It’s fairly well-known that if you take a GLP-1 receptor agonist drug (like Ozempic, Wegovy, Mounjaro etc) for weight loss and then stop, the weight will return.

See for example: What happens when I stop taking a drug like Ozempic or Mounjaro?

This is important to consider, as it means that starting to take a GLP-1 RA drug is something one should be prepared to then continue doing for the rest of one’s life, if one wants to keep the weight off.

There are, of course, a lot of people who go onto GLP-1 RAs with the rationale “I’ll just use this to lose the weight, and then I’ll keep the weight off with my diet and lifestyle”.

Which sounds reasonable, but because of the specific mechanisms of actions of GLP-1 RAs, it simply doesn’t work that way (indeed, there are even reasons that you may, after stopping taking GLP-1 RAs, be more disposed to put weight on than you were before you started*). So, by the best of current science (which admittedly is not amazing when it comes to this topic), it does seem that taking GLP-1 RAs is a lifetime commitment.

You can read more about this here: Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity

*We wrote previously about how a person who has been on GLP-1 RAs may afterwards be even more inclined to put on fat than before:

❝Of the four studies that actually looked at the macros (unlike most studies), they found that on average, protein intake decreased by 17.1%. Which is a big deal!

It’s an especially big deal, because while protein’s obviously important for everyone, it’s especially important for anyone trying to lose weight, because muscle mass is a major factor in metabolic base rate—which in turn is much important for fat loss/maintenance than exercise, when it comes to how many calories we burn by simply existing.

A reasonable hypothesis, therefore, is that one of the numerous reasons people who quit GLP-1 agonists immediately put fat back on, is because they probably lost muscle mass in amongst their weight loss, meaning that their metabolic base rate will have decreased, meaning that they end up more disposed to put on fat than before.

And, that’s just a hypothesis and it’s a hypothesis based on very few studies, so it’s not something to necessarily take as any kind of definitive proof of anything, but it is to say—as the researchers of this review do loudly say—more research needs to be done into this, because this has been a major gap in research so far!❞

Read in full: Semaglutide’s Surprisingly Unexamined Effects

So, what about short-term interruptions?

We like to bring you hot-off-the-press science news, in this case, it’s so new that the paper in question hasn’t actually been published yet.

However, a press release was made at the Endocrine Society’s annual meeting—yesterday, at time of writing.

The good news: they found that GLP-1 medications like semaglutide and tirzepatide remain effective for weight loss even when access is disrupted.

The bad news: it’s not like the disruption didn’t have a negative impact, though; weight loss was also temporarily disrupted; temporary partial weight regain was a relevant factor (just, weight regained was then lost again upon continuing)

In numbers: 6,392 participants in a metabolic health program were tracked over at least one year; the program combined GLP-1 RA treatment with lifestyle changes in food, exercise, sleep, and emotional health, plus one-on-one coaching. Of those, 72.5% of participants experienced at least one GLP-1 access disruption; 11.1% had multiple. Here’s how much difference that made:

• Without access disruptions: 17% average weight loss at 12 months, 20.1% at 24 months.
• With access disruptions: 13.7% average weight loss at 12 months, 14.9% at 24 months.
• With only 1–4 treatments in 12 months: >10% average weight loss at 12 months, no data for 24 months (in all likelihood they regained the weight as is normal, but the data was not recorded so we can’t say that for sure)

While we can’t link to the paper that hasn’t been published yet, we can link to the press release: Study finds patients with interrupted GLP-1 access still achieve significant weight loss

All of which points to the idea that “some is still better than none” when it comes to drug availability, and that one probably shouldn’t become overly stressed about missing a dose (for example, due to supply problems, cost issues, bureaucratic hold-ups on a repeat prescription, that kind of thing).

Nevertheless, that doesn’t mean things will necessarily be easy, for example:

❝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

Source: Gamechanger drug for treating obesity cuts body weight by 20% ← University College London Hospitals (NHS)

Want to maximize your chances of good results?

First, you might want to make sure you’re on the best GLP-1 RA for you, and that’s probably going to change over time as new drugs are developed and rolled out.

