As I shared with you yesterday, there’s a “new” promise of “the magic pill.”  It comes in injectable form, but conceptually, it's perceived as "a fix."  Something exogenous will solve a problem for you.

Sure, the medication will have an insert with warnings and a hefty disclaimer at the end of their joyous TV commercials, but doesn’t the widespread desire for the drug have everything to do with the desire for magic? 

When people seek  magic, they tend to ignore the hazard signs.

With any new drug, the warnings are present in plain sight, but when it comes to weight loss, the hope of success without effort overrides caution in far too many cases.

WE ARE ETHICAL, BUT DOES THAT MATTER?

As Fitness Professionals, we ethically emphasize the importance of movement, dietary shifts, and behavior change, but given the choice, most Americans with excess bodyfat would choose “the pill” over commitment and energy expenditure.

Sad?  Yes. 

True?  Yes.

That shouldn’t disillusion you.  It should help you understand where you can excel in a field that is plagued by fitness failure. 

Blatant brutal honesty is in order here.  Most personal trainers are not equipped to truly reverse chronic disease and the weight loss resistant condition that is the most prevalent “symptom.”  Sure you can help someone add muscle, and eat better, but when endocrine disruption begins (as it does in the case of ALL Chronic Disease), “exercise and eat right” isn’t enough.

Most personal trainers will react to the previous paragraph, as they were never taught to understand the chronic condition that underlies T2 Diabetes, Hypothyroidism, and Metabolic Syndrome.  I've learned to call this condition REMASS (Restrictive Endocrine Maladaptive Adrenal Stress Syndrome) and . . . it's completely reversible!  With the right strategy (and I’m more than willing to share that strategy).

Understanding how to prescribe exercise, and talking to clients about macro-nutrition, is simply not enough to restore metabolic function in those who have lost some metabolic ground.  We must, if we are to conquer the “I-Just-Want-A-Pill Monster,” we have to become adept in shifting mindset, in educating, and . . . here’s the  biggie . . . in incorporating a science-based strategy for “healing,” for restoring parasympathetic recovery, and for reversing inflammation.

That’s exactly what I and my trainers have learned to do.

Right now, I’m going to explain a bit about the release of Wegovy, a drug with mass appeal (although it will not live up to the promises), but stay with me.  I’m going to take awhile to get there as I want you to see clearly enough to re-direct people when they’re magnetized to yet a new arrival of “the weight loss pill.”  In this case, it’s an injection, but the theory is the same.  It’s easy and you don’t have to do a whole lot to drop the pounds that concern you.

As a new drug shows itself on the horizon, I prepare.  I study the research, I look for the benefits and risks, and I package it into a presentation that compares the long-term outcome with the promise of lasting change I and my team can provide.

In this article, a small snapshot of the insights I share in my professional programs, I’ll present some key points that might help you inspire people to re-think the “new drug” and opt to invest in that which you profess and implement.

DO WEIGHT LOSS DRUGS WORK?

Here’s the short answer. 

Yes. 

But that should lead to another question.

Is the drug-induced Weight Loss healthy, beneficial, and lasting? 

That second question turns the initial Yes into a hard NO WAY. 

WHAT DO WE ALREADY KNOW?

We know that destructive bouts with calorie deprivation bring weight loss accompanied by metabolic slowdown and internal shifts that ensure the pounds lost will return. 

We know that the most popular restrictive diets are “successful” for the companies that sell them, in terms of repeat business, primarily because they fail people.  Why has this illusory “result” proven to stand the test of time?  Shouldn’t people have figured it out by now?

We know the reason they fail to see the flaws in ineffective diets.  They are conditioned to judge their progress by their scale weight.  This is reinforced by a whole lot of “medical” literature and an ever-growing emergence of new twists on “cutting calories.”  Most weight-loss-wanters never learn to distinguish between fat loss, muscle loss, reduction in bone density, and water loss.  And so, they’re willing victims of a multi-billion dollars industry that dances with drug releases.

Finally, we know that it's pretty easy to trick a human body into dropping 10 or more pounds of water weight, placing them on the scale for a moment of celebration, and then allowing the weight to return.

Knowing this, it becomes evident that if a drug taps into any mechanism for weight loss that might negatively impact metabolism, might increase the future likelihood of weight loss resistance, or might threaten systems, cells, or organs, it isn’t a solution.  If it promotes and delivers gratification of rapid weight loss, its likely a trick, and as history will demonstrate, at times those tricks are not only disappointing in the way of outcomes, but dangerous or deadly.

While you’ll see the word “new” in promoting Wechovy, and you’ll see or hear the tagline, “the first weight loss drug of its kind,” weight loss drugs have been with us for pretty close a century.

