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Here is my little PSA on Ozempic… if you’re considering this drug, check this out and check out podcast number 246 from The Drive.
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About:
The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 60 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, and much more.
Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan.
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So happy I followed what you've learned about Ozempic, the findings lead me to take my mother off Ozempic and put her back on Metformin.
The nurse practitioner used this, but she came out looking like a shrunken shell of herself. Not for me.
I have lost 40lbs over the course of 2 years while increasing my weight training exercise.
What changed? Pharma marketing.
Thank you for this short, Peter. Also, I want to give you a shout out regarding your Early program- wow! I love it! Learning so much, Peter. I feel so blessed to have access to all the knowledge, framework and strategies you have put into that program. Thank you❤
The clinical studies I’ve read showed that lean muscle mass is preserved – can you provide some citations for your claims?
You sound incompetent
That is just crazy that they just go by body weight. You can loose 15 lbs cutting an arm off but is that what you really want to do…………….
Here's the things that gets me though. If you are eating 200g of protein and working out intensely lifting weights, then why do you need Ozempic ?
My husband has recently been prescribed this drug for his Type 2 Diabetes and hearing about these side effects scares me to death. His regular diabetic meds made him lose a massive amount of weight (much of it was muscle), so he absolutely cannot afford to lose any more weight on this. But he risks a stroke if he doesn't go on it.
I find endogenous leptin is good!
This guy is the classic duche bag
I think it brought on my heart attach.
You will learn how bad Ozempic is, Weight Watchers, when your members complain about waking up with messy sheets. I would never go back to WW knowing that they offered this.
Anyone know if the comparison video to newer solution ever happened?
Isn’t this the FDA with carb high food chart? As the population gets older, it would be nice to have a more holistic view of healthy bodies beyond weight and BMI. I can lose 7 pounds a day from water loss from exercise. I still feel body recouping with muscle gain and a steady long term loss of fat from better eating and regular exercise is the name of the game.
Ozempic is a pharmaceutical dream.. it’s expensive and you have to stay on it forever or you will gain all your weight and more
I’m taking it and I have no side effects. So weird.
What is the risk of not taking it when all else doesn’t work?
It has a longgggg. Half life of 5 days!! It works and it works well. However it does slow your gastrointestinal emptying.
My wife pointed out to me that the math here doesn't hold up: If one is 100lbs, and 30% fat, losing 5lbs of fat and 5lbs of muscle (50% ratio, as Dr. Attia said of Ozempic), then one's body composition would still have improved from 30% to 27.8% (= 25 / 90).
This guy is super smart. Looking at all factors. Forcing the body unnaturally to go into starvation mode will never have a good outcome. Increase leptin levels naturally reduces weight. But doctors would never tell people this. No money in it.
Who doesn't own stock in LLY and NVO?? Forget AI, these drugs are the real revolution. THE game changer effecting all other fields of healthcare. About time. People need help and these drugs do the job. Hallelujah!
Yet another "doctor" spouting shit while providing zero solutions through their own practice. Just stop commenting on ozempic because you're not qualified to talk about it until you prove you have some sort of success rate in helping people overcome food addiction.
Doctors have no interest in curing you of anything. A patient cured is a customer lost. And if the obesity epidemic just in the U.S. alone went away tomorrow the medical-industrial complex would lose out on as much as $210 billion dollars in a year's time since they would have no reason to provide obesity-related care any more.
Doctors should be dirt poor, take the money out of medicine.
Please make a follow up video, comparing these two!
Are there journal findings on this information? If so, please provide a link. I am guessing there should have been some findings about muscle mass weight loss somewhere before the drug was approved. Always accept but verify. 🙂
It's not worth losing muscle mass! Plus all the other dangerous side effects they're not telling you about.
My question is how effective is it in diabetic patients? Use over insulin and metformin?
Second question – how does it impact pancreatic function and insulin sensitivity in users who aren’t type 2 diabetics. Are there set backs to one’s natural hormones and or function of insulin after use age for weight loss?
Great video, thank you!
Is there a difference when you control for protein and resistance training? Don’t people lose lean body mass anyway when they decrease calories without weight training and sufficient protein?
I'm a type 2 diabetic. I take a medium size dose. The highest dose ruins my GI system. I don't consider it an appetite suppressant. It helps with my blood sugar. That's my experience.
interesting you should mention muscle. I know someone who is now experiencing all sorts of heart issues, low blood pressure, heart rhythm irregular/ hard to control. The heart is the most important muscle in the body. Could there be a link here with that? One lady developed gallstones and her endocrinologist took her off the drug, said to have the gallbladder removed. Seems extreme to me; why not try bile salts for awhile before doing that? All this reminds me of the bypass heart surgery of decades back. Seemed like what was being bypassed was the whole idea of controlling insulin.
For the sake of clarity, I believe Peter got his numbers wrong in his example at 2:47.
He said given a fat-loss-to-weight-loss ratio of 50% or 0.5, if someone dropped from 200lb to 180 (therefore losing 10lb fat and 10lb muscle), that would only be good if the person was MORE than 50% body fat. In fact, the opposite is true (proof below). The actual rule of thumb is that the person's body fat % needs to be LESS than the the fat-loss-to-weight-loss ratio (fat lost (i.e. 10 lb) / overall weight lost (i.e. 20 lb)) for the overall body fat % to drop. If the person's body fat % is higher than the fractional fat loss as per his example, this is actually a BAD thing.
Proof (with 2 very exaggerated examples), assuming 50% of weight lost is fat and 50% is muscle:
Ex.1) Someone at 75% body fat and 200lb total body weight who lost 10lb fat and 10lb muscle would have gone from 150lb body fat (200*0.75*100%) to 140lb body fat. this is 140lb/180lb, which is a relative increase to ~77.8% body fat.
