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YOU NEED OZEMPIC? · No Forking Nonsense - The Nutritionist UK

• 0:00
  @paulthenutritionist: Welcome to No Forking Nonsense, the podcast that slices through the nonsense and serves you straight talking nutrition advice that actually works. I'm Paul, a registered nutritionist and your host. And every episode, I'll be debunking diet myths, breaking down confusing food advice and giving you practical science backed tips to help you eat better, feel better and get your hedge back. There'll be no fads. Before we get started on this episode, I just wanted to say if you want five days of completely free coaching from me, a registered leading nutritionist, for free straight in your inbox, go to tinyurl.com/kickstarter26 and you will get five days of completely free coaching straight in your inbox just by clicking that link.
• 0:48
  So if you have enjoyed anything that I have ever said, go to tinyurl.com/kickstarter26. Let's get into the episode. Hello and welcome to another episode of No Forking Nonsense and today it's a big one. We're talking about fat jabs. Ozempic, Wegovy, Mounjaro, whatever trendy name you want to call it.
• 1:11
  You've seen your friends, perhaps your family, your colleagues, half of Instagram jabbing themselves up the arse on a weekly basis, posting before and after photos and you've likely if you're overweight or if you're struggling with your weight or if you've got friends or family who are struggling with their weight, you've likely read about it, considered it and you're wondering whether it is the right thing to do. And if you're sat there doing the actual work, so being mindful of what you're eating, perhaps moving a little bit more, you're hitting your protein, you're being patient, you're being pretty boring when it comes to trying to feel better, lose a bit of weight, you might be thinking should I just take OZEMPIC? And the answer is no, probably not and here s why. For those who don't know, I m Paul Evans, registered nutritionist and this is Second Most Listen to Nutrition podcast in The United Kingdom and today we re talking about why OZEMPIC and the rest of them is probably not the answer and why it is actually just another shortcut that it is abundantly clear both in terms of people who I have been working with and just from the research that's coming out that it doesn't seem to be working long term and what you should probably be doing instead.
• 2:31
  And I'm going to give you balance, there are people who should be taking it but 95% of you who are considering it probably shouldn't. So the first thing we have to do is explore what is OZEMPIC and why everyone's obsessed with it. So let's talk about what the stuff actually does. So OZEMPIC is what we call a GLP-one receptor agonist. So what it does is it mimics a hormone that your gut naturally produces to tell your brain that you're full, so that's called leptin.
• 3:02
  It was actually designed for type two diabetes so in 2018 I was invited to parliament in my role with the British Obesity Society where we were having a big conversation about this and it was really seedy, I didn't like it, we didn't even talk about it but then a piece of paper came round and we had to sign and it was honestly for me it was really eye opening about this is lobbying, I was basically being lobbed and I worked for a charity. Anyway, regardless of that, it was designed for type two diabetes but then research noticed that people on it lost massive amounts of weight because they literally weren't hungry anymore. So the studies look really impressive, so there was a trial in 2021 which found that the average weight loss was about 15% of body weight over sixty eight weeks and some people lost like 25%. And then there was another trial in 2022 which found that with Mounjaro people were losing 20 to 22% of weight loss which is better than some bariatric surgeries and cheaper. So yeah people did lose weight and they lost a lot of it fast but, and this is the bit that I need you to pay attention to, that's where the problem starts because losing weight fast on a drug that suppresses your appetite does not fix a single thing about why you gain weight in the first place.
• 4:24
  It is like putting a plaster on a bullet wound and then saying I m healed. Whereas what s actually happening is that you re not hungry because the drug is hijacking your leptin. Remember I m going to talk about leptin and ghrelin a lot. Leptin is the hormone that tells you you re full, ghrelin is the hormone that tells you that you're hungry. So your body still wants to eat and your brain still has all the patterns, the habits, the emotional triggers and the lack of knowledge around nutrition, the drug is just kind of muting the signal and the second you stop the drug, which is what you're going to do at some point because A) it costs 300 and you can't be spending that every month for the rest of your life, but also because it's not sustainable, all of those problems come screaming back and then inevitably sadders away.
