Two New Weight Loss Drugs – Saxenda® and Ozempic®

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Dr. Maupin discusses two weight loss drugs that can help you feel full.

Saxenda®: is a GLP-1 agonist that normalizes blood sugar and causes decrease in appetite as well as slower emptying of the stomach and which makes people feel full longer. was used for treating Type II Diabetics under the name Victoza® for years. It is now offered in a higher dosage in a larger pen specifically for weight loss.  It also reverses the insulin resistance both diabetics and obese people develop by eating too many carbohydrates in their diet. 

People who have a significant weight problem, Insulin Resistance, or Type 2 Diabetes responds well to this medication because it works on relieving insulin resistance, normalizing blood sugar and controlling hunger, in addition to helping people get to their ideal weight!   For those people who genetically are never full, this is the drug for them to make them feel full, maybe for the first time in their lives!

 

My experience with never feeling full:

I never understood those kids and adults who had to eat constantly or who could eat 2-3 plates of food at a time. I just had never walked in their shoes…. until I was pregnant. At that time in my life, I was 118 lbs. when I got pregnant, I never could catch up by eating enough in a day to feed both of us, while I was pregnant.  I felt full at the beginning of a meal but was really hungry, so I had to eat every 30 or 40 minutes during my waking hours.  I was hungry all the time!  Eating literally ruled my life and it made me think about food all the time.  I felt like I was in the prison of my body, but it was a good experience for me to have because now I understand how terrible a genetic albatross always being hungry or never being full is!  If you feel like that it is an inherited trait so there are probably other family members who feel the same way. As people lose weight on Saxenda, they feel less and less hungry and are more satiated by eating.

 Back to my experience with feeling hungry all the time, and never full.  When I delivered my daughter, I was thrilled to not be manipulated all day and night by my hunger.  It was the happiest day of my life to see the beautiful baby that she was, and also to be in control of my eating again.  I think those patients who have this problem for a lifetime will be just as grateful to find Saxenda®.

This medication is one of those that you have to slowly increase over 4 weeks to the maximum dose. The biggest side effect is reflux esophagitis and that means two things…that the patient ate too much out of habit, instead of hunger, or they already have the problem of reflux, and this drug makes it worse.

The second most common side effect of Saxenda® is diarrhea.  If a patient doesn’t follow a low carb diet this medication causes the carbs to dump into the intestines and that causes diarrhea.

The application of this medication is that you take a subcutaneous shot (very small needle) every day in the abdomen like insulin, but it is not an insulin replacement.

 

The Saxenda® dosing schedule

Patients should follow a 4-week dose escalation to reach the clinically
efficacious 3-mg dose.

The Saxenda® starting dose is 0.6 mg per day for 1 week.

Patients increase the dose by 0.6 mg each week until the full maintenance
dose of 3 mg is reached.

If patients cannot tolerate an increased dose during dose escalation, consider delaying escalation for approximately 1 week.

If a patient cannot tolerate the 3-mg dose, discontinue treatment.

There are people who can’t take either of these drugs (Contraindications): Patients with MEN I and II, Medullary Thyroid Cancer, History of Pancreatitis, and or Pregnancy.

 

There are so many people who could benefit from Saxenda®. I believe it is the key to normal weight and normal appetite.  I regret that the pharmaceutical company finds it necessary to charge a price that only a few people can afford.

If you have obesity as a diagnosis and have high fasting blood sugars or have failed Metformin ER treatment then your insurance company may pay for your Saxenda®, but it will take a pre certification by your doctor or Nurse practitioner.

OZEMPIC® is another drug used for weight loss.  In many ways Ozempic® is a lot like Saxenda®, however it is only one shot a week.  The side effects are not as severe with Ozempic®, and the price is lower.  Your insurance may very well pay for Ozempic®, as it has for many of our patients at BioBalance Health®.

Ozempic dosage for obese diabetics is gradually increased as follows:

 

1st and 2nd  injection is 0.25 mg/week x 2 weeks

3rd and 4th   injection is 0.5 mg/week x 2 weeks

5th week and thereafter 0.1 mg/week

 

Dosage for weight loss patients on Ozempic:

1st and second injection is 0.25 mg/week x 2 weeks

Thereafter injection is 0.5 mg/week

Only in resistant cases do non-diabetics have to increase to 1.0 mg/week

  

Side Effects of both drugs include:

  • Symptoms of hypoglycemia like headache, fatigue, and insomnia.
  • Reflux esophagitis and the cough associated with it when you lie down.
  • Distention of the abdomen from slow bowel peristalsis.

 

 How to put it all together for Weight Loss:

 

  1. Exercise daily for 45 minutes or more—normal life activity is not enough to be considered exercise! If you walk for exercise, you must walk briskly, and walking briskly means you can’t talk and walk at the same time.
  1. Diet: Eat a low carbohydrate diet (know what that means) which means no sugar and no alcohol while you are working toward your ideal weight. Replace carbohydrates with a high protein diet including meat, cheese, eggs and protein shakes, Whey protein is preferable and tastes the best. You must eat Vegetables and fruits of every color 3 times a day. Snacks can be veggies, nuts, cheese, yogurt, eggs, and or fresh fruit. No baked goods, no crackers, bread, junk food or fast food.
  2. A High protein diet means eating as many grams of protein as your weight in lbs. if you are active. Eat ½ of that in protein if you are not exercising that day. A delicious protein powder that actually tastes good is Phormula #1 –I like the “mint ice cream sandwich” flavor….I can eat that as a meal substitute alone or blended with frozen fruit 3 meals a day.
  1. Drink filtered water and lots of it! At least 80 fl oz a day.
  1. No alcohol 
  1. If you want to lose weight in certain spots like your waist or your thighs, I recommend the Juvashape Ultrasound fat destroyer with Skin Tightening combination. It helps you lose fat where you want to when you have lost enough to be concerned about getting your shape back.
  1. Medications assist in this process and speed weight loss along. Saxenda® and Oxempic® can be prescribed by BioBalance Health in our weight loss program.

 

If you are interested in coming in for a weight loss program, please go to our website biobalancehealth.com and fill out the history forms and have your blood drawn and we will make an appointment for you as soon as possible.

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author.   www.BioBalanceHealth.com  (314) 993-0963.

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