Ozempic’s cousin drug liraglutide is about to get cheaper. But how does it stack up?

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Fourteen years ago, the older drug cousin of semaglutide (Ozempic and Wegovy) came onto the market. The drug, liraglutide, is sold under the brand names Victoza and Saxenda.

Patents for Victoza and Saxenda have now expried. So other drug companies are working to develop “generic” versions. These are likely be a fraction of current cost, which is around A$400 a month.

So how does liraglutide compare with semaglutide?

Halfpoint/Shutterstock

How do these drugs work?

Liraglutide was not originally developed as a weight-loss treatment. Like semaglutide (Ozempic), it originally treated type 2 diabetes.

The class of drugs liraglutide and semaglutide belong to are known as GLP-1 mimetics, meaning they mimic the natural hormone GLP-1. This hormone is released from your small intestines in response to food and acts in several ways to improve the way your body handles glucose (sugar).

How do they stop hunger?

Liraglutide acts in several regions of the unconscious part of your brain, specifically the hypothalamus, which controls metabolism, and parts of the brain stem responsible for communicating your body’s nutrient status to the hypothalamus.

Its actions here appear to reduce hunger in two different ways. First, it helps you to feel full earlier, making smaller meals more satisfying. Second, it alters your “motivational salience” towards food, meaning it reduces the amount of food you seek out.

Liraglutide’s original formulation, designed to treat type 2 diabetes, was marketed as Victoza. Its ability to cause weight loss was evident soon after it entered the market.

Shortly after, a stronger formulation, called Saxenda, was released, which was intended for weight loss in people with obesity.

How much weight can you lose with liraglutide?

People respond differently and will lose different amounts of weight. But here, we’ll note the average weight loss users can expect. Some will lose more (sometimes much more), others will lose less, and a small proportion won’t respond.

The first GLP-1 mimicking drug was exenatide (Bayetta). It’s still available for treating type 2 diabetes, but there are currently no generics. Exenatide does provide some weight loss, but this is quite modest, typically around 3-5% of body weight.

For liraglutide, those using the drug to treat obesity will use the stronger one (Saxenda), which typically gives about 10% weight loss.

Semaglutide, with the stronger formulation called Wegovy, typically results in 15% weight loss.

The newest GLP-1 mimicking drug on the market, tirzepatide (Mounjaro for type 2 diabetes and Zepbound for weight loss), results in weight loss of around 25% of body weight.

What happens when you stop taking them?

Despite the effectiveness of these medications in helping with weight loss, they do not appear to change people’s weight set-point.

So in many cases, when people stop taking them, they experience a rebound toward their original weight.

Person holds Saxenda pen
People often regain weight when when they stop taking the drug. Mohammed_Al_Ali/Shutterstock

What is the dose and how often do you need to take it?

Liraglutide (Victoza) for type 2 diabetes is exactly the same drug as Saxenda for weight loss, but Saxenda is a higher dose.

Although the target for each formulation is the same (the GLP-1 receptor), for glucose control in type 2 diabetes, liraglutide has to (mainly) reach the pancreas.

But to achieve weight loss, it has to reach parts of the brain. This means crossing the blood-brain barrier – and not all of it makes it, meaning more has to be taken.

All the current formulations of GLP-1 mimicking drug are injectables. This won’t change when liraglutide generics hit the market.

However, they differ in how frequently they need to be injected. Liraglutide is a once-daily injection, whereas semaglutide and tirzepatide are once-weekly. (That makes semaglutide and tirzepatide much more attractive, but we won’t see semaglutide as a generic until 2033.)

What are the side effects?

Because all these medicines have the same target in the body, they mostly have the same side effects.

The most common are a range of gastrointestinal upsets including nausea, vomiting, bloating, constipation and diarrhoea. These occur, in part, because these medications slow the movement of food out of the stomach, but are generally managed by increasing the dose slowly.

Recent clinical data suggests the slowing in emptying of the stomach can be problematic for some people, and may increase the risk of of food entering the lungs during operations, so it is important to let your doctor know if you are taking any of these drugs.

Because these are injectables, they can also lead to injection-site reactions.

Doctor consults with patient
Gastrointestinal side effects are most common. Halfpoint/Shutterstock

During clinical trials, there were some reports of thyroid disease and pancreatitis (inflammation of the pancreas). However, it is not clear that these can be attributed to GLP-1 mimicking drugs.

In animals, GLP-1 mimicking drugs drugs have been found to negatively alter the growth of the embryo. There is currently no controlled clinical trial data on their use during pregnancy, but based on animal data, these medicines should not be used during pregnancy.

Who can use them?

