Understanding GLP-1 Weight Loss Drugs
- Former talk show host Oprah Winfrey, 70, has admitted to thinking that “thin people” had more self control or “willpower” until she began taking a GLP-1 agonist drug to shed extra weight. However, Oprah hasn’t revealed which blockbuster weight loss drug she used.
- Semaglutide is a GLP-1 receptor agonist, meaning that it mimics the effects of GLP-1 in the body. Given as weekly subcutaneous injections, it is normally prescribed to manage blood glucose levels in diabetic patients. It also leads to a significant amount of weight loss in these patients.
- It’s important to note there are a variety of drugs available right now for weight loss, like Nova Nordisk’s semaglutide—which can be purchased under brand names Ozempic, Weygovy, and Rybelsu—and Tirzepatide, sold under the brand names Mounjaro and Zepbound. Others include Phentermine (Adipex-P, Lomaira), a prescription medication which lessens one’s appetite, Contrave (naltrexone/bupropion), and bupropion (the generic form of Wellbutrin).
- The Centers for Disease Control and Prevention (CDC) says, “Being overweight or having obesity are linked with a higher risk of getting 13 types of cancer.” Some of these cancers include breast, colon, ovarian, and stomach (gastric).
- If you’re considering taking a weight loss drug, talk with your care team about whether that’s a good option for you. And make sure you consider good diet and exercise practices as a part of your treatment plan.
Speaking on a recent episode of her “The Oprah Podcast,” titled, “Ozempic & Weight Loss Drugs: How They Work in Your Brain,” the 70-year-old talk show icon opened up about the major realization she had when taking a GLP-1 medication, a blockbuster weight loss drug.
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Oprah, who has noticeably lost weight, also addressed the issue that many people who lose weight struggle with—thinking that once the weight is lost they have won the battle. However, it’s an ongoing journey that takes work.
She further explained, “We think that because you’ve lost the weight you’ve solved the problem, because in the past, every time you went on a diet, once you lost the weight, you thought, ‘now this is it. I’ve done it. I’ve succeeded.'”
“And we think,” she continued, assuming Dr. Jastreboff feels the same way, which she confirmed she does, “We think that the problem is solved. But the problem isn’t solved because the disease hasn’t gone away just because you lost the weight. The disease is still there.”
Oprah then likened obesity to alcoholism, saying, “In alcoholism, you cannot go back to drinking because your brain … just because you’ve gotten sober … doesn’t mean you can now have a drink.
“We can’t go back … otherwise you gain the weight.”
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This isn’t the first time Oprah spoke about her weight loss, which was done with the help of a GLP-1 drug, she also spoke with People Magazine in December 2023, saying, “I now use it as I feel I need it, as a tool to manage not yo-yoing.
“There’s a medically approved prescription for managing weight and staying healthier. In my lifetime, it feels like relief, redemption, and a gift, and it is not something to hide behind and once again be ridiculed for. I’m absolutely done with the shaming from other people and particularly myself.”
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As for the shame she previously felt when it comes to weight loss drugs, she said during an Oprah Daily panel in September 2023, called “The State of Weight,” “One of the things I carried so much shame for, and even when I first started hearing about the weight loss drugs, at the same time I was going through knee surgery.
“And I felt I’ve got to do this on my own because if I take the drug, that’s the easy way out.”
“There’s a part of me that feels, like I think a lot of people feel with bariatric surgery, that I’ve got to do it the hard way, I’ve got to keep climbing the mountains, I’ve got to keep suffering, and I’ve got to do that because otherwise I somehow cheated myself.”
Looking back on that panel, Oprah told People, “I had the biggest aha along with many people in that audience.
“I realized I’d been blaming myself all these years for being overweight, and I have a predisposition that no amount of willpower is going to control.”
After saying that “obesity is a disease” and “It’s not about willpower, it’s about the brain,” she continued, “The fact that there’s a medically approved prescription for managing weight and staying healthier, in my lifetime, feels like relief, like redemption, like a gift, and not something to hide behind and once again be ridiculed for. I’m absolutely done with the shaming from other people and particularly myself.”
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Oprah also recently decided not to run for re-election on Weight Watcher’s board of directors, but insisted she was committed to continuing support for the program.
“Weight health is a critically important topic and one that needs to be addressed at a broader scale. I plan to participate in a number of public forums and events where I will be a vocal advocate in advancing this conversation,” Winfrey said in a statement last February.
How Does Semaglutide Work?
Semaglutide, the key ingredient in popular weight loss drugs, works by impacting the glucagon-like peptide-1 (GLP) GLP-1 hormone.
