Cause for caution with weight loss drugs like Ozempic | Peter Attia, M.D.


24 comments

  • 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.

  • 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

  • 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

  • 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

  • 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.

  • 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.

  • 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?

  • Great video, thank you!

  • 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?

  • It's not worth losing muscle mass! Plus all the other dangerous side effects they're not telling you about.

  • 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. 🙂

  • Please make a follow up video, comparing these two!

  • 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.

  • 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!

  • 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.

  • 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).

  • It has a longgggg. Half life of 5 days!! It works and it works well. However it does slow your gastrointestinal emptying.

  • What is the risk of not taking it when all else doesn’t work?

  • I’m taking it and I have no side effects. So weird.

  • 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

  • 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.

  • Anyone know if the comparison video to newer solution ever happened?

  • 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.

  • I think it brought on my heart attach.

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