The GLP-1 mimicking drugs for weight loss (Wegovy, Saxenda, Zepbound/Mounjaro) are approved for use by people with obesity and are meant to only be used in conjunction with diet and exercise.

These drugs must be prescribed by a doctor and for obesity are not covered by the Pharmaceutical Benefits Scheme, which is one of the reasons why they are expensive. But in time, generic versions of liraglutide are likely to be more affordable.

Sebastian Furness, ARC Future Fellow, School of Biomedical Sciences, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • The Magic of L-theanine

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    All The Benefits Of Caffeine And More, Without The Drawbacks? What’s The Catch?

    It just takes one extra supplement.

    For many of us, our morning brew is practically a ritual, but caffeine can also cause all kinds of problems ranging from caffeine jitters to caffeine crashes to caffeine addiction and withdrawal. Surely, something could be better?

    Well, yes it could! You doubtlessly know about green tea’s antioxidant properties, but its amino acid, l-theanine (which can be taken as a supplement with coffee, if you don’t enjoy green tea) has so much more to offer:

    • L-theanine has been found to reduce stress responses—and let’s face it, when we most want/need a coffee is often when facing stress
    • It also reduces anxiety, making it a very safe “downer” without the problems of, for example, alcohol—or other potentially addictive substances
    • It’s far more than just that, though! Paradoxically, l-theanine also improves alertness (what other calming things promote alertness? Not so many)
    • Part of its trick is that it also improves accuracy—whereas stimulants like caffeine may produce a twitchy, jumpy, responsiveness, l-theanine’s signature effect is a calm state of sharp readiness. Caffeine works by stimulating the adrenal gland and increasing blood pressure, while simultaneously blocking adenosine receptors so that your body doesn’t notice its own tiredness—which is why you’re likely to crash later, when the tiredness that had been masked, all hits at once. Instead, l-theanine taken with caffeine acts as a moderator of that, making for a longer, gentler curve. In terms of subjective experience, what this can mean for many people is: no more caffeine jitters!
    • All this means that while l-theanine can boost all kinds of cognitive function, including alertness and accuracy, many like to take in the evening as it can also promote a good night’s sleep, ready to be at your best the next day.
    • How much to take? 200mg is a commonly used dosage, which in supplement terms is usually a single capsule. A lot easier to take than the 40 cups of green tea that this dosage would otherwise be!

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  • No, beetroot isn’t vegetable Viagra. But here’s what else it can do

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Beetroot has been in the news for all the wrong reasons. Supply issues in recent months have seen a shortage of tinned beetroot on Australian supermarket shelves. At one point, a tin was reportedly selling on eBay for more than A$65.

    But as supplies increase, we turn our attention to beetroot’s apparent health benefits.

    Is beetroot really vegetable Viagra, as UK TV doctor Michael Mosley suggests? What about beetroot’s other apparent health benefits – from reducing your blood pressure to improving your daily workout? Here’s what the science says.

    What’s so special about beetroot?

    Beetroot – alongside foods such as berries, nuts and leafy greens – is a “superfood”. It contains above-average levels per gram of certain vitamins and minerals.

    Beetroot is particularly rich in vitamin B and C, minerals, fibre and antioxidants.

    Most cooking methods don’t significantly alter its antioxidant levels. Pressure cooking does, however, lower levels of carotenoid (a type of antioxidant) compared to raw beetroot.

    Processing into capsules, powders, chips or juice may affect beetroot’s ability to act as an antioxidant. However, this can vary between products, including between different brands of beetroot juice.

    Is beetroot really vegetable Viagra?

    The Romans are said to have used beetroot and its juice as an aphrodisiac.

    But there’s limited scientific evidence to say beetroot improves your sex life. This does not mean it doesn’t. Rather, the vast number of scientific studies looking at the effect of beetroot have not measured libido or other aspects of sexual health.

    How could it work?

    When we eat beetroot, chemical reactions involving bacteria and enzymes transform the nitrate in beetroot into nitrite, then to nitric oxide. Nitric oxide helps dilate (widen) blood vessels, potentially improving circulation.

    The richest sources of dietary nitric oxide that have been tested in clinical studies are beetroot, rocket and spinach.

    Nitric oxide is also thought to support testosterone in its role in controlling blood flow before and during sex in men.

    Beetroot’s ability to improve blood flow can benefit the circulatory system of the heart and blood vessels. This may positively impact sexual function, theoretically in men and women.

    Therefore, it is reasonable to suggest there could be a modest link between beetroot and preparedness for sex, but don’t expect it to transform your sex life.

    What else could it do?

    Beetroot has received increasing attention over recent years due to its antioxidant and anti-tumour effect in humans.

