Semaglutide for Weight Loss?
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Semaglutide for weight loss?
Semaglutide is the new kid on the weight-loss block, but it’s looking promising (with some caveats!).
Most popularly by brand names Ozempic and Wegovy, it was first trialled to help diabetics*, and is now sought-after by the rest of the population too. So far, only Wegovy is FDA-approved for weight loss. It contains more semaglutide than Ozempic, and was developed specifically for weight loss, rather than for diabetes.
*Specifically: diabetics with type 2 diabetes. Because it works by helping the pancreas to make insulin, it’s of no help whatsoever to T1D folks, sadly. If you’re T1D and reading this though, today’s book of the day is for you!
First things first: does it work as marketed for diabetes?
It does! At a cost: a very common side effect is gastrointestinal problems—same as for tirzepatide, which (like semaglutide) is a GLP-1 agonist, meaning it works the same way. Here’s how they measure up:
- Head-to-head study: Effects of subcutaneous tirzepatide versus placebo or semaglutide on pancreatic islet function and insulin sensitivity in adults with type 2 diabetes
- Head-to-head systematic review: Semaglutide for the treatment of type 2 Diabetes Mellitus: A systematic review and network meta-analysis of safety and efficacy outcomes
As you can see, both of them work wonders for pancreatic function and insulin sensitivity!
And, both of them were quite unpleasant for around 20% of participants:
❝Tirzepatide, oral and SC semaglutide has a favourable efficacy in treating T2DM. Gastrointestinal adverse events were highly recorded in tirzepatide, oral and SC semaglutide groups.❞
What about for weight loss, if not diabetic?
It works just the same! With just the same likelihood of gastro-intestinal unpleasantries, though. There’s a very good study that was done with 1,961 overweight adults; here it is:
Once-Weekly Semaglutide in Adults with Overweight or Obesity
The most interesting things here are the positive results and the side effects:
❝The mean change in body weight from baseline to week 68 was −14.9% in the semaglutide group as compared with −2.4% with placebo, for an estimated treatment difference of −12.4 percentage points (95% confidence interval [CI], −13.4 to −11.5; P<0.001).❞
In other words: if you take this, you’re almost certainly going to get something like 6x better weight loss results than doing the same thing without it.
❝Nausea and diarrhea were the most common adverse events with semaglutide; they were typically transient and mild-to-moderate in severity and subsided with time. More participants in the semaglutide group than in the placebo group discontinued treatment owing to gastrointestinal events (59 [4.5%] vs. 5 [0.8%])❞
~ ibid.
In other words: you have about a 3% chance of having unpleasant enough side effects that you don’t want to continue treatment (contrast this with the 20%ish chance of unpleasant side effects of any extent)!
Any other downsides we should know about?
If you stop taking it, weight regain is likely. For example, a participant in one of the above-mentioned studies who lost 22% of her body weight with the drug’s help, says:
❝Now that I am no longer taking the drug, unfortunately, my weight is returning to what it used to be. It felt effortless losing weight while on the trial, but now it has gone back to feeling like a constant battle with food. I hope that, if the drug can be approved for people like me, my [doctor] will be able to prescribe the drug for me in the future.❞
~ Jan, a trial participant at UCLH
Is it injection-only, or is there an oral option?
An oral option exists, but (so far) is on the market only in the form of Rybelsus, another (slightly older) drug containing semaglutide, and it’s (so far) only FDA-approved for diabetes, not for weight loss. See:
A new era for oral peptides: SNAC and the development of oral semaglutide for the treatment of type 2 diabetes ← for the science
FDA approves first oral GLP-1 treatment for type 2 diabetes ← For the FDA statement
Where can I get these?
Availability and prescribing regulations vary by country (because the FDA’s authority stops at the US borders), but here is the website for each of them if you’d like to learn more / consider if they might help you:
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White Noise vs Pink Noise
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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
❝I live in a large city and even late at night there is always a bit of background noise. While I am pretty used to it by now, I find I don’t sleep nearly as well in the city as I do in the country. I have seen some stuff about “white noise” generators. I was wondering whether you have any thoughts about the science behind these, and whether it is something I should try out – or maybe I should be trying something completly different.❞
The science says…
❝Our data show that white noise significantly improved sleep based on subjective and objective measurements in subjects complaining of difficulty sleeping due to high levels of environmental noise. This suggests that the application of white noise may be an effective tool in helping to improve sleep in those settings.❞
That said, you might also consider “pink noise”, which is very similar to white noise (having all frequencies normally audible to the human ear), but has greater intensity of lower frequencies, creating a more deep and even sound. While white noise and pink noise are both great at “muting” external sounds like those that have been disturbing your sleep, pink noise may have an advantage in helping to stimulate deep and restful sleep:
❝This study demonstrates that steady pink noise has significant effect on reducing brain wave complexity and inducing more stable sleep time to improve sleep quality of individuals.❞
Source: Pink noise: effect on complexity synchronization of brain activity and sleep consolidation
There may be extra benefits to pink noise, too:
Acoustic Enhancement of Sleep Slow Oscillations and Concomitant Memory Improvement in Older Adults
Rest well!