• 5:09
  So I really want to be clear about this: OZEMPIC is not a solution, it's temporary suppression of the actual problem and here's why. So in 2022, there was a study which found that participants who stopped semaglutide after 68 regained two thirds of the weight within a year and some regained all of it. That's because they didn't learn anything, So they didn't change their relationship with food, they didn't build habits, they didn't understand the basics of nutrition and fuelling and their energy, they didn't address their metabolism, they didn't learn how to eat properly, they just stopped being hungry for a while and being hungry if you're very overweight is usually not the only issue and when the drug stops, obviously the ghrelin increases and the leptin decreases, ghrelin being the hunger hormone, leptin being the iron full hormone and unless you've learnt how to manage that and you've learnt how to manage the energy in your body, the weight will come back too. This is the same story for every bad diet. There is a reason why Slimming World and Weight Watchers, I mean they're absolutely bombing now because the same people who are going to Weight Watcher and Slimming World are looking for the shortcuts with fat jabs.
• 6:23
  Keto as well, juice cleansers, all show you how to lose weight fast, but you will regain it when you stop because you haven't learned anything. And OZEMPIC and all the other fat jabs are just expensive injectable versions of that same broken cycle. The other thing as well is when you're not fuelling yourself and you're putting yourself in such a calorie deficit that you haven't got a choice about, you are losing weight but it's not just fat, a lot of it is muscle as well. There was a study that explored in 2023 how body composition changes with semiglutide treatment and people on the GLP-one drugs, again they lost weight fast but twenty five to forty percent of that weight was lean muscle mass and not fat. Let me put that into perspective: if you lose 20 kilograms on the ZEMPIC, about eight kilograms of that is muscle.
• 7:13
  So why does that matter if you're looking to lose weight? Well, what we have to remember is that muscle will burn calories at rest, so the more muscle that you have, the higher your metabolism is, will keep you stronger and more functional, will prevent obviously fragility, injuries as you age, but also will stop you looking gone. So we all know people, was it called back when it first came out like the Mounjaro face or Ozempic face and you can look at people and they just look gone, they look like they've been starving themselves because they literally have. But when you lose muscle, and I'm not talking about people who go to the gym and lift weights every day, I'm talking about just you, the standard person who maybe does a little bit of exercise here and there, you still have a significant proportion of muscle. But when you lose that, your metabolism will absolutely tank and you burn fewer calories.
• 8:00
  You also become weaker, you also look deflated and you're setting yourself up to regain fat faster when you stop that drug. You're essentially becoming smaller, weaker and more metabolically broken than you were previously. And when you regain that weight, which you definitely will, you will regain it as fat and not muscle. So you end up fatter and weaker than when you started, which is essentially just self destruction on a payment plan and you're going to feel like shit because you have absolutely no energy. The other thing that is probably being brushed under the carpet quite a lot is the side effects.
• 8:38
  Clinical trials, remember everything I say is backed up by receipts. The clinical trials that we have seen have shown that forty four percent of people feel nauseous, thirty percent of people have diarrhoea, twenty four percent vomiting, twenty four percent constipation, twenty percent abdominal pain, 18% fatigue and weakness, and there is also a significant amount of proportion of people who are taking as much as MNJARO or the rest of them and because their appetite is so low they don't even want to drink water and I don't need to go into a separate tangent about why it's so important you're drinking at least two litres of water. Nearly half of the people on these drugs are spending months feeling like they've got food poisoning and it's not just the mild discomfort some people can't work, some people can't exercise, some people can't function, but there's also now we're seeing serious side effects. So gastroparesis, which is stomach paralysis and some of these cases are permanent. There's a lot of talk about gallbladder problems because of increased risks of gallstones and inflammation, again exasperated by not consuming enough water.