Integral to blood sugar control, GLP-1 is a hormone released by the gut in response to food. It causes the pancreas to release insulin. A rising blood insulin level causes all the body tissues to start absorbing glucose (blood sugar) from the bloodstream, thereby lowering blood glucose levels. GLP-1 also prevents the release of glucagon, which is a hormone that raises blood sugar levels by stimulating liver cells to release glucose and helps people feel full for longer. These effects can also cause people to lose weight.
Modern studies on GLP-1 have shown that it has a role beyond glucose control. It modulates immune cells, including NK cells, in a way necessary for weight loss.
Semaglutide is a GLP-1 receptor agonist, meaning that it mimics the effects of GLP-1 in the body. Given as weekly subcutaneous injections, it is typically prescribed to manage blood glucose levels in patients with diabetes. It also leads to significant weight loss in these patients.
Although semaglutide has been approved for blood sugar control in people with type II diabetes under the brand name Ozempic, and for weight loss under the brand name Wegovy, it has not been approved for use as an immune booster or cancer preventive. Thus, it should not be prescribed for that purpose. Those taking it to control their diabetes or weight, however, can expect the additional benefit of improving their immunity, as per a recent study, and lowering their cancer risk, as a link between weight and cancer does exist.
It’s important to note that there are a variety of drugs available right now for weight loss, such as Novo Nordisk’s semaglutide — which can be purchased under the brand names Ozempic, Wegovy, and Rybelsus — and Tirzepatide, sold under the brand names Mounjaro and Zepbound. Others include Phentermine (Adipex-P, Lomaira), a prescription medication that reduces appetite; Contrave (naltrexone/bupropion); and bupropion (the generic form of Wellbutrin).
Living a Healthy Lifestyle
One major part of weight loss is eating healthy and good exercise habits, something SurvivorNet experts recommend.
The general recommendations for a healthy lifestyle are the same whether you have cancer or not. Dr. Ken Miller, the Director of Outpatient Oncology at the University of Maryland Greenebaum Cancer Center, has some guidelines for cancer survivors who are concerned about a recurrence:
- Exercise at least two hours a week, and walking counts.
- Eat a low-fat diet. The Women’s Intervention Nutrition Study, which looked at early-stage breast cancer patients, found that a low-fat diet was associated with reduced risk for cancer recurrence, particularly in those with estrogen receptor-negative cancers. Other studies have found that foods with a high glycemic index that are digested quickly and cause a spike in blood sugar may lead to tumor growth in lung cancer patients.
- Eat a colorful diet with lots of fruits and vegetables. The American Cancer Society recommends aiming for two to three cups of vibrant vegetables and fruits each day.
- Maintain a healthy weight. Studies have shown that being obese can increase your risk for several types of cancer.
Dr. Ken Miller says a healthy diet and regular workout routine are important
Cancer Risk and Obesity
Bodyweight can be a sensitive subject for many people on any given day. However, among cancer patients whose treatment and diagnosis may influence their weight, the numbers on the scale fuel an already emotional journey.
The Centers for Disease Control and Prevention (CDC) says, “Being overweight or having obesity are linked with a higher risk of getting 13 types of cancer.”
Research published in the journal “Cancers” says that “Obesity also increases the risk of dying from cancer and may influence the treatment choices. About 4–8% of all cancers are attributed to obesity.”
Some of the cancers associated with being overweight or obese include:
- Colon
- Breast
- Ovarian
- Esophagus
- Pancreatic
- Multiple myeloma
- Endometrial
- Liver
According to the National Cancer Institute (NCI), fat tissue “produces excess amounts of estrogen,” which is associated with an increased risk of certain cancers, including breast, ovarian, and endometrial cancer. The NCI says a person who is severely obese is “7 times” more likely to be diagnosed with endometrial cancer.
Obesity is associated with high levels of insulin, which can lead to colon, kidney, prostate, and endometrial cancer.
Obesity can affect cancer survivors in various ways, including the chance of cancer recurrence and overall quality of life.
To learn more about your ideal healthy weight, determine your body mass index (BMI).
Body weight that exceeds what the body mass index deems appropriate for your weight and height can help determine body fat content. Although your BMI can help you learn if you are at a healthy weight, underweight, overweight, or obese, other factors may contribute to your overall health.
The NCI analyzed several studies to observe physical activity’s impact on overall cancer risk. The NCI says that “higher levels of physical activity are linked to lower risk of several types of cancer.”
Regular exercise, a balanced diet, and managing stress are some ways people can practice leading a healthy life. For cancer survivors, a healthier lifestyle alongside getting regular checks for recurrence may improve your quality of life.
Contributing: SurvivorNet Staff
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