The Rise In The Use Of Diabetes Drugs For Weight Management
GLP-1 medications were first approved by the FDA to treat diabetes back in 2005, but they have been making headlines lately as an increasingly popular treatment for obesity. While these drugs can be effective for weight management, there are some things to consider about their rise in popularity and virality online.
The relationship between obesity and insulin
To understand why these drugs work for both type 2 diabetes and weight loss, it can help to understand how obesity and insulin are connected.
Insulin is a hormone secreted by the pancreas that regulates blood sugar. When someone eats, the food is broken down into sugars that circulate in the blood. This increase in blood sugar signals the pancreas to release insulin. The insulin then acts as a key, letting the sugar into the cells, where it can be used as energy. When this happens, blood sugar levels decrease, signaling the pancreas to stop secreting insulin.
Sometimes, the cells in the liver, muscle, and fat tissues stop responding to insulin appropriately. The “key” no longer works, and these cells cannot efficiently take up glucose from the blood. This is called insulin resistance.
To overcome this, the pancreas produces more and more insulin. Blood sugar levels typically remain within the normal range as long as the pancreas can make enough insulin to get the cells to take up glucose. If the cells are too resistant, blood sugar levels begin to rise, which can cause prediabetes or type 2 diabetes.
The elevated levels of insulin that occur as a result of insulin resistance affect the body in several ways. Elevated insulin levels are associated with high LDL cholesterol, high triglyceride levels, high blood pressure, heart failure, kidney disease, and hardening of the arteries, whether someone has diabetes or not. Plus, elevated insulin levels can result in weight gain, which can make insulin resistance even worse.
Multiple factors contribute to insulin resistance, including the following:
- Excess body fat. Researchers believe that obesity, especially excess fat in the belly and visceral fat around the organs, is a main cause of insulin resistance. Research suggests that belly fat produces hormones that can lead to long-term inflammation, which can contribute to insulin resistance.
- Eating habits. Meals and snacks that include a lot of highly processed foods high in carbohydrates and saturated fats has been found to contribute to insulin resistance. These foods are digested very quickly, which can lead to blood-sugar spikes. These increases put more pressure on the pancreas to make more insulin, which can result in insulin resistance.
- Lack of exercise. A lack of exercise can lead to weight gain, which can contribute to insulin resistance. However, vigorous-intensity exercise training may effectively reduce insulin resistance.
How GLP-1 medications work
GLP-1 medications mimic a natural hormone in the body called glucagon-like peptide-1, or GLP-1. This hormone is made in the small intestines and has several roles, including:
- Triggering the pancreas to release insulin to lower blood sugar levels
- Slowing stomach emptying so that less sugar enters the bloodstream
- Increasing satiety, fullness, and satisfaction
- Blocking the secretion of glucagon to reduce glucose in the bloodstream
GLP-1 medications or GLP-1 antagonists are synthetic substances that attach themselves to GLP-1 receptors on various cells. They cause the same effects as the natural substance, potentially leading to improved blood sugar control and weight loss.
Medical necessity
GLP-1 antagonists were first developed as a way to manage diabetes, specifically by lowering blood sugar levels. People on the medications started losing weight, which led to studies about using GLP-1 medications for weight loss. While the rise in popularity of these drugs can be partially attributed to their use by celebrities and the prevalence of posts on social media, their promising efficacy is also a part of it. As with all other medications that require a prescription, you must go through a doctor to get them.
The FDA has approved eight different GLP-1 medications for people with type 2 diabetes to improve blood sugar control in combination with exercise and nutritious food consumption. Although generally not the first-line therapy for diabetes, these drugs can be used in combination with other diabetes medications for people who continue to have difficulty controlling their blood sugar.
There are two FDA-approved options for weight loss, both of which are also used to treat type 2 diabetes. Generally, these two medications may be prescribed for people with a BMI of 30 or greater or those with a BMI of 27 or greater who also have at least one weight-related health condition.
These parameters can mean that not everyone who wants one of these medications will be able to get it. The increased demand has led to a , and because the two options approved for weight loss are also used to treat type 2 diabetes, some people who rely on them for blood glucose management may have a hard time finding them.
Another challenge brought on by the popularity of these medications is the increase in online providers and telehealth weight management services who may be prescribing these medications inappropriately. Because of the shortages, these providers may be referring people to pharmacies that provide compounds of the medication that are not FDA-approved and do not have the same effects.
Also, these medications are not without risks. They can cause low blood sugar and lead to gastrointestinal discomfort, including constipation, diarrhea, nausea, and vomiting.
Other ways to improve insulin resistance and manage weight
If you are concerned about insulin resistance, some lifestyle changes may help, including:
- Getting more exercise. Exercise can be an effective tool for reversing insulin resistance. One small study found that a single 45-minute session of moderate-intensity exercise was enough to improve insulin sensitivity and that six weeks of consistent exercise could improve it by as much as 40%.
- Making small changes to your food intake. Research shows that meals high in whole grains, vegetables, fruits, nuts, and olive oil can reduce the risk of developing type 2 diabetes, but any meal plan low in carbs and fat can help. Making minor adjustments, such as using brown rice instead of white rice or whole wheat bread instead of white bread, eating more fruits and vegetables, or limiting refined sugar, may be beneficial. However, each person can have different allergies and nutrition needs, so it’s recommended that people living with diabetes speak with a doctor for specific food recommendations.
- Managing stress. Stress causes the body to release cortisol, which can affect insulin production. Everyone experiences stress from time to time, but learning skills to manage it can improve physical and mental health.
Body image and mental health
Body image refers to what you think and feel about your appearance as well as how comfortable you are in your own skin. Body image is related to the behaviors that result from these thoughts and feelings.
People with obesity, particularly women, may be more likely to experience challenges with body image, but this doesn’t just affect people who are overweight. Women who are not overweight or those who are underweight can also have a negative body image, and factors other than weight can affect how people feel about their bodies.
For people whose body image is affected by their weight, it can sometimes be challenging to see images of people online celebrating their weight loss success. Research shows that frequently comparing one’s own physical appearance to images on social media can increase body dissatisfaction and the drive for thinness.
A negative body image can significantly affect your mental health. However, working with a mental health professional can help you learn to manage your feelings and challenge inaccurate thoughts about yourself.
For some people, talking about body image can be a vulnerable experience. If this is the case for you, online therapy sessions may help you feel more comfortable because you can attend sessions from the comfort of your home or anywhere you feel safe. With an online therapy platform like BetterHelp, you can communicate with your provider via audio, video, or live chat, depending on how you feel the most comfortable.
Research shows that online therapy can be an effective way to treat a variety of eating disorders. One study resulted in generally large reductions in body dissatisfaction and small to moderate effects for social functioning, self-esteem, quality of life, and physical and mental health.
Takeaway
Extensive studies have shown that GLP-1 agonists, drugs originally developed to support diabetes management, can also be effective at helping people lose weight. However, these medications are typically prescribed in conjunction a plan for eating nutritious food and getting regular exercise.
For those whose body image is related to their weight, comparing themselves to people on social media can impact their mental health. Research suggests that talking to an online therapist can help decrease body dissatisfaction and increase self-esteem. If you don’t feel comfortable discussing these concerns in traditional in-person therapy, you might consider online therapy, which allows you to connect with a therapist from home. With online therapy, you can be matched with a counselor who has experience helping people with body image concerns or similar challenges. Take the first step toward getting support with body image concerns and contact BetterHelp today.
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