    Clinical trials have not verified all beetroot’s active ingredients and their effects. However, beetroot may be a potentially helpful treatment for various health issues related to oxidative stress and inflammation, such as cancer and diabetes. The idea is that you can take beetroot supplements or eat extra beetroot alongside your regular medicines (rather than replace them).

    There is evidence beetroot juice can help lower systolic blood pressure (the first number in your blood pressure reading) by 2.73-4.81 mmHg (millimetres of mercury, the standard unit of measuring blood pressure) in people with high blood pressure. Some researchers say this reduction is comparable to the effects seen with certain medications and dietary interventions.

    Other research finds even people without high blood pressure (but at risk of it) could benefit.

    Beetroot may also improve athletic performance. Some studies show small benefits for endurance athletes (who run, swim or cycle long distances). These studies looked at various forms of the food, such as beetroot juice as well as beetroot-based supplements.

    How to get more beetroot in your diet

    There is scientific evidence to support positive impacts of consuming beetroot in whole, juice and supplement forms. So even if you can’t get hold of tinned beetroot, there are plenty of other ways you can get more beetroot into your diet. You can try:

    • raw beetroot – grate raw beetroot and add it to salads or coleslaw, or slice beetroot to use as a crunchy topping for sandwiches or wraps
    • cooked beetroot – roast beetroot with olive oil, salt and pepper for a flavour packed side dish. Alternatively, steam beetroot and serve it as a standalone dish or mixed into other dishes
    • beetroot juice – make fresh beetroot juice using a juicer. You can combine it with other fruits and vegetables for added flavour. You can also blend raw or cooked beetroot with water and strain to make a juice
    • smoothies – add beetroot to your favourite smoothie. It pairs well with fruits such as berries, apples and oranges
    • soups – use beetroot in soups for both flavour and colour. Borscht is a classic beetroot soup, but you can also experiment with other recipes
    • pickled beetroot – make pickled beetroot at home, or buy it from the supermarket. This can be a tasty addition to salads or sandwiches
    • beetroot hummus – blend cooked beetroot into your homemade hummus for a vibrant and nutritious dip. You can also buy beetroot hummus from the supermarket
    • grilled beetroot – slice beetroot and grill it for a smoky flavour
    • beetroot chips – slice raw beetroot thinly, toss the slices with olive oil and your favourite seasonings, then bake or dehydrate them to make crispy beetroot chips
    • cakes and baked goods – add grated beetroot to muffins, cakes, or brownies for a moist and colourful twist.
    Three squares of beetroot/chocolate cake with white icing and nuts sprinkled on top
    You can add beetroot to baked goods. Ekaterina Khoroshilova/Shutterstock

    Are there any downsides?

    Compared to the large number of studies on the beneficial effects of beetroot, there is very little evidence of negative side effects.

    If you eat large amounts of beetroot, your urine may turn red or purple (called beeturia). But this is generally harmless.

    There have been reports in some countries of beetroot-based dietary supplements contaminated with harmful substances, yet we have not seen this reported in Australia.

    What’s the take-home message?

    Beetroot may give some modest boost to sex for men and women, likely by helping your circulation. But it’s unlikely to transform your sex life or act as vegetable Viagra. We know there are many contributing factors to sexual wellbeing. Diet is only one.

    For individually tailored support talk to your GP or an accredited practising dietitian.

    Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Lecturer, Southern Cross University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • How to be kind to yourself (without going to a day spa)

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    “I have to be hard on myself,” Sarah told me in a recent telehealth psychology session. “I would never reach my potential if I was kind and let myself off the hook.”

    I could empathise with this fear of self-compassion from clients such as Sarah (not her real name). From a young age, we are taught to be kind to others, but self-kindness is never mentioned.

    Instead, we are taught success hinges on self-sacrifice. And we need a healthy inner critic to bully us forward into becoming increasingly better versions of ourselves.

    But research shows there doesn’t have to be a trade-off between self-compassion and success.

    Self-compassion can help you reach your potential, while supporting you to face the inevitable stumbles and setbacks along the way.

    What is self-compassion?

    Self-compassion has three key ingredients.

    1. Self-kindness

    This involves treating yourself with the same kindness you would extend towards a good friend – via your thoughts, feelings and actions – especially during life’s difficult moments.

    For instance, if you find yourself fixating on a minor mistake you made at work, self-kindness might involve taking a ten-minute walk to shift focus, and reminding yourself it is OK to make mistakes sometimes, before moving on with your day.

    2. Mindfulness

    In this context, mindfulness involves being aware of your own experience of stress or suffering, rather than repressing or avoiding your feelings, or over-identifying with them.