• 9:49
  Problems with inflammation of the pancreas, which again can be life threatening. I saw in animal studies there's links between certain fat jabs and thyroid tumours, again seen in animal studies, unclear in humans yet. And then suicidal ideation, there are early reports of decreased depression, thoughts. We haven't got the long term data yet. These jabs have only been widely used for weight loss since about 2021 and that is three to four years.
• 10:23
  What's going to happen in ten years, twenty years, thirty years of injecting this weekly? We have literally no idea and we're learning all of the time. The other thing is it costs an absolute fortune. So let's do the maths, you are looking at about 200 to £300 a month for Wegovy or Mounjaro privately in The UK, which is anything up to £4,000 a year. For the rest of your life, if you're going to take it, because you regain the weight when you stop, so you're probably going to be sinking back on it.
• 10:49
  Over ten years you're looking at anything from 25 to 40 grams. Over twenty years you're looking at anything from 50 to 80 grams. That is a deposit on a house, that's a car, that's your kids university fees. For what? To suppress your appetite whilst you fail to learn about your body, basically are living in a different body without the knowledge education about nutrition, how to eat, how to fuel, you're not able to go to parties and enjoy your birthday parties, your kids birthday parties, weddings.
• 11:19
  It's not the answer. Do you know what's cheaper? Learning how to eat, building habits and actually doing the work to address your energy to understand the basics of your nutrition for free. This doesn't fix the real problem. You didn't gain the weight because you're too hungry.
• 11:39
  You gained the weight because you don't know how to eat, you don't know when to eat, potentially you've been yo yo dieting for years and your metabolism's broken. You use food to cope with stress, to cope with boredom, to cope with emotions, you don't move enough, perhaps your sleep is shit, which by the way isn't going to get much better if you go on fat jabs and you don't have healthy habits and OZEMPIC doesn't fit any of that. And I can categorically tell you this because I have worked with hundreds and hundreds of clients who A) have gained weight in the ways I've just said above and B) I've had people who've come to me off the back of fat jabs. All that fat jabs do are make you less hungry temporarily and when you stop them you are back to square one. Except now you're weaker, your metabolism is worse, you've wasted thousands of pounds and you're putting yourself at risk at all of those health conditions I outlined above.
• 12:32
  What it essentially is, is you're avoiding the real problem. So let s have some balance here. Who should actually use it? Probably five percent of the population are an exception to everything I ve said. I m not completely anti OZEMPIC, Mounjaro and all the rest of them.
• 12:50
  There are people who should use it, but it s a very small group and if you listen to this, you re probably not in that small group. So people who are with severe obesity and life threatening health conditions, so if you have type two diabetes it s out of control, if your BMI is over 40, you have sleep apnoea, you have high risk of heart attack or stroke, joint damage from excess weight. If you're at the very far end of like you're beyond probably your doctor is essentially saying to you listen we're in big trouble here, we're in too deep here and you think that you are well out of control of any slow patient help then or again you've tried absolutely everything for six months plus, even with professional support, which by the way I've never ever worked with anyone who hasn't got results from working with a nutritionist, then yeah okay, a ZEMPIC might save your life. 2023 there was SELECT trial where semaglutide reduced major cardiovascular events by twenty percent in people with pre existing heart disease and who were very, very overweight. For these people, the health risks of staying obese completely outweigh the risks of the drug.
• 14:00
  That's the only kind of sector of people. The other group of people I guess are people who can afford it forever and who are willing to risk all of these health problems and are willing to do the work alongside it. If you can genuinely afford £300 a month for the rest of your life without any financial strain, you're committed to strength training three to four times a week, you're committed to eating at the very least 1.6 to two grams of protein per kilogram of body weight to preserve muscle and you're committed to working with a nutritionist to learn how to eat properly and to energise and fuel yourself and you understand that this is a tool and not a replacement for doing the work, then okay we use it as a tool. But that's not most people. If you are any of the following people, the 95% of people listening to this, then you shouldn't use it.