I’m going to give you a brief tour through Weight Loss Drug History to help you see the ever-emergent pattern (one that you want to be willing to point out when confronted with “I want the drug” emitting from the lips of someone that should trust you with their health and fitness future).

FROM A CENTURY AGO TO WEGOVY

100 years ago, thyroid hormone was extracted from sheep and pigs and sold as a weight loss medication.  People lost weight.  People developed chronic hyperthyroid conditions.  People developed irregular heartbeats.  Some people died.

Near 1930 a buzz began around a chemical compound called dinitrophenol (DNP).  DNP resulted in rapid and significant weight loss by acting within the mitochondria to drive up basal metabolic rate.  First released with the words “safe and effective” it had a short run. 

There was illness.  There were crippling effects.  There were deaths, and in 1938 DNP was deemed “extremely dangerous and not fit for human consumption.”
 

A crazy note related to DNP . . .

DNP is sold as a chemical dye ingredient, as an antiseptic, as an herbicide (unsafe for human consumption) and . . . as a fat loss aid by extreme risk-takers in the world of bodybuilding and physique competition.  “If it’ll help me lose fat, I’ll try it.”  That sentiment ignores the high risk of toxicity, the increased thermogenesis (people have died from heat stroke because their body heat elevated rapidly and dramatically from the use of DNP).

I digress . . . back to the story . . .

After DNP was pulled, the drug manufacturers began to see the “mass frenzy buying response” that amplified the profit potential of a drug that promised weight loss. 

Enter amphetamines. 

Dexadrine was the weight loss drug of choice.  Doctors handed out dexadrine prescriptions to any patient complaining of being “too fat.” 

The main flaw with dexadrine and the spin-off compounds that followed was . . .

Addiction!

And with addiction came risk of overdose.  And lots of side effects ranging from tremors to psychosis.  Oh, and death.  For real.

In the 1950’s the FDA took on greater authority, and with the "Amphetamine Control Law" passed in 1951, these stimulant weight loss drugs went away from the realm of “commonly prescribed weight loss solutions.”  They didn't go away.  They just went into a sort of gray area, black market, or "other use" category.

In 1965, a different type of stimulant / appetite suppressant called aminorex fumarate was released and it wasn’t long before users of this new obesity control drug started frequenting Emergency Rooms with chest pain.  A disturbingly common diagnosis among these individuals was Primary Pulmonary Hypertension (PPH). 

PPH is a rare heart / lung disease where the vessels constrict and pressure is severely elevated. 

There is no cure. 

It doesn’t get better.  It typically leads to death by way of cardiac arrest.

In 1968 aminorex fumarate went the way of its predecessors.

DO YOU SEE A PATTERN?

A drug shows promise as an obesity treatment, it’s brought to the market, it generates massive revenues, people get sick and die, nobody loses weight healthfully or permanently, the drug is pulled.

I can give you other examples of this recurring scenario, but let’s recognize that from the 1960’s to the 1990’s, obesity skyrocketed, the drug companies found greater funding, and enhanced their lobbying power, and the race to come up with the next “weight loss miracle” was picking up steam. 

If something had weight loss as a side effect, all eyes were on it, often regardless of the risks.

The next major release, in fact, the biggest weight loss drug ever, hit the market in 1992.  It combined a stimulant weight loss drug from the 70s, phentermine, with a drug that acted at the serotonin centers of the brain called fenfluramine. 

On the drug you were speeding, but your medicated brain told you you were calm and relaxed. 

You don’t eat.  Your brain tells you you’re satiated.

In 1996, over 18,000,000 prescriptions were written for Phen-Fen, and later that year cases of heart lesions, valve injuries, and . . . this will sound familiar if you’ve been reading from start to finish . . . a significant and disturbing emergency of PPH. 

I said earlier there was no cure for this condition, but let me lay out the entire picture.  If you take a drug to lose weight, and you develop PPH, you have a choice. 

You can die, or, you can get a complete heart and lung transplant and pray. 

Or . . . you can stop believing in the next weight loss drug miracle!

It didn’t end when Phen-Fen was pulled, but it did create a bit of caution preceding new releases, as the manufacturers of Phen-Fen had to pay $3.75 Billion in damages, and . . . the lawsuits continue to come in right up until 2022!  This was a costly release in many ways.

After Phen-Fen, Orlistat was the next one to gain public awareness.  It was released under the name Xenical and the marketing said it can lead to weight loss and should be combined with a calorie-restricted diet and exercise. 

Hmmph.  Jellybeans can help you lose weight if they come with an order for calorie cutting and exercise!  In fact, users of Orlistat would have been better off with jellybeans. 

Orlistat attracted and clung to fat in the digestive tract and carried that dietary fat out the other end without allowing it to be absorbed.  It doesn’t take a research scientist to recognize that this would clearly interfere with the absorption of Vitamins A, D, E, and K (fat soluble vitamins) but it gets uglier. 