Ex.2) Using the same logic, someone at 25% body fat & 200lb body weight would have 50lb of fat. Losing 20lb total (10lb fat, 10lb muscle) would drop them to 40lb fat and 180lb total, giving a new value of ([40/180]*100%) 22% body fat.
Important caveat: Peter cites on the Megyn Kelly Show that from DXA scan data, the weight loss his patients are experiencing on Ozempic is roughly two thirds lean body mass and one third fat. Now given that obesity can be defined as roughly 30% body fat in females and 25% in males, despite other valid concerns he points out, their total body fat % might not be increasing as drastically as Peter suggests. Example below:
Ex.3) At 200lb, 30% body fat (the low-end obesity cutoff for females) gives 60lb of fat. Let's assume Peter's cited fat-loss-to-weight-loss ratio of 1:3.
Losing 30lb would mean losing (30lb *(1 lb fat per 3 lb total)) ~10lb fat and ~20lb muscle (ignoring other sources of weight loss for simplicity). New numbers give a 170lb woman with (60lb fat – 10lb fat) 50lb of fat. This gives her a new value of (50lb fat / 170lb total *100%) 29.4% body fat, which isn't too far off the starting point. This is expected, since the original body fat % (30%) is only slightly lower than the fat-loss-to-weight-loss ratio (33%), which would only slightly affect body fat % in the predicted downwards direction. To reiterate, this is a "good" direction only because her initial body fat % was LOWER than the fat-loss-to-weight-loss ratio. Clearly the results would be more impressive if the ratio shifted to 1:1 or even 2:1 fat:muscle.
I fully admit I'm being overly pedantic, but for those who love numbers, I hope my examples have helped clarify his argument. It's important not to overlook his bigger point (which I believe is the real takeaway) that the 1:2 fat-to-lean-body-mass weight loss ratio in this context is very concerning and ideal weight loss should be much closer to his previously-stated 3:1 ratio (i.e. only ~25% of total weight lost should be coming from sources other than fat, not 66%).
Stay healthy and curious folks! <3
I don't pig out like I used to. I can get away without eating for two days and as far as sweets I have no issues I seldom Carrier cash or cards and simple black coffee curves my appetite. It's good it's very good. Summer months and this year five mile walks twice a day is good I'm Not a weight lifter jazz o size kind of person if I could have a bike that be cool cheapest known by every person in the world to do is get up go for a walk I'm still 360 pounds but much less fat and weee but more muscle
You can't meet your protein intake, you throw out everything: water, apples etc. You just can't eat too much, if you do, you throw up, it's like the stomach cannot hold more food
Why would someone want to lose 10lbs? Uk is bmi based, I don’t understand how someone can even get it without a large loss required for heath. This is what gives it a bad name, not those 300-400lb people wanting to not go via surgery route etc.
If you eat less food but the food you continue to eat is the same crappy shit that got you overweight, then you're an idiot.
You obviously didn’t watch the Tucker Carlson podcast! Much more than a need for caution
We have not seen as much muscle mass loss with GLP-1 RAs in our practice and we have been using it for over 5 years. What we think is the difference is we do not use this medication without first managing or initiating the management of the metabolic/hormonal/micronutrient issues with each individual patient. We require all patients to utilize specific amino acids complexes as adjuncts to the GLP-1 RAs. Not much muscle mass loss and we do measure via Body Comp devises, DXA, BodPod. One of the mistakes made in general practices when prescribing these types of medications is not managing metabolic stress concurrently…..
I’m a physician, and not a day goes by that I’m not asked for a prescription for these drugs.
I tell them muscle is the currency of longevity, and too hard to regain once lost. They can expect longer, better quality lives with good muscle and extra fat than “skinny fat”
For the love of god if a patient is on a high protein diet and works out you will be fine. It’s that people want it easy. People want a drug that makes them lose weight, build muscle from just breathing and watching tv.
Does anyone have the sources he’s speaking of?
I tried searching and can’t find anything
The FDA using body weight as an index of efficacy is ridiculous. I always say to people "sure you want to lose 'weight?' Do you want to lose hair? Teeth? Bones? Muscle?" Everyone gets that – except the FDA? Also what I would say, is you'd be hard pressed to eat the requisite protein on Ozempic – you just feel way too sick. It's like saying to someone stepping off a rollercoaster – here have this chicken breast." Barf. ' I'd say that is a huge issue. You just can't eat enough protein to maintain the muscle mass and if you manage to, you can't keep it down.
I’m so happy PA fully endorses Ozempic as a miracle cure with no downside! I sprinkle Ozempic on my Fen-Fen flakes. Marry me, Peter!
Yo ho ho Ozempic music 🎶
Is that a causal relationship? Or is it happening because they are losing weight rapidly and not resistance training or eating enough protein?
In other words, if you controlled for resistance training and protein intake would there be any difference?
You can’t suppress appetite without generating anorexic tendencies at the same time. The person loses fat but then they lose muscle mass on account of malnutrition and caloric deficits too. The risk is not worth the reward for most….
I think this is good advice and an important warning. However, where did you get the 50% muscle loss figure that you quote in your video. It is not supported by any actual data in the studies I've read, and there are many. This has been identified as an issue, but the largest figure I've seen is up to 40% percent with the majority of patients seeing closer to a 30% ratio of fat to muscle loss. 25% is the expected percentage of muscle wasting with any weight loss, even without any medication. As a physician, you need to be more careful and precise with your data when presenting information to a public that is likely to see you as an authority on the matter.