Weight Loss Injections: The Truth Behind Clinical Trials and Snake Oil Remedies

Decoding Weight Loss Injections: Understanding the Science Behind GLP-1 Agonists

A series of articles for Foodguides has detailed the current GLP-1 Agonists available on the market, exploring their potential recommendations from medical providers for diabetes or weight management. It's recommended to refer to previous articles for insights into these medications' mechanisms and potential benefits. GLP-1 agonists, short for "glucagon-like peptide-1 receptor agonists," function by reducing blood sugar levels through mimicking the effects of the natural hormone GLP-1, thereby promoting insulin secretion. Regarding weight loss, their mechanism involves a multifaceted, complex process. They slow down the rate of food digestion and absorption in the gastrointestinal tract, reducing food intake by enhancing the feeling of satiety, thus curbing hunger.

In this article, I want to look more closely at the future of these drugs and impart some caution regarding some scary practices happening out there.

Ozempic® and GLP-1 Agonists: A Closer Look at Efficacy, Safety, and Potential Risks

Previous articles explored the potential risks and overall safety profile of GLP-1 medications. By far, the most common side effects reported are gastrointestinal, including constipation, diarrhea, indigestion, bloating, belching, abdominal pain, nausea, and vomiting. Other common side effects reported are hypoglycemia, headache, fatigue, and dizziness. Most of these side effects decrease over time as the body gets used to the medication. 

There are a few more serious side effects that, while rare, individuals should be aware of. About 1% of users may develop gastroparesis, also called “stomach paralysis,” which may or may not go away after stopping the medication. If you have a personal or family history of certain types of thyroid or other endocrine cancer, GLP-1 medications will likely not be recommended for you. If you have had pancreatitis in the past, these medications will likely not be recommended for you unless you and your medical provider decide the benefit outweighs the risk. There is also research being done now to evaluate if these medications may increase the risk of depression, suicidal ideation, or other mental health issues.

GLP-1s are effective overall for helping with both diabetic control and weight loss. Always remember no medicine is a magic cure. They are part of a balanced lifestyle change to improve overall health. There are also studies now evaluating their further cardiovascular benefits, decreasing fat around the liver in non-alcoholic fatty liver disease, and other possible health benefits.

The Promising Realm of Clinical Trials: Unveiling the Evidence for Weight Loss Injections

We briefly discussed in previous articles that the GLP-1 medications pharmaceutical companies are always in the lab trying to find something new and better than what is currently on the market. This is partially because they want something for patients that will work better with fewer side effects and partially because the patent on medications eventually expires. They are businesses, and they always want to make money. 

One drug that has completed phase 2 clinical trials, which means it is not approved yet, is retatrutide, owned by pharmaceutical company Eli Lilly. Retatrutide is unique compared to what is currently on the market. It is not only a GLP-1 agonist like semaglutide and a glucose-insulinotropic polypeptide agonist like tirzepatide, but it is also a glucagon receptor agonist and appears to be more effective than anything currently on the market. 

Internationally, anti-obesity medications are such big business that stock market analysts compile reports of what companies have different drugs in the research “pipeline” and sell these reports because if a new drug comes to market, that pharmaceutical company’s stock may become more valuable. 

When reading these types of market research reports, it is interesting that one pharmaceutical company may purchase another company’s drug before it ever reaches the human trial phase and then not develop it because they have a similar drug on the market. 

Unmasking the Deceptions of Snake Oil Weight Loss Remedies

While writing this, all GLP-1s approved for treating obesity are on the United States Food and Drug Administration (FDA) critical shortage list. While these medicines are on the critical shortage list, they can be manufactured by compounding pharmacies if specific criteria are met. These criteria include, among others, that the drug must be “essentially a copy” of the medication on the shortage list, and a valid prescription for an identified patient must be provided. 

However, there are certain quality standards that the compounding pharmacies are exempt from if the conditions are met during the critical shortage. These are quality standards that are generally applied to drug manufacturers. In theory, this could increase the risk when obtaining medications from a compounding pharmacy. This is why it is very important that if you obtain medications from a compounding pharmacy, you ensure they are a licensed compounding pharmacy. The federal critical shortage laws may waive certain quality standards, but these pharmacies are state-licensed. To maintain their state licensing, they must maintain the state-mandated quality standards. 

One way to check if it is a licensed compounding pharmacist is when you see a medical provider and they are sending in a prescription; then, you should always have the option of speaking to a pharmacist and asking for the phone number. The FDA also has a website with links to all the state pharmacy board's websites so you can check to see if the pharmacy has an active license. 

Protecting Yourself from Weight Loss Scams: Recognizing Red Flags and Seeking Expert Guidance

Brace yourself for a cautionary tale. Many people are seeking cheaper alternatives because of the shortage of GLP-1 medications and the cost associated with obtaining medications when insurance denies coverage. I do not advise it, but if you were to dip your toe into the dark side of the internet and start searching for cheap alternatives- a seedy, barely legal underbelly is operating on the internet and ready to take advantage of the unwary consumer. 

Many websites purport that they are selling some form of these medicines but will state they are “not for human use” to bypass the legal requirement for a prescription. They may state that what they are selling is for “research” and that by purchasing from the website, you agree that you will only be using whatever you purchase on animals in a laboratory setting. Some even seem to be selling medications that have not finished clinical trials and have been approved for human use by the FDA. There is no assurance that you will receive what you think you are buying. There is no reason to believe that what is being sold is packaged in a sterile environment that is a standard for injected medications. 

America’s Poison Control Centers, which handle emergency phone calls related to poisoning, had an increase of 1,500% in calls associated with GLP-1s in 2023 compared to 2022. In 94% of the calls, semaglutide was the only drug reported. This is believed to be tied to the increase in individuals ordering from websites that are providing non-prescribed drugs. These websites do not provide information or education on administration since they plainly state they are not for “human use.” As we have talked about before, the actual GLP-1 prescribed medications have potential side effects. In overdose cases, GLP-1 medications can even cause seizures and require hospitalization. 

These medications require a prescription. If someone offers to sell you something without a prescription, RUN AWAY!

Empowering Informed Decisions: A Balanced Approach to Weight Loss and Health

Obesity is common, costly, and chronic in the United States. Obesity can lead to type 2 diabetes, heart disease, and some cancers. There is no quick fix or miracle cure for obesity or being overweight. Changing your overall health and losing weight takes a conscious effort, and maintaining weight loss means maintaining changes long-term. This usually includes changes in many lifestyle factors, including diet, activity level, hydration, sleep, and possibly using medication, among other things. 

If you and your healthcare provider decide that medication will help you with your weight loss and wellness, then discuss your options and proceed after being informed of the plan of care. Also, know that you have your social support, including friends and family, and your healthcare provider supporting you as you become the best version of yourself.

1. _{CDC (2023, February 24). About Overweight & Obesity. Centers for Disease Control and Prevention. Retrieved January 12, 2024.}
2. _{FDA (2023, June 8). Locate a State-Licensed Online Pharmacy. Retrieved January 12, 2024.}
3. _{Jastreboff, A. M., MD, PhD, Kaplan, L. M., Md, PhD, Frias, J. P., MD, Wu, Q., PhD, & Du, Y., PhD (2023, August 10). Triple–Hormone-Receptor Agonist Retatