023 Dec 14;389(24):2221–32.
- Kosiborod MN, Abildstrøm SZ, Borlaug BA, Butler J, Rasmussen S, Davies M, et al. Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity. N Engl J Med. 2023 Sep 21;389(12):1069–84.
- Karakasis P, Patoulias D, Fragakis N, Klisic A, Rizzo M. Effect of tirzepatide on albuminuria levels and renal function in patients with type 2 diabetes mellitus: A systematic review and multilevel meta-analysis. Diabetes Obes Metab [Internet]. 2023 Dec 20.
- Ida S, Kaneko R, Imataka Ok, Okubo Ok, Shirakura Y, Azuma Ok, et al. Effects of Antidiabetic Drugs on Muscle Mass in Type 2 Diabetes Mellitus. Curr Diabetes Rev. 2021;17(3):293–303.
- Wilding JPH, Batterham RL, Calanna S, Van Gaal LF, McGowan BM, Rosenstock J, et al. Impact of Semaglutide on Body Composition in Adults With Overweight or Obesity: Exploratory Analysis of the STEP 1 Study. J Endocr Soc. 2021 Could 3;5(Supplement_1):A16–7.
- Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 18;384(11):989–1002.
- Reinmann A, Gafner SC, Hilfiker R, Bruyneel AV, Pataky Z, Allet L. Bariatric Surgery: Consequences on Functional Capacities in Patients With Obesity. Entrance Endocrinol. 2021 Apr 1;12:646283.
- Carlsson LMS, Carlsson B, Jacobson P, Karlsson C, Andersson-Assarsson JC, Kristensson FM, et al. Life expectancy after bariatric surgery or usual care in patients with or without baseline type 2 diabetes in Swedish Obese Subjects. Int J Obes. 2023 Oct;47(10):931–8.
- Wilding JPH, Batterham RL, Davies M, Van Gaal LF, Kandler Ok, Konakli Ok, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022 Aug;24(8):1553–64.
- Shopper developments: 2024 Meals & Wellness particular. The New Shopper. (n.d.). https://newconsumer.com/trends/consumer-trends-2024-food-wellness/
- Gorgojo-Martínez JJ, Mezquita-Raya P, Carretero-Gómez J, Castro A, Cebrián-Cuenca A, de Torres-Sánchez A, et al. Clinical Recommendations to Manage Gastrointestinal Adverse Events in Patients Treated with Glp-1 Receptor Agonists: A Multidisciplinary Expert Consensus. J Clin Med Res [Internet]. 2022 Dec 24;12(1).
- Tantawy SA, Kamel DM, Abdelbasset WK, Elgohary HM. Effects of a proposed physical activity and diet control to manage constipation in middle-aged obese women. Diabetes Metab Syndr Obes. 2017 Dec 14;10:513–9.
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