• 14:51
  So people who want to use five to 10 kilograms, people who haven't tried working with a registered nutritionist, people who can't afford 50 gs a year, people who think it's a magic fix and aren't willing to train and eat enough to fuel themselves. People with a history of disordered eating, because this will make it worse. People who are already under eating and over trained, you've got to fix your metabolism first. If you are in any of these categories, Ozempic is not the answer for you and you don't need it. So here's what you should do instead.
• 15:26
  So if OZEMPIC isn't the answer, what is? I've said this before: it is boring, it's not sexy, but working on understanding how to eat properly, when to eat, how to build habits, doing the work is the long term answer to what you're after. The first step is to fix your metabolism if it's broken. If you've been yo yo dieting and eating 1,200 calories for most of your life doing hours of cardio, your metabolism is probably quite suppressed so we need to get you out of that. So what we do is we gradually increase your calories from one to 150 calories per week, we'll get you up to maintenance, we'll rebuild your metabolism over eight to twelve weeks and then we create a small deficit when your body is rebalanced, which is the opposite of what a ZEMPIC does.
• 16:14
  You'll be eating more, not less, you're fixing your body, not suppressing it. Remember the aim is to eat as much food as possible, whilst still losing weight. That is how you sustainably lose fat consistently. In addition to that, we want you eating enough protein, about 1.6 to 2.2 grams per kilogram of body weight to preserve any muscle during weight loss to keep you full because with having enough protein, which most people don't do, your natural appetite suppresses and it will support your metabolism, it's great for recovery, it's great for your hair, it's great for your skin and this is what OZEMPIC users are missing because they're not hungry, so they're not eating enough protein, they're losing muscle mass, they're essentially screwing themselves. Once we've done all of that we can create a moderate calorie deficit, so roughly anything from depending on how much weight you have on you, you say about 20%, but two to maybe if you're really heavy 500 calories below maintenance, not in a huge deficit so that you feel like shit and you're starving.
• 17:17
  Sustainable fat loss is about 0.5 to 1% of body weight per week. That's about 0.25 to one kilogram per week for most people. It's slow, it's boring, but it's sustainable and unlike being on jabs, you won't regain it when you stop because you've learned how and when to eat properly. The other thing that you have to prioritise unfortunately it's boring, but sleep. If you're sleeping for four hours, your sleep is poor, it increases your hunger hormones, you've got no energy and everything goes to shit.
• 17:51
  If you can sleep six to eight hours, you're going to find you're in a much better space. Managing your stress as well, so high cortisol will increase appetite and water retention, again this is exacerbated by lack of sleep, but we have to be patient. Weight loss sustainably that stays will take months, not weeks. It's not sexy, it's not exciting, it's boring, doesn't make the headline, but it works forever, not just while you're on a drug. And that is why I have clients who have worked with me for six months to a year and they have lost 20 kilograms, 25 kilograms.
• 18:26
  I've got a client recently, Ed, who I think I've spoken about before, he messaged me the other day saying he's lost 20 kilograms which is the same as a seven year old daughter. He started working with me in July. So I get it, it's really overwhelming, you don't know where to start, you've tried diets before, they don't seem to work and that is why I am constantly banging on about you getting five days of free coaching for free. It is the exact process I use my clients condensed into five days and delivered in your inbox every day from tomorrow morning. So I go through absolutely everything that you need, so we look at how to work out your calories, simple things that you can do to increase your appetite, how to improve your energy, All really simple things that you can do every single day for the next five days to begin the process of losing weight.