    Basically, you must see your stress with a clear (mindful) perspective before you can respond with kindness. If we avoid or are consumed by our suffering, we lose perspective.

    3. Common humanity

    Common humanity involves recognising our own experience of suffering as something that unites us as being human.

    For instance, a sleep-deprived parent waking up (for the fourth time) to feed their newborn might choose to think about all the other parents around the world doing exactly the same thing – as opposed to feeling isolated and alone.

    It’s not about day spas, or booking a manicure

    When Sarah voiced her fear that self-compassion would prevent her success, I explained self-compassion is distinct from self-indulgence.

    “So is self-compassion just about booking in more mani/pedis?” Sarah asked.

    Not really, I explained. A one-off trip to a day spa is unlikely to transform your mental health.

    Instead, self-compassion is a flexible psychological resilience factor that shapes our thoughts, feelings and actions.

    It’s associated with a suite of benefits to our wellbeing, relationships and health.

    Massage therapist massaging woman's back
    A one-off trip to a day spa is unlikely to transform your mental health.
    baranq/Shutterstock

    What does the science say?

    Over the past 20 years, we’ve learned self-compassionate people enjoy a wide range of benefits. They tend to be happier and have fewer psychological symptoms of distress.

    Those high on self-compassion persevere following a failure. They say they are more motivated to overcome a personal weakness than those low on self-compassion, who are more likely to give up.

    So rather than feeling trapped by your inadequacies, self-compassion encourages a growth mindset, helping you reach your potential.

    However, self-compassion is not a panacea. It will not change your life circumstances or somehow make life “easy”. It is based on the premise that life is hard, and provides practical tools to cope.

    It’s a factor in healthy ageing

    I research menopause and healthy ageing and am especially interested in the value of self-compassion through menopause and in the second half of life.

    Because self-compassion becomes important during life’s challenges, it can help people navigate physical symptoms (for instance, menopausal hot flushes), life transitions such as divorce, and promote healthy ageing.

    I’ve also teamed up with researchers at Autism Spectrum Australia to explore self-compassion in autistic adults.

    We found autistic adults report significantly lower levels of self-compassion than neurotypical adults. So we developed an online self-compassion training program for this at-risk population.

    Three tips for self-compassion

    You can learn self-compassion with these three exercises.

    1. What would you say to a friend?

    Think back to the last time you made a mistake. What did you say to yourself?

    If you notice you’re treating yourself more like an enemy than a friend, don’t beat yourself up about it. Instead, try to think about what you might tell a friend, and direct that same friendly language towards yourself.

    2. Harness the power of touch

    Soothing human touch activates the parasympathetic “relaxation” branch of our nervous system and counteracts the fight or flight response.

    Specifically, self-soothing touch (for instance, by placing both hands on your heart, stroking your forearm or giving yourself a hug) reduces cortisol responses to psychosocial stress.

    Middle-aged man hugging himself
    Yes, hugging yourself can help.
    http://krakenimages.com/Shutterstock

    3. What do I need right now?

    Sometimes, it can be hard to figure out exactly what self-compassion looks like in a given moment. The question “what do I need right now” helps clarify your true needs.

    For example, when I was 37 weeks pregnant, I woke up bolt awake one morning at 3am.

    Rather than beating myself up about it, or fretting about not getting enough sleep, I gently placed my hands on my heart and took a few deep breaths. By asking myself “what do I need right now?” it became clear that listening to a gentle podcast/meditation fitted the bill (even though I wanted to addictively scroll my phone).The Conversation

    Lydia Brown, Senior Lecturer in Psychology, The University of Melbourne

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Sizing Aside: Are You Wearing The Right Bra For Your Breast Shape?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s well-known that most women wear incorrectly-fitting bras. Even with careful measurements, buying “off-the-rack” can be a challenge, because the sizing system only takes two measurements, when there are actually many more things to consider. Today’s video demystifies a lot of what else is going on!

    For example…

    Some of the different breast shapes/arrangements to consider:

    • Wide-set breasts: likely to find there’s a bit of a gap between your breasts and the inside (nearest to your sternum) parts of the cups—while spilling out a little at the outside edges. The solution? Bras that offer side-support, to keep things pointing more forwards. Central-closing bras can also help gather things together, and a balconette bra can redistribute things more evenly. Any of these options will be a lot more comfortable.
    • Small breasts: bralettes are your friend, keeping things comfortable while not wearing more bra than necessary to do the job (of course going braless is also an option, but we’re talking bra-fitting here, not bra-flinging-off never to be seen again)
    • Deflated breasts: often the case for someone who used to have larger breasts, but they lost size for hormonal reasons rather than for weight loss reasons. This often occurs a little while after childbirth, and also happens a lot in menopause. The bra recommendation for this? A push-up plunge bra with ¾ coverage not only provides cleavage if that’s wanted, but also, will keep things much more snug and thus more evenly-distributed. If ever you’ve found yourself needing to adjust yourself every now and gain while out, this will fix that and keep you comfortable for much longer.