We wrote about that here: Better Than Ozempic? ← which finds that tirzepatide is better than semaglutide, retraglutide is better than tirzepatide, and an as yet unnamed tetra-receptor agonist drug is better than retraglutide.

You can also improve your results whichever drug you’re on, by bearing in mind: 10 Mistakes To Sabotage Your Ozempic Progress

Want a more natural approach?

It is possible to get many of the effects of GLP-1 RAs without taking GLP-1RAs, by enjoying foods that increase incretin, a hormone group (the most well-known of which is GLP-1) that slows down stomach emptying, which means a gentler blood sugar curve and feeling fuller for longer. It also acts on the hypothalamus, controlling appetite via the brain too (signalling fullness and reducing hunger).

For what foods to focus on, see:

5 Ways To Naturally Boost The “Ozempic Effect” ← this is from Dr. Jason Fung, who is perhaps most well-known for his work in functional medicine for reversing diabetes, and he’s once again giving us sound advice about metabolic hormone-hacking with dietary tweaks!

You can also check out: Ozempic vs Five Natural Supplements

Enjoy!

“When it’s gone, it’s gone” is the common belief when it comes to tooth enamel. Nevertheless, there are such things as hydroxyapatite toothpaste which is not only as pathogen-killing as fluoride, but also has the added bonus of being based on one of the main minerals our teeth are made of (hydroxyapatite is a calcium phosphate compound), so it does aid in rebuilding,

There are pros and cons to both, by the way: Fluoride Toothpaste vs Non-Fluoride Toothpaste – Which is Healthier? ← with interesting numbers on the toxicity of each!

In that comparison (we compared fluoride to hydroxyapatite) we picked the fluoride on the basis of “they both do the job equally well, and they’re both very safe, but technically everything has a toxicity level, and fluoride’s is the relatively safest of these two very safe products”.

However, that’s assuming for the general job of “keeping teeth healthy”. If your teeth need remineralizing, hydroxyapatite will better promote that.

For more details, see: Tooth Remineralization: How To Heal Your Teeth Naturally

So, what’s this about keratin?

As you may be aware, keratin is a protein that can be used to make everything from your eyelashes to the horn of a rhinoceros to the wool of a lamb. Also, less usefully, sebaceous cysts, which (despite the name) or not filled with sebum, but keratin. See: How To Get Rid Of A Sebaceous Cyst

Researchers (Dr. Sara Gamea et al.) have discovered that when combined with calcium and phosphate from saliva (or, indeed, from hydroxyapatite), keratin self-organizes into a crystal-like framework that mimics natural enamel, gradually forming a dense, mineralized barrier over tooth surfaces.

And, which will be a huge relief to many, the keratin layer blocks nerve channels responsible for pain, protects against acid erosion, and prevents further enamel loss, offering both immediate comfort and long-term defense.

You can read the paper in full here: Biomimetic Mineralization of Keratin Scaffolds for Enamel Regeneration

While it’s not on the shelves just yet (discoveries do not leap straight from laboratories to supermarkets), Dr. Gamea and her team expect that the material could appear in consumer toothpaste or dentist-applied gels (like nail varnish) within a few years.

Why a few years? Because that’s how science and industry works: a discovery is made, and while that study is peer-reviewed, the important thing then is for others to also test it and see if they get the same results. So, that’ll require teams of scientists to beg on their hands and knees apply for grant money (often tied to the academic year), perform the studies (which will typically take months), get their work published (they hope), and finally get a commercial interest to take it up and mass produce it, and then a distributor to distribute it, and a retailer to retail it, all with contract negotiations in between each step.

So, while you’re waiting…

Want to learn more?

You might also like to read our own three-part series on dental health:

• Toothpastes & Mouthwashes: Which Help And Which Harm?
• Flossing Without Flossing?
• Less Common Oral Hygiene Options ← we recommend the miswak! Not only does it clean the teeth as well as or better than traditional brushing, but also it changes the composition of saliva to improve the oral microbiome, effectively turning your saliva into a biological mouthwash that kills unwanted microbes and is comfortable for the ones that should be there.

Take care!