Ozempic, a GLP-1 receptor agonist generically known as semaglutide, has been used to help manage type 2 diabetes mellitus and, more recently, in medical weight management. Recent study findings show that Ozempic has a monthly growth rate of 83.9%.
Ozempic has been considered a significant advancement in diabetes management, offering support for glycemic control, increased insulin sensitivity, and suppression of glucagon secretion.
Ozempic's recent increase in popularity is mainly attributed to its potential effects on weight management, which have attracted the medical community and beyond. Studies have shown potential weight regain after stopping semaglutide. One year after the withdrawal of once-weekly semaglutide injections and lifestyle interventions, patients gained two-thirds of their prior weight loss, with similar changes in cardiometabolic health.
Maintaining metabolic health through lifestyle modification after discontinuing Ozempic is crucial to support long-lasting changes and optimal health.
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What Is Ozempic?
Ozempic mimics GLP-1, a hormone naturally produced by the gut in response to food intake. It binds to GLP-1 receptors on pancreatic beta cells, which may help reduce glucose levels in the body by stimulating increased insulin production.
GLP-1s also suppress glucagon, a hormone that raises blood sugar levels by releasing stored glucose from the liver. GLPs provide a feeling of fullness, which may lead to reduced food intake and support weight management. Study findings show a 12% reduction in body weight over 68 weeks.
Common Uses
These mechanisms of GLP-1s are considered effective in managing type 2 diabetes mellitus and obesity and may be considered in treatment plans. Weight management effects include appetite suppression, slower gastric emptying, and reduced caloric intake.
Cardiovascular benefits have been associated with the use of Ozempic as well, potentially reducing stroke and heart attack risk.
Why People Stop Using Ozempic
While the key benefits of blood sugar control, appetite reduction, weight management, and reduced cardiovascular risk are appealing, as with most pharmaceuticals, there are potential risks and side effects that providers and patients alike should consider.
Side Effects
The most common side effects seen with Ozempic use are gastrointestinal effects, including:
- Nausea
- Bloating
- Constipation
- Diarrhea
- Vomiting
- Acid reflux
Further, the risk of hypoglycemia (low blood sugar levels) may increase when the drug is combined with other blood sugar-lowering medications. It is vital to monitor glucose levels to ensure safety measures when utilizing diabetes medications.
Pancreatitis (inflammation of the pancreas) is a medical emergency that has been reported in patients using Ozempic. Symptoms include nausea, vomiting, and abdominal pain that may radiate to the back.
There have also been reports of kidney issues. Thus, patients with a history of kidney disease may not be ideal candidates for Ozempic, or a provider may opt to monitor kidney function closely.
In animal studies, semaglutide has been associated with an increased risk of thyroid tumors. Although not confirmed in humans, providers should keep this in mind in patients with a history of thyroid cancer or other thyroid disorders.
Other Considerations
Patients should plan to be taking semaglutide for a minimum of 3 to 6 months for medical weight management, and people with type 2 diabetes likely will require a longer duration.
Patients may stop semaglutide due to reaching their health goals, costs, or if they experienced unfavorable side effects. No matter the reason for discontinuation, it is essential for patients to work closely with providers in a management treatment plan to support long-lasting results.
Staying Metabolically Healthy After Ozempic
It is possible to support metabolic health after taking Ozempic. Here are some evidence-based tips:
Nutrition & Diet
A healthy diet is fundamental to maintaining stable blood sugars and weight. Balancing meals may help prevent blood sugar spikes and crashes, provide consistent energy levels, and reduce the risk of chronic health issues like cardiovascular disease.
High-glycemic foods cause rapid increases in blood sugar levels. The glycemic index categorizes foods from 0 to 100 based on how significantly they impact blood sugar levels.
- Low Glycemic Index (55 or less): Foods associated with a slower release of glucose into the bloodstream, including vegetables, most fruits, legumes, and whole grains.
- Medium Glycemic Index (56-69): Foods that moderately impact blood sugar levels, like whole grain breads and brown rice.
- High Glycemic Index (79 and above): Foods that may spike blood sugar levels rapidly, such as sugary cereals, candy, fruit juices, soft drinks, white rice, white pasta, white bread, and pastries.
A well-balanced diet includes low glycemic foods, portion monitoring, and incorporation of the following:
- Protein: Lean proteins such as fish, poultry, beans, and tofu may help increase satiety and stabilize blood sugar. The daily protein requirement varies depending on several factors, including age, sex, activity level, and overall health goals. The recommended daily allowance for protein is 0.8 grams per kilogram of body weight per day.
- Healthy Fats: Unsaturated fats such as nuts, seeds, olive oil, and avocado are essential. On average, the recommended daily allowance of healthy fats for ages 19 and up includes 1.6 g per day for males and 1.1 g per day for females.
- High Fiber: High-fiber foods like vegetables, fruits, whole grains, and legumes may slow the absorption of sugar. On average, the recommended daily allowance of fiber includes 25-30 grams.
- Complex Carbohydrates: Fruits, vegetables, whole grains, and legumes are digested slower than simple sugars and provide a steady release of glucose into the bloodstream. On average, the recommended daily diet includes 45-65% of complex carbohydrates.
Supplements
Providers may recommend certain supplements to support metabolic health, especially during or after a weight management journey or health transformative process.
- Berberine: Berberine has been referenced as "Nature's Ozempic" due to its potential impact on insulin sensitivity and blood sugar levels. some text
- Recommended Dosing: 500 mg two-three times per day before meals
- Chromium: Chromium may help improve glucose metabolism and enhance insulin effects.some text
- Recommended Dosing: 25-35 mcg per day
- Coenzyme Q10: CoQ10 supports mitochondrial function, the powerhouses of the cells, by enhancing energy production and reducing oxidative stress.some text
- Recommended Dosing: 100-200 mg per day
- Vitamin D: Vitamin D has many benefits, including supporting immune function, reducing inflammation, and enhancing insulin sensitivity. some text
- Recommended Dosing: Based on blood levels, on average 1,000-2,000 IU per day
- Omega-3 Fatty Acids: Fish oil or algae oil supplements support heart health, enhance insulin sensitivity, and reduce inflammation.some text
- Recommended Dosing: 1-3 g per day of EPA/DHA
- Magnesium: Magnesium may help regulate blood pressure, support glucose metabolism, and improve insulin sensitivity. some text
- Recommended Dosing: 200-400 mg per day
- Alpha-Lipoic Acid: ALA is an antioxidant that may help lower inflammation and improve insulin sensitivity. some text
- Recommended Dosing: 300-600 mg per day
- Cinnamon Extract: Cinnamon may help lower blood sugar levels.some text
- Recommended Dosing: 500-1,000 mg per day
- Probiotics: Probiotics support gut health, which may influence weight management and insulin sensitivity.some text
- Recommended Dosing: On average, 1-10 billion CFUs per day
- Fiber Supplements: Fiber may help control blood sugar levels and support digestive health. some text
- Recommended Dosing: 5-10 gm per day
Physical Activity
Regular exercise and movement are important in managing metabolic health and weight. Regular exercise may boost metabolism, increase muscle mass, support cardiovascular health, and reduce inflammation.
Exercise recommendations to consider:
- Aerobic Training: 150-300 minutes per week of moderate-intensity or 75-100 of vigorous intensity
- Resistance Training: Minimum 2 times per week, including 1-3 sets, or 8-12 reps, of 8-10 different exercises
Lifestyle
Maintaining metabolic health for long-term success encompasses a whole-body approach, optimizing the mind, body, and spirit. Whole health involves managing stress, obtaining high-quality sleep, and having meaningful relationships with friends and family.
Along with the incorporation of healthier habits, some habits may negatively impact metabolic health, including:
- Intake of high glycemic foods (highly processed foods, meats, and sugary foods)
- Excessive alcohol intake
- Nicotine and tobacco use
- Environmental toxin exposure
Lab Testing for Metabolic Health
Lab testing is essential in diagnosing metabolic disorders and evaluating disease severity.
Blood Sugar Monitoring
Blood tests to monitor include:
These tests should continue to be monitored past Ozempic's discontinuation to trend the efficacy of treatment plans.
Lipid Profile
Due to the association between cardiovascular health and metabolic disease, a lipid panel should be assessed to evaluate the risk or level of cardiovascular disease.
Additional Lab Tests
- C-peptide may provide clues as to how much insulin the body is producing
- Liver function tests
- Kidney function test
Ordering comprehensive lab testing is necessary for preventing, evaluating, and treating metabolic disorders. It presents providers with evidence of where the disorder is occurring. Providers interpret lab results and translate them into actionable steps for improving health based on patients' needs.
Ongoing Medical Supervision
Regular check-ups are essential in tracking the progress of metabolic health. These periodic visits are vital to continue past discontinuation of Ozempic to help manage weight, monitor blood sugar, reduce cardiovascular disease risk, and avoid potential complications of metabolic health issues.
A whole-body approach requires integrating different healthcare providers and specializations to maintain metabolic stability. This may include dieticians, physicians, endocrinologists, sleep specialists, acupuncturists, and physical therapists.
Treatment plan adjustments may be necessary where additional medications or supplementations may be warranted. A flexible approach to managing health post-Ozempic is needed due to the complexity of metabolic health.
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Key Takeaways
- Critical strategies for managing metabolic health after Ozempic include focusing on a balanced and nutritious diet, regular exercise, stress management, and high-quality sleep. Nutrition and exercise are powerful tools that may help protect against metabolic health issues.
- Regular monitoring through lab testing with a healthcare professional is critical for long-lasting results and provider review of treatment efficacy. Subsequent follow-ups support preventative methods for metabolic health complications and cardiovascular health.
- Working with a healthcare provider empowers patients to take control of their health, encouraging them to stay on track with their health goals and leading to optimal health.
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