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Does Quitting Bread For 30 Days Trigger Weight Loss?
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Here’s what’s going on, physiologically:
On the rise
In few words: cutting bread for 30 days can lead to weight loss for some people, but the initial change is often more a matter of reduced water retention and bloating rather than immediate fat loss. In particular, it’s common for people feel lighter within the first week or so because reducing fermentable carbohydrates can decrease gas production and resultant digestive discomfort, especially in those with sensitive guts.
On which note…
About wheat components and tolerance: certain compounds in wheat—such as gluten, lectins, and phytates—don’t affect everyone the same way, but in those whose physiologies don’t handle them well, repeated exposure contributes to low-grade inflammation and/or mineral absorption issues, all of which can trigger feelings of sluggishness.
Speaking of feelings, it’s worth noting that digestion of gluten can produce peptides that mildly interact with opioid receptors, so temporary cravings during the first 1–2 weeks is generally a matter of neurobiological adaptation.
However, there are some more things to consider, for example: bread is primarily starch that rapidly converts to glucose, triggering insulin release, which means that reducing frequent refined carbohydrate exposure (i.e. most bread) will typically lower fasting insulin and improve blood sugar stability over time.
This is relevant also to the weight loss issue, because when insulin spikes happen less often, your body can more easily switch between burning glucose and stored fat.
In short, a 30-day break from bread can function as a short-term self-experiment to observe changes in energy, digestion, cravings, and possibly weight, but long-term metabolic health depends much more on overall dietary patterns than on any single food.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
Grains: Bread Of Life, Or Cereal Killer?
Take care!
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Genetic Risk Factors For Long COVID
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Some people, after getting COVID, go on to have Long COVID. There are various contributing factors to this, including:
- Lifestyle factors that impact general disease-proneness
- Immune-specific factors such as being immunocompromised already
- Genetic factors
We looked at some modifiable factors to improve one’s disease-resistance, yesterday:
And we’ve taken a more big-picture look previously:
Beyond Supplements: The Real Immune-Boosters!
Along with some more systemic issues:
Why Some People Get Sick More (And How To Not Be One Of Them)
But, for when the “don’t get COVID” ship has sailed, one of the big remaining deciding factors with regard to whether one gets Long COVID or not, is genetic
The Long COVID Genes
For those with their 23andMe genetic data to hand…
❝Study findings revealed that three specific genetic loci, HLA-DQA1–HLA-DQB1, ABO, and BPTF–KPAN2–C17orf58, and three phenotypes were at significantly heightened risk, highlighting high-priority populations for interventions against this poorly understood disease.❞
For those who don’t, then first: you might consider getting that! Here’s why:
Genetic Testing: Health Benefits & Methods
But also, all is not lost meanwhile:
The same study also found that individuals with genetic predispositions to chronic fatigue, depression, and fibromyalgia, as well as other phenotypes such as autoimmune conditions and cardiometabolic conditions, are at significantly higher risk of long-COVID than individuals without these conditions.
Good news, bad news
Another finding was that women and non-smokers were more likely to get Long COVID, than men and smokers, respectively.
Does that mean that those things are protective against Long COVID, which would be very counterintuitive in the case of smoking?
Well, yes and no; it depends on whether you count “less likely to get Long COVID because of being more likely to just die” as protective against Long COVID.
(Incidentally, estrogen is moderately immune-enhancing, while testosterone is moderately immune-suppressing, so the sex thing was not too surprising. It’s also at least contributory to why women get more autoimmune disorders, while men get more respiratory infections such as colds and the like)
Want to know more?
You can read the paper itself, here:
*GWAS = Genome-Wide Association Study
Take care!
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Body Sculpting with Kettlebells for Women – by Lorna Kleidman
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For those of us who are more often lifting groceries or pots and pans than bodybuilding trophies, kettlebells provide a way of training functional strength. This book does (as per the title) offer both sides of things—the body sculpting, and thebody maintenance free from pain and injury.
