Advances In Medications & Diet Strategies

Obesity is considered “A chronic, treatable neurometabolic disease projected to affect ¼ of the world’s population by 2035.” Over 10% of the population in the US were considered severely obese in 2024. The market to treat obesity is rapidly changing in today’s world.

The new weight loss medications are also being used as a main treatment plan for those with type 2 diabetes. The ones that are most familiar to you probably include Ozempic and Mounjaro for diabetes and Wegovy and Zepbound which are specifically used for weight loss.

These same drugs are now being studied and sometimes used to help fight addictions including drug use, alcoholism or smoking cigarettes. They are also being tested as a form of treatment for those who suffer with obesity and sleep apnea.

The GLP1 and GIP injectable medications are always prescribed along with a healthy diet and exercise to lose weight and control blood sugars. Trials showed that these injectable medications were almost as effective for sleep apnea treatment as a CPAP machine. Taking these medications reduced the incidence of pre-diabetes eventually turning into type 2 diabetes.

The common side effects of these injectables include nausea, vomiting, diarrhea, and constipation. Patients with severe dehydration, kidney disease, diabetic retinopathy or a history of pancreatitis are usually discouraged from taking them.

Although these 1 or 2 hormone agonists assist with weight loss, they also increase loss of muscle mass not just fat. This can lead to more frailty and weakness. The risk of poor balance goes up as well as the risk of your falling. Due to the recent high demand of Ozempic and Zepbound, they were not available for a long period of time. As of February 2025, there are no longer “shortages of GLP1-GIP drugs.”

What is on the horizon?

When you have a fully functioning pancreas “your body carefully regulates your blood sugar with insulin and glucagon.” Glucagon is a hormone produced by the pancreas that plays a crucial role in keeping blood sugars at a normal level. It works with the liver to release stored glucose when blood sugars drop too low. It also assists with breakdowns of fat.

Eli Lilly is developing a triple-hormone agonist medication that is still in the experimental stages. It is called Retatrutide and the probable FDA approval date will occur in 2027. The 3rd hormone added is Glucagon-GCG. When given during the studies, this drug increased energy, controlled hunger, helped regulate blood sugars and produced high amounts of weight loss.

The added GCG also better controlled blood pressure, total A1C (3 month) values, as well as improved lipid levels and fasting glucose numbers. It also prevented fatty liver disease from progressing and even “wiped out some already present liver fat.”

5-7% of the patients with type 2 diabetes in the US, develop significant liver disease which includes high levels of fat in the liver. The new medication side effects were like the already approved drugs which included nausea, gas, diarrhea, vomiting, loss of appetite and constipation.

Eli Lilly also acquired a new drug called Bimagrumab (from Versanis Bios for 2 billion dollars in 2023) to retain muscle mass with this specific weight loss treatment. It prevents the “activity of a protein called myostatin, to help preserve muscle.” As previously noted, muscle loss is common with the original diabetes weight loss medications Ozempic and Mounjaro.

Regeneron is testing Trevogrumab to preserve muscle mass while still promoting weight loss. This study should be finished in 2026.

Kero’s pharma (Kero’s Ker-065) targets myostatin, increases lean mass and decreases fat mass. Still in the experimental phase, it may be given alone or with Ozempic or Wegovy to preserve muscle mass.

What are the overall benefits of GLP1 and GIP injectable medications for people with or without diabetes?

Weight loss
Cardiac benefits
Renal benefits
Helps decrease alcohol and drug addiction
Reduces COPD (chronic obstructive pulmonary disease) exacerbations
Lowers cognitive decline
Reduces the risk of dementia
Liver benefits

What are the negative factors related to GLP1 and GIP injectable medications for people with or without diabetes?

Loss of muscle mass
Costs in the US are higher than other countries
GI side-effects such as nausea, vomiting and constipation
Acute gall stone disease
Acute bowel obstruction
Bile duct blockage
Pancreatitis
Allergic reactions
Ozempic Face – skin sagging and wrinkles on the face and neck due to rapid weight loss

Obesity is partly due to our current diet. Consider trying the Intuitive Eating Plan

As stated before, “obesity is reaching epidemic proportions.” Obesity remains one of the biggest risk factors in developing type 2 diabetes. The supermarkets in the US stock over 30,000 items. Many of these items are processed or ultra-processed. Food manufacturers have used food science to “replace fat with sugar and sugar with fat.” None of this is considered healthy eating.

Diet programs and plans have come and gone. Our diet has become healthier over the years in certain aspects and much unhealthier in others. Since 1995, “Intuitive Eating: a Revolutionary Program” written by 2 dietitians, Evelyn Tribole and Elyse Resch, has sold over 700,000 copies.

