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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Black Cohosh vs The Menopause
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Black Cohosh, By Any Other Name…
Black cohosh is a flowering plant whose extracts are popularly used to relieve menopausal (and postmenopausal) symptoms.
Note on terms: we’ll use “black cohosh” in this article, but if you see the botanical names in studies, the reason it sometimes appears as Actaea racemosa and sometimes as Cimicfuga racemosa, is because it got changed and changed back on account of some disagreements between botanists. It’s the same plant, in any case!
Read: Reclassification of Actaea to include Cimicifuga and Souliea (Ranunculaceae)
Does it work?
In few words: it works for physical symptoms, but not emotional ones, based on this large (n=2,310) meta-analysis of studies:
❝Black cohosh extracts were associated with significant improvements in overall menopausal symptoms (Hedges’ g = 0.575, 95% CI = 0.283 to 0.867, P < 0.001), as well as in hot flashes (Hedges’ g = 0.315, 95% CIs = 0.107 to 0.524, P = 0.003), and somatic symptoms (Hedges’ g = 0.418, 95% CI = 0.165 to 0.670, P = 0.001), compared with placebo.
However, black cohosh did not significantly improve anxiety (Hedges’ g = 0.194, 95% CI = -0.296 to 0.684, P = 0.438) or depressive symptoms (Hedges’ g = 0.406, 95% CI = -0.121 to 0.932, P = 0.131)❞
~ Dr. Ryochi Sadahiro et al., 2023
Source: Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis
Here’s an even larger (n=43,759) one that found similarly, and also noted on safety:
❝Treatment with iCR/iCR+HP was well tolerated with few minor adverse events, with a frequency comparable to placebo. The clinical data did not reveal any evidence of hepatotoxicity.
Hormone levels remained unchanged and estrogen-sensitive tissues (e.g. breast, endometrium) were unaffected by iCR treatment.
As benefits clearly outweigh risks, iCR/iCR+HP should be recommended as an evidence-based treatment option for natural climacteric symptoms.
With its good safety profile in general and at estrogen-sensitive organs, iCR as a non-hormonal herbal therapy can also be used in patients with hormone-dependent diseases who suffer from iatrogenic climacteric symptoms.❞
~ Dr. Castelo-Branco et al., 2020
(iCR = isopropanolic Cimicifuga racemosa)
So, is this estrogenic or not?
This is the question many scientists were asking, about 20 or so years ago. There are many papers from around 2000–2005, but here’s a good one that’s quite representative:
❝These new data dispute the estrogenic theory and demonstrate that extracts of black cohosh do not bind to the estrogen receptor in vitro, up-regulate estrogen-dependent genes, or stimulate the growth of estrogen-dependent tumors❞
Source: Is Black Cohosh Estrogenic?
(the abstract is a little vague, but if you click on the PDF icon, you can read the full paper, which is a lot clearer and more detailed)
The short answer: no, black cohosh is not estrogenic
Is it safe?
As ever, check with your doctor as everyone’s situation can vary, but broadly speaking, yes, it has a very good safety profile—including for breast cancer patients, at that. See for example:
- Black cohosh efficacy and safety for menopausal symptoms: the Spanish Menopause Society statement
- Black cohosh (Cimicifuga racemosa): safety and efficacy for cancer patients
- The safety of black cohosh (Actaea racemosa, Cimicifuga racemosa)
Where can I get some?
We don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
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Superfood-Stuffed Squash
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This stuffed squash recipe is packed with so many nutrient-dense ingredients, yet it feels delightfully decadent—a great recipe to have up your sleeve ready for fall.