Kleidman first explains the basics of kettlebell training, and how to get the most from one’s workouts, before discussing what kinds of exercises are best for which benefits, and finally moving on to provide full exercise programs.
The exercise programs themselves are fairly comprehensive without being unduly detailed, and give a week-by-week plan for getting your body to where you want it to be.
The style is fairly personal and relaxed, while keeping things quite clear—the photographs are also clear, though if there’s a weakness here, it’s that we don’t get to see which muscles are being worked in the same as we do when there’s an illustration with a different-colored part to show that.
Bottom line: if you’re looking for an introductory course for kettlebell training that’ll take you from beginner through to the “I now know what I’m doing and can take it from here, thanks” stage.
Click here to check out Body Sculpting With Kettlebells For Women, and get sculpting!
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What Size Breakfast Is Best, By Science?
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“Breakfast is the most important meal of the day”, the popular wisdom goes. But, what should it consist of, and how much should we be eating for breakfast?
It has been previously established that it is good if breakfast is the largest meal of the day:
…with meals getting progressively smaller thereafter.
Of course, very many people do the inverse: small (or skipped) breakfast, moderate lunch, larger dinner. This, however, is probably more a result of when eating fits around the modern industrialized workday (and thus gets normalized), rather than actual health considerations.
So, what’s the latest science?
A plucky band of researchers led by Dr. Karla-Alejandra Pérez-Vega investigated the importance of breakfast in the context of heart health. This research was done as part of a larger study into the effects of the Mediterranean Diet on cardiovascular health, so if anyone wants a quick recap before we carry on, then:
The Mediterranean Diet: What Is It Good For? ← the answer, by the way, is “pretty much everything”
…and there are also different versions that each use the Mediterranean Diet as the core, while focussing extra on a different area of health, including one to make it extra heart-healthy:
Four Ways To Upgrade The Mediterranean ← most anti-inflammatory / gut-healthiest / heart-healthiest / brain-healthiest
What they found
In their sample population (n=383) of Spanish adults aged 55–75 with pre-diagnosed metabolic syndrome who, as part of the intervention of this 36-month interventional study, had now for the past 36 months been on a Mediterranean diet but without specific guidance on portion sizes:
- Participants with insufficient breakfast energy intake had the highest adiposity (which is a measure of body fat expressed as a percentage of total mass)
- Participants with low or high (but not moderate) breakfast energy intake had the larger BMI and waist circumference over time
- Participants with low or high (but not moderate) breakfast energy intake had higher triglyceride and lower HDL (good) cholesterol levels
- Participants who consumed 20–30% of their daily calories at breakfast enjoyed the greatest improvements in lipid profiles, with lower triglycerides and higher HDL (good) cholesterol levels
- Participants with lower breakfast quality (lower adherence to Mediterranean Diet) had higher blood pressure levels
- Participants with lower breakfast quality (lower adherence to Mediterranean Diet) had higher blood sugar levels
- Participants with lower breakfast quality (lower adherence to Mediterranean Diet) had lower estimated glomerular filtration rate (which is an indicator of kidney function)
- Participants with higher breakfast quality (higher adherence to Mediterranean Diet) had lower waist circumference, higher HDL cholesterol, and better kidney function
You can see the paper itself here in the Journal of Nutrition, Health, and Aging:
What this means
According to this research, the heart-healthiest breakfast is:
- not skipped
- Mediterranean Diet adherent
- within the range of of 20–30% of the total calories for the day
Want to make it even better?
Consider:
Before You Eat Breakfast: 3 Surprising Facts About Intermittent Fasting
Enjoy!
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Just One Thing – by Dr. Michael Mosley
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This is a collection of easy-to-implement changes that have good science behind them to show how they can benefit us. Some things are obvious (e.g: drink water); others, less so (e.g: sing, to reduce inflammation).
The book is divided thematically into times of the day, though in many cases it’s not a hard rule that a thing needs to be done at a certain time. Others are, like a cold shower in the morning and hot bath before bed—you might not want to switch those around!
The style is very pop-science, and does not have in-line citations for claims, but it does have a bibliography in the bag organized by each “one thing”, e.g. it might say “get some houseplants” and then list a number of references supporting that, with links to the studies showing how that helps. For those with the paper version, don’t worry, you can copy the URL from the book into your browser and see it that way. In any case, there are 2–6 scientific references for each claim, which is very respectable for a pop-sci book.
Bottom line: if you’re looking for evidence-based “one little thing” changes that can make a big difference, this book has lots!
Click here to check out Just One Thing, and improve your life!
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