The drug led to anal leakage and loose and oily stools.  That one went away in pretty short order.

Other drugs and stimulants that found their way into the market for other purposes found their way into medical prescription for weight loss programs (such as HCG, Adderall, and other drugs for off-label use) but the newest class of drugs are the ones I want to now focus on.  They are injectables with semaglutide as the active ingredient.

Semaglutide acts at the glucagon receptor to alter the output of pancreatic hormones and affect the balance between insulin and glucagon.  It is a Glucagon-Like Peptide agonist, GLP-1.  It found its place as an infrequent injection to help manage blood sugar in diabetics.  Because insulin spikes (due primarily to insulin resistance) is a primary factor in the onset of diabetes, the mechanism of action “makes sense,” not in a curative way, but in terms of it “managing” blood sugar for a brief period of time.

There are many brand names for GLP-1 drugs.  You’ll recognize some from their TV commercials.

• Trulicity
• Byetta
• Victoza
• Ozempic

The side effects of these drugs included weight loss.  Eureeka! 

With a wide open field for a new drug release, the Danish company Novo Nordisk saw the open sea and dove right in.

The drug Ozempic (from Novo Nordisk), which comes with valid warnings of increased likelihood of pancreatitis, pancreatic cancer, and thyroid cancer, and which clearly said it is not prescribed for weight loss, is re-released as the  weight loss drug Wegovy.

And I share this with you now because the ad spend budget set aside for advertising and marketing Wegovy in January 2023 (after the season of gluttony) is astronomical.

I would never tell anyone to stop using a drug, nor would I tell them not to take a drug, as that’s outside of my scope of practice.  But I can act in anyone’s best interest by providing information that adjusts their line of thought and leads them to make better decision.  Simply understanding the history of weight loss drugs, seeing the pattern of consequence and failure, and recognizing that the drug companies have increased revenues despite side effects and death should be enough to arm you with some food for thought that you can pass along.

I’ll leave it at that and provide a few references to research studies specifically addressing the side effects of semalutide (this is just a small sampling.  There’s an entire rabbit hole you’re free to go down as you continue to research). 

I’ll also point out that when we nutritionally guide our clients to stabilize blood sugar, they will naturally improve the balance of insulin and glucagon (without side effects) and when we integrate the strategies I alluded to earlier, and I share in my professional programs, the choice between the drug or our  offerings isn’t a choice at all.

Prepare for 2023 now, and be prepared to battle for your  client’s minds.  You can win!

Be Prepared.  Be Powerful.  Be Better,

Phil Kaplan

P.S.  I'm going to list a few relevant studies below, but before you dive into that rabbit hole, REGISTER FOR THE NOVEMBER 1st CHALLENGE!

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AND NOW . . . RESEARCH REFERENCES

Elashoff M, Matveyenko AV, Gier B, Elashoff R, Butler PC. Pancreatitis, pancreatic, and thyroid cancer with glucagon-like peptide-1-based therapies. Gastroenterology 2011;141:150–156 

Butler PC, Matveyenko AV, Dry S, Bhushan A, Elashoff R. Glucagon-like peptide-1 therapy and the exocrine pancreas: innocent bystander or friendly fire? Diabetologia 2010;53:1–6 

Gier B, Matveyenko AV, Kirakossian D, Dawson D, Dry SM, Butler PC. Chronic GLP-1 receptor activation by exendin-4 induces expansion of pancreatic duct glands in rats and accelerates formation of dysplastic lesions and chronic pancreatitis in the Kras(G12D) mouse model. Diabetes 2012;61:1250–1262 

Elashoff M, Matveyenko AV, Gier B, Elashoff R, Butler PC. Pancreatitis, pancreatic, and thyroid cancer with glucagon-like peptide-1-based therapies. Gastroenterology 2011;141:150–156 

Butler PC, Matveyenko AV, Dry S, Bhushan A, Elashoff R. Glucagon-like peptide-1 therapy and the exocrine pancreas: innocent bystander or friendly fire? Diabetologia 2010;53:1–6

Gier B, Matveyenko AV, Kirakossian D, Dawson D, Dry SM, Butler PC. Chronic GLP-1 receptor activation by exendin-4 induces expansion of pancreatic duct glands in rats and accelerates formation of dysplastic lesions and chronic pancreatitis in the Kras(G12D) mouse model. Diabetes 2012;61:1250–1262 

Gier B, Butler PC, Lai CK, Kirakossian D, DeNicola MM, Yeh MW. Glucagon like peptide-1 receptor expression in the human thyroid gland. J Clin Endocrinol Metab 2012;97:121–131