You will need
- 1 large or two medium butternut squashes, halved lengthways and seeds removed (keep them; they are full of nutrients! You can sprout them, or dry them to use them at your leisure), along with some of the flesh from the central part above where the seeds are, so that there is room for stuffing
- 2 cups low-sodium vegetable stock
- 1 cup wild rice, rinsed
- 1 medium onion, finely chopped
- ½ cup walnuts, roughly chopped
- ½ cup dried
cranberriesgoji berries ← why goji berries? They have even more healthful properties than cranberries, and cranberries are hard to buy without so much added sugar that the ingredients list looks like “cranberries (51%), sugar (39%), vegetable oil (10%)”, whereas when buying goji berries, the ingredients list says “goji berries”, and they do the same culinary job. - ¼ cup pine nuts
- ½ bulb garlic, minced
- 1 tbsp dried thyme or 2 tsp fresh thyme, destalked
- 1 tbsp dried rosemary or 2 tsp fresh rosemary, destalked
- 1 generous handful fresh parsley, chopped
- 1 tbsp chia seeds
- 1 tbsp nutritional yeast
- 1 tbsp black pepper, coarse ground
- ½ tsp MSG or 1 tsp low-sodium salt
- Extra virgin olive oil, for brushing and frying
- Aged balsamic vinegar, to serve (failing this, make a balsamic vinegar reduction and use that; it should have a thicker texture but still taste acidic and not too sweet; the thickness should come from the higher concentration of grape must and its natural sugars; no need to add sugar)
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 400°F / 200°C.
2) Brush the cut sides of the squash with olive oil; sprinkle with a pinch of MSG/salt and a little black pepper (grind it directly over the squash if you are using a grinder; hold the grinder high though so that it distributes evenly—waiters in restaurants aren’t just being dramatic when they do that with pepper or Parmesan or such)
3) Arrange them cut-sides-down on a baking tray lined with baking paper, and roast for at least 30 minutes or until tender.
4) While that is roasting, add the chia seeds to the wild rice, and cook them in the low-sodium vegetable stock, using a rice cooker if available. It should take about the same length of time, but if the rice is done first, set it aside, and if the squash is done first, turn the oven down low to keep it warm.
5) Heat some oil in a sauté pan (not a skillet without high sides; we’re going to need space in a bit), and fry the chopped onion until translucent and soft. We could say “about 5 minutes” but honestly it depends on your pan as well as the heat and other factors.
6) Add the seasonings (herbs, garlic, black pepper, MSG/salt, nooch), and cook for a further 2 minutes, stirring thoroughly to distribute evenly.
7) Add the rice, berries, and nuts, cooking for a further 2 minutes, stirring constantly, ensuring everything is heated evenly.
8) Remove the squash halves from the oven, turn them over, and spoon the mixture we just made into them, filling generously.
9) Drizzle a lashing of the aged balsamic vinegar (or balsamic vinegar reduction), to serve.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Brown Rice vs Wild Rice – Which is Healthier?
- Why You Should Diversify Your Nuts!
- Goji Berries: Which Benefits Do They Really Have?
- Chia: The Tiniest Seeds With The Most Value
- The Many Health Benefits Of Garlic
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- 10 Ways To Balance Blood Sugars
Take care!
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The Web That Has No Weaver – by Ted Kaptchuk
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At 10almonds we have a strong “stick with the science” policy, and that means peer-reviewed studies and (where such exists) scientific consensus.
However, in the spirit of open-minded skepticism (i.e., acknowledging what we don’t necessarily know), it can be worth looking at alternatives to popular Western medicine. Indeed, many things have made their way from Traditional Chinese Medicine (or Ayurveda, or other systems) into Western medicine in any case.
“The Web That Has No Weaver” sounds like quite a mystical title, but the content is presented in the cold light of day, with constant “in Western terms, this works by…” notes.
The author walks a fine line of on the one hand, looking at where TCM and Western medicine may start and end up at the same place, by a different route; and on the other hand, noting that (in a very Daoist fashion), the route is where TCM places more of the focus, in contrast to Western medicine’s focus on the start and end.
He makes the case for TCM being more holistic, and it is, though Western medicine has been catching up in this regard since this book’s publication more than 20 years ago.
The style of the writing is very easy to follow, and is not esoteric in either mysticism or scientific jargon. There are diagrams and other illustrations, for ease of comprehension, and chapter endnotes make sure we didn’t miss important things.
Bottom line: if you’re curious about Traditional Chinese Medicine, this book is the US’s most popular introduction to such, and as such, is quite a seminal text.
Click here to check out The Web That Has No Weaver, and enjoy learning about something new!