• 19:24
  It's completely free, it works long term, it doesn't require you to have injections or spend 300 to 500 pounds a month, you just have to do what's asked of you every single morning. You do that and you will begin to feel and see results and if you're willing to do that, go to tinyurl.com/kickstarter26. That's tinyurl.com/kickstarter26 or click the show notes below. You can start tomorrow morning for five days completely free and by the end of next week you will feel better, you'll start to understand how to eat properly and you'll know what to do and you will not need OZEMPIC. So let me be kind of honest with you, if you are considering OZEMPIC because you cannot be bothered to learn how to eat properly, then you are not going to succeed.
• 20:16
  Not just with fat jabs but with everything. Because fat loss isn't the hard part, keeping it off is. And keeping it off requires understanding your nutrition, understanding your body, building those habits, managing stress and emotions without food, being consistent even when life gets hard and being able to ask questions for somebody who knows what the fuck they're on about. The amount of people who go on these fat jabs and are literally just kicked into the vortex and said told, go on, off you go, good luck, see you in a few months and they still don't know how to eat. OZEMPIC doesn't teach you how and what to eat, it doesn't teach you anything about your body, it just mutes your hunger whilst you avoid the real work and the real answers and when you stop that drug, which you will because you have to, you will find that your side effects are absolutely unbearable and you will regain everything.
• 21:07
  Except now you will be weaker, will be metabolically broken and thousands of pounds poorer. Is that really the outcome that you want? Or do you want to actually learn how and what to eat, how to do this properly, you never have to think again? It s completely up to you. But if you choose a shortcut, you will probably fail eventually.
• 21:30
  And I'm telling you now, I've seen it firsthand, it will fail you. The bigger picture is, and this is what really fucks me off about fat jabs, it's a pharmaceutical company profiting off people's desperation whilst doing nothing to fix the actual problem. We live in a broken food environment. We know that portion sizes are absolutely huge, sugar's in everything, we sit on our ass for ten hours a day and the education around nutrition and food in schools is abysmal. And instead of fixing that, we're selling people expensive drugs that suppress their appetite.
• 22:05
  It's a £20,000,000,000 industry which is literally not addressing the real problem. What would actually solve obesity is teaching nutrition in schools properly, making whole foods affordable, taxing junk food, building cities for walking and cycling, providing mental health support because emotional eating is very common, but that doesn't make pharmaceutical companies bit to pounce. So instead we get jabs, which is as I say a plaster just being shoved on a bullet wound and it's a shortcut that doesn't work and people are just throwing money at it. As I said fat jabs are unlikely to be the answer. It's a temporary suppression of hunger that doesn't fix why you gain the weight, causes brutal side effects, costs you thousands, makes you lose muscle and stops working the second stop take.
• 22:56
  For ninety five percent of people it is a waste of your money and guaranteed path to regaining. The actual answer is learning how and what to eat, understanding your body, learning sustainable habits, fixing your metabolism if it s broken, making sure that you are prioritising you, you are able to live a life, you control your environment, you don't let your environment control you and your patient. It is boring, working with a nutritionist is fucking boring but it's effective and unlike fat jabs, it works for him. So stop looking for shortcuts, stop thinking there's an easy way out, there isn't, it didn't take you a month to get to where you are, but a starting point for free is tinyurl.com/kickstarter26. Sign up for those five days of free coaching, start tomorrow, do the work.
• 23:50
  And five days from now, you will understand nutrition a little bit more, you'll hopefully understand what your body needs, you'll start to feel the benefit and you won't need OZEMPIC or any other drug or any other shortcut. It would just be you, the knowledge you have and a consistency to follow through. And that is the answer and it always has. So I hope you found that useful. Please share this with somebody you think needs this and I shall speak to you next time.
• 24:16
  Cheerio. That's it for this episode of No Forking Nonsense where the fluff gets binned and the facts get served. If you found this helpful, it with someone who could do with some clarity from an expert. Way. And make sure you hit follow so you don't miss what's coming next.
• 24:30
  And if you want more straight talking, no nonsense nutrition advice, come and find me on Instagram Paul the Nutritionist. Until next time, eat smart, feel human again, and stop falling for the Forking Nonsense. See you next time.