The book was updated in 2020 and the plan is currently taking off again with “interesting concepts to lose weight and maintain the weight loss.” It is evidence-based and associated with positive physical and mental health indicators. It tries to encourage self-trust. Always check with your health care provider before you start any new eating plan.

Intuitive eating is based on 10 principles to help you develop a healthy relationship with food. You may start with just 2-3 principles and do them in no specific order. You can add other principles as you get comfortable with the others. Since there are no written recipes or strict restrictions, it may be confusing at the beginning.

Intuitive eating reminds you there is “no better one diet” or “no better one food” around the corner. The main concept is to use physical hunger as an indicator as opposed to written diet rules and emotional cues. The philosophy is to foster a healthy relationship with food “which is a win-win for anyone, especially people with diabetes.”

Intuitive eating can help you pay better attention to how foods affect your blood sugar. The diet culture believes “restrictive diets are necessary to be healthy.” This then leads to diet deprivation, binge eating, overeating and creates a continuous cycle along with shame and guilt.

Another principle of the present diet culture is “good foods verses bad foods” or “finish the bad foods today and start fresh again tomorrow, then only eating good foods.” This is not considered helpful advice and diet culture does not teach you how to “eat responsibly.” Intuitive eating teaches you to “respect your body and respect your bone structure.” It also encourages you not to expect everyone to look the same or be super thin.

The Intuitive Eating Plan Concepts

Principle 1

Reject the diet culture. Do not get caught in too many rules and regulations. Do not jump from the latest diet program today to the very next one tomorrow. Do not get on the “bandwagon.”

Principle 2

Honor your hunger. Excessive hunger results in unconscious eating. Try to eat when you are moderately hungry, not starving. For instance, what if you measured your hunger on a scale from 1-10? Do not eat at level 1-2, think about eating when you reach level 3-5. Eat until you reach level 6-7 and do not stuff yourself until you reach level 9-10. It may take you a while to understand hunger cues.

Principle 3

Make peace with food- do not consider it “the enemy” waiting to overpower you. Eat because you are hungry and because it tastes good. Do not choose one or the other.

Principle 4

Discover the satisfaction factor of eating food- Remind yourself, it is ok to enjoy what you are eating and the sensations you feel. Remember the sight, smell, sound, touch and taste of your food. Chew slowly and savor your food.

Principle 5

Feel your fullness. Observe and listen to your body. Ask yourself “am I still hungry or do I feel full?” Am I stuffed or am I satiated?

Principle 6

Challenge the food police. Do not let friends, family or colleagues decide what, when and how much you should eat. Do not give away your independence. Do not acknowledge comments. Focus on your needs.

Principle 7

Be kind to yourself. Do not allow anxiety, fear, loneliness, boredom, frustration or anger to take over and allow you to eat emotionally. You may be happier in the short term, but food never resolves your true feelings.

Principle 8

Respect your genetic blueprint- Accept the size of your hands, feet and bone structure. Do not be overly self-critical. Everyone is not supposed to be thin or super thin.

Principle 9

Move your body. Discover the feeling and motion of exercise or physical movement. Do not obsess about how many calories you burned. Think about how good it feels to move.

Principle 10

Honor your health. Remember to vary your foods to include all the nutrients and know there is not one perfect food. Rotate new fruits, vegetables and whole grains to your plan.

“What you eat and how you move your body only accounts for 10% of your health.” But make that 10% count! Do not oversimplify or over complicate eating. Realize that all carbohydrates are not created equal. Concentrate on beans, legumes, whole grains, fresh fruit and vegetables. Look for high fiber and low sugar foods. Think about what healthy choices you can add to your plate, not subtract.

Benefits of intuitive eating:

Lower BMI (body mass index
Lower triglycerides
Fewer eating disorders
Less emotional eating
Higher feelings of well-being
Higher body acceptance
More unconditional self-love
Recommended for all ages and all genders
Increased balance of foods selected
GLP1s can help with intuitive eating since it slows gastric emptying

Specific diabetes benefits:

Manage blood sugars better. When blood sugars are controlled, you have less extreme hunger, higher food satisfaction and a healthier relationship with food
Encourages you to eat at healthy intervals every 4-5 hours based on your hunger level
Allows you to release rigid food rules
Helps you set reasonable food boundaries
Respond to hunger signals more frequently
Learn to be more flexible in meal planning
More sustainable than low calorie, low carbohydrate diet plans
Get feedback by monitoring blood sugars