    There’s more, along with a visual guide, so do check it out:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Further reading

    While we haven’t written about this specifically (maybe we’ll do a “Life Hacks” edition one of these days), we have written about…

    Keeping Abreast Of Your Cancer Risk

    Take care!

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  • Macadamia Nuts vs Brazil Nuts – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing macadamia nuts to Brazil nuts, we picked the Brazil nuts.

    Why?

    They’re a lot more nutrient dense! But watch out…

    First, to do due diligence in terms of macros: Brazil nuts have twice as much protein and less fat, as well as being a little higher in fiber and slightly lower in carbs.

    In terms of vitamins, Brazil nuts are about 10x higher in vitamin E, while macadamias are somewhat higher in several B-vitamins.

    The category of minerals is where it gets interesting. Macadamia nuts are a little higher in iron and considerably higher in Manganese. But… Brazil nuts are a lot higher in calcium, copper, magnesium, phosphorus, potassium, selenium, and zinc.

    About that selenium… Specifically, it’s more than 5,000x higher, and a cup of Brazil nuts would give nearly 10,000x the recommended daily amount of selenium. Now, selenium is an essential mineral (needed for thyroid hormone production, for example), and at the RDA it’s good for good health. Your hair will be luscious and shiny. However, go much above that, and selenium toxicity becomes a thing, you may get sick, and it can cause your (luscious and shiny) hair to fall out. For this reason, it’s recommended to eat no more than 3–4 Brazil nuts per day.

    In short… Brazil nuts are much more nutrient dense in general, and thus come out on top here. But, they’re so nutrient dense in the case of selenium, that careful moderation is advised.

    Want to learn more?

    You might like to read:

    Why You Should Diversify Your Nuts

    Take care!

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  • Do Probiotics Work For Weight Loss?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝Can you talk about using probiotics for weight loss? Thanks❞

    Great question! First, a quick catch-up:

    How Much Difference Do Probiotic Supplements Make, Really?

    Our above-linked article covers a number of important benefits of probiotic supplements, but we didn’t talk about weight loss at all. So let’s examine whether probiotics are useful for weight loss.

    Up-front summary: the science is unclear

    This 2021 systematic review found that they are indeed very effective:

    ❝The intake of probiotics or synbiotics could lead to significant weight reductions, either maintaining habitual lifestyle habits or in combination with energy restriction and/or increased physical activity for an average of 12 weeks.

    Specific strains belonging to the genus Lactobacillus and Bifidobacterium were the most used and those that showed the best results in reducing body weight.

    Both probiotics and synbiotics have the potential to help in weight loss in overweight and obese populations.❞

    Source: Effects of Probiotics and Synbiotics on Weight Loss in Subjects with Overweight or Obesity: A Systematic Review

    This slightly older (2015) systematic review and meta-analysis found the opposite:

    ❝Collectively, the RCTs examined in this meta-analysis indicated that probiotics have limited efficacy in terms of decreasing body weight and BMI and were not effective for weight loss.❞

    Source: Probiotics for weight loss: a systematic review and meta-analysis

    And in case that’s not balanced enough, this 2020 randomized controlled trial got mixed results:

    ❝Regression analysis performed to correlate abundance of species following supplementation with body composition parameters and biomarkers of obesity found an association between a decrease over time in blood glucose and an increase in Lactobacillus abundance, particularly in the synbiotic group.

    However, the decrease over time in body mass, BMI, waist circumstance, and body fat mass was associated with a decrease in Bifidobacterium abundance.❞

    Source: Effects of Synbiotic Supplement on Human Gut Microbiota, Body Composition and Weight Loss in Obesity

    Summary

    Probiotics may or may not work for weight loss.

    In all likelihood, it depends on the blend of cultures contained in the supplement. It’s possible that Lactobacillus is more beneficial for weight loss than Bifidobacterium, which latter may actually reduce weight loss.

    Or it might not, because that was just one study and correlation ≠ causation!

    We’d love to give you a hard-and-fast answer, but if the data doesn’t support a hard-and-fast answer, we’re not going to lie to you.

    What we can say for sure though is that probiotics come with very many health benefits, so whether or not weight loss is one of them, they’re a good thing to have for most people.

    Some further articles that may interest you:

    Take care!

    Don’t Forget…

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