Weight loss med downsides

Q: I’m overweight and have Type 2 diabetes and want to start taking one of the medicines that everyone is clamoring for — called semaglutide, I think. Is that a good idea? — John G., Madison, Wisconsin

A: Semaglutide was originally designed as a Type 2 diabetes medication, but when folks saw that it promoted weight loss, they started using it off label. Now one brand, Wegovy, is Food and Drug Administration approved for weight loss. Two other brands (with lower doses) are approved only for Type 2 diabetes. They’re Ozempic and Rybelsus.

You need to talk with your doctor about your best approach to controlling your blood sugar levels. But it’s important to realize that whether you have Type 2 diabetes and/ or are overweight and take semaglutide for weight loss, it only helps you shed pounds while you’re taking it. Stop and it’s likely you’ll regain the weight you lost.

That’s because while semaglutide lowers the weight and fat content that your body wants you to maintain, it doesn’t change that set point for good. And folks who are overweight or obese have established what’s called the “defended fat mass set point” at a level that almost demands you maintain a higher amount of body fat.

That’s why making slow, permanent changes to your lifestyle choices (nutrition, sleep, exercise and stress management — by building a posse, finding a purpose and enjoying play) is the best way to lose weight and keep it off.

Working with your physician, create a plan that leads to weight loss of a pound a week (two, max) by adopting an unprocessed, plant-based diet, finding physical activities you enjoy so they provide the equivalent of 10,000 steps daily, stopping bad habits (smoking anything, alcohol use and abuse), and making sure you get seven hours of quality sleep nightly. It may take a while, but you won’t be stuck on a medication that does have potential side effects — instead you’ll become healthier and happier every day. You know where there’s even more info: “The Great Age Reboot.”