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The Book Of Hormones – by Dr. Shweta Patel
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The subtitle promising “through every stage of life” is a slight overstatement, as the book barely touches on puberty, but we know that the vast majority of our readers have left that one far behind in the past, so probably this is not such an issue.
Where the book gives more attention is in general adult life, through the years of potential fertility, into menopause and beyond. This means lots about the hormonal fluctuations inherent to the menstrual cycle (both the normal, and the still-quite-commonly abnormal, e.g. in cases of PCOS etc), the before-during-after of pregnancy, and many hormonal matters that are not related to sex hormones, such as stress-related hormones and food-related hormones. As such, the book certainly lives up to its title; it is indeed “the book of hormones”.
The style is light and conversational; we get a lot of lessons in chemistry here, but it never feels like it, and there’s certainly no hard science, just clear and easy explanations.
Bottom line: if you’d like to understand hormones quite comprehensively but in a light-hearted manner, this book is a very pleasant and educational read.
Click here to check out The Book Of Hormones, and understand them!
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Shoulders Range – by Elia Bartolini
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Shoulder flexibility and mobility can be a big deal, especially when it starts to decline—more so than other kinds of flexibility. Most seniors can get through the day without doing the splits against a wall, for example, but shoulder tightness can be more of a problem if you can’t easily get into or out of your clothes.
If you think it couldn’t happen to you: the great Jane Fonda has a now-famous photoset of her looking glamorous in a dress at a red carpet event, and then looking frazzled making breakfast in the same dress in her kitchen the next morning, because, as she wrote, “I couldn’t get my dress unzipped so I slept in it”.
Now, “to avoid ending up like Jane Fonda” is not a series of words that usually precedes advice, but in this case: this book delves into the science of one of the most quirky joints of the human body, and how to leverage this to maximize shoulder mobility, while maintaining adequate strength (because flexibility without strength is just asking for a dislocation) without doing anything that would actually bulk up our shoulders, because it’s just about progressing through passive, active, and tensed stretching, static, dynamic, and loaded stretching, as well as PNF stretching and antagonist stretching.
If that seems like a lot of stretching, don’t worry; the author presents a series of workouts that will take us through these stretches in a very small amount of time each day.
The style is instructional like a textbook, with clear diagrams where appropriate, and lots of callout boxes, bullet points, emboldening for key points, etc. It all makes for every easy learning.
Bottom line: if you’d like to improve and maintain your shoulder mobility, this is an excellent book for that.
Click here to check out Shoulders Range, and perfect your shoulders and upper body flexibility!
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6 Signs Of Stroke (One Month In Advance)
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Most people can recognise the signs of a stroke when it’s just happened, but knowing the signs that appear a month beforehand would be very useful. That’s what this video’s about!
The Warning Signs
- Persistently elevated blood pressure: one more reason to have an at-home testing kit and use it regularly! Or a smartwatch or similar that’ll do it for you. The reason this is relevant is because high blood pressure can lead to damaging blood vessels, causing a stroke.
- Excessive fatigue: of course, this one can have many possible causes, but one of them is a “transient ischemic attack” (TIA), which is essentially a micro-stroke, and can be a precursor to a more severe stroke. So, we’re not doing the Google MD thing here of saying “if this, then that”, but we are saying: paying attention to the overall patterns can be very useful. Rather than fretting unduly about a symptom in isolation, see how it fits into the big picture.
- Vision problems: especially if sudden-onset with no obvious alternative cause can be a sign of neural damage, and may indicate a stroke on the way.
- Speech problems: if there’s not an obvious alternative explanation (e.g. you’ve just finished your third martini, or was this the fourth?), then speech problems (e.g. slurred speech, trouble forming sentences, etc) are a very worrying indicator and should be treated as a medical emergency.
- Neurological problems: a bit of a catch-all category, but memory issues, loss of balance, nausea without an obvious alternative cause, are all things that should get checked out immediately just in case.
- Numbness or weakness in the extremities: especially if on one side of the body only, is often caused by the TIA we mentioned earlier. If it’s both sides, then peripheral neuropathy may be the culprit, but having a neurologist take a look at it is a good idea either way.
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Two Things You Can Do To Improve Stroke Survival Chances
Take care!
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