E xcess weight is a heavy burden. It imposes browse the internet for five minutes and you will be inundated with countless suggestions for diets and exercise programs to help promote weight loss. Despite the best intentions and determination to keep off the pounds, even highly motivated people can see the scale creep upward despite their efforts. When the newest generation of prescription weight-loss drugs proved effective, therefore, it seemed like a miracle. According to Sharleen Sidhu, MD, an endocrinologist with MarinHealth who specializes in weight management and medication research, the new drugs were discovered during clinical trials originally designed to treat type 2 diabetes. physical limitations, reduces mobility, increases health risks and it’s also contrary to societal expectations that idealize a svelte body. Few people want to be obese or severely overweight, but shedding unwanted pounds remains one of life’s biggest challenges. The demand for remedies is great. Simply “Weight loss was repeatedly observed as a secondary benefit,” she says. The medication proved to be clinically meaningful, thus prompting obesity-based trials as well. Researchers began using higher doses of Ozempic to promote weight loss and discovered that participants had lost 14.9% of their body mass after taking the medication for 68 weeks. Mounjaro, approved for type 2 diabetes and marketed as Zepbound for weight loss, showed even stronger results, with a 29% average weight loss. Ozempic received FDA approval for treatment of type 2 diabetes in 2017 and is used off-label
for weight loss. Wegovy is a higher dose version that the FDA approved specifically for weight management in 2021. Zepbound received FDA approval in 2023. A balancing act Prescription medications such as Ozempic and Zepbound are members of a class of drugs known as GLP-1, or glucagon- like peptide-1, agonists. Glucagon is a hormone produced by the pancreas along with insulin to help control blood sugar levels. Our bodies need blood sugar to be balanced in order for organs like the heart, liver, kidneys and brain to operate efficiently. Usually, when blood sugar is too high, as it is in diabetes, the pancreas makes insulin to lower it, and when it’s too low, it makes glucagon to increase it. When the glucagon level is persistently low, it can lead to weight gain, because individuals may feel hungry and eat more to increase their blood sugar level even though they don’t need the extra calories. In such cases, GLP-1 agonists are useful, because they mimic glucagon, thus increasing the blood sugar level and reducing hunger. Multiple mechanisms work to make GLP-1 agonists effective, and one of the main results is satiety modulation. “Medication slows down gastric emptying, and that makes you feel full sooner,” says Sidhu. At the same time, it improves glycemic control and increases glucose-dependent secretion, which helps improve metabolic health. She adds that older drugs such as naltrexone, which is used in combination with bupropion and marketed as Contrave, focus on appetite suppression.
30 NorthBaybiz
March | April 2026
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