Many people have experienced radical transformations when it comes to weight loss, but if you ask any one of them, they’ll tell you it wasn’t easy. Weight loss is difficult, and while many claim to have the “secret” to losing weight, there’s no way to avoid the radical lifestyle change that weight loss entails. However, there are some tools that doctors can give you to help make the process just a little bit easier.
The truth about weight loss is that sometimes diet and exercise alone are not enough to see substantial results. Even if one sticks to a strict meal plan and exercise regimen, they still might not shed the pounds they hope to lose. This is because there are many factors that affect a person’s ability to lose weight beyond how many calories they consume and burn.
It’s important to note that every person’s weight loss journey could look entirely different. “People’s propensity to lose unwanted pounds can also be affected by factors such as their genetics or pre-existing medical conditions,” says Sergio Padron, founder and CEO of leading prescription weight loss program MD Exam. “It’s not always as easy as achieving a caloric deficit.”
For example, those with insulin resistance might have issues losing weight because their body does not burn fat like a normal body should. Patients with hypothyroidism (an underactive thyroid), for example, might struggle to lose weight because their metabolism is lower and their bodies burn less energy. Even conditions like chronic stress and anxiety can legitimately hinder weight loss, as the “stress hormone” cortisol has a direct connection with fat storage.
Hormones and weight loss
The common thread between these conditions is hormones. Hormones are part of the body’s endocrine system, functioning as “chemical messengers” within the body, regulating its function and affecting several essential body processes.
“Insulin, cortisol, and the several hormones produced by the thyroid gland are all hormones that can profoundly affect someone’s weight loss or gain,” Padron explains.
Take insulin, for example. Insulin has the role of regulating the storage of fat in the body. When insulin levels rise, it stops the body from burning fat and encourages it to store incoming energy from food as fat.
The relationship between the thyroid and a person’s weight is complex, due to the thyroid’s role in regulating the body’s basal metabolic rate (BMR). Since a person’s BMR plays an essential role in regulating the body’s energy balance, the thyroid plays an important role in regulating a person’s weight.
The connection between cortisol and weight is a bit more indirect, and disputed by some. However, the purpose of cortisol is to stimulate glucose production. The excess glucose produced by the body is then stored as fat.
Although these hormones occur naturally in the body and play an important role in your health and wellness, if they begin to act out of control, they can have undesirable effects, such as preventing one from losing weight — or even causing weight gain. Luckily, doctors have found ways to effectively manage the effects of these hormones to enable better weight loss.
How weight loss drugs affect hormones
A class of drugs called glucagon-like peptide-1 drugs (better known as GLP-1s) was created for the treatment of type 2 diabetes, but has since shown a great deal of potential in treating obesity and helping people with their weight loss goals. As a result, GLP-1s also have a positive effect on health conditions, such as cardiovascular risks, blood pressure, and cholesterol.
GLP-1 drugs work in three primary ways:
- Stimulating the release of insulin by the pancreas after eating.
- Inhibiting the release of a hormone called glucagon, which stimulates the liver to release sugars stored in the bloodstream.
- Slowing the absorption of glucose into the blood by reducing the speed at which the stomach empties after eating.
“In simple terms, GLP-1s work by interacting with the hormones that make you feel hunger,” Padron explains. “The result is that you feel fuller faster when you eat, which in turn encourages you to eat less. In this way, GLP-1 drugs can help support weight loss goals for those for whom diet and exercise are not working alone.”
One of the most common GLP-1 drugs used as a weight loss medication, and the one Padron and his team use in their primary programs is Semaglutide. Available as a weekly injection or an oral dissolvable tablet, Semaglutide is one of the most effective appetite-suppressing weight loss drugs on the market. One study shows that patients who took Semaglutide in addition to lifestyle changes lost 15-20% of their body weight on average after 68 weeks, compared to 2.6% for those who only implemented lifestyle changes.
Semaglutide is FDA-approved for weight loss under the brand name Wegovy, although many doctors will prescribe other forms of Semaglutide off-label to help their patients achieve their weight loss goals. On Wegovy’s website, they describe the drug as “working similarly to natural appetite hormones,” which allows users to eat fewer calories, and lose weight as a result.
Another hormone, called gastric inhibitory peptide (GIP), also plays an important role in regulating the pancreas’s secretion of insulin after eating. Some weight loss drugs are what are called “dual GIP and GLP-1 receptor agonists,” which target both hormones. The result is the most powerful weight loss effects possible.
One such drug is known as Tirzepatide, which is one of the strongest weight loss drugs on the market. “The appetite suppression associated with Tirzepatide is powerful and creates a radically different relationship with food,” says Padron. “Our doctors recommend patients start with one of the other drugs before setting out with Tirzepatide, but for those who need the more extreme assistance, this is an option.”
Ultimately, Padron reminds those setting out on their weight loss journey that weight loss drugs are only an additional tool to help achieve those goals. “To effectively lose weight at high levels — and keep it off for good — you must combine diet and exercise with weight loss drugs,” he says. “Lifestyle changes are essential for anyone who hopes to lose weight. The effects of weight loss drugs simply tap into your body’s biology to make it easier for you to stick with these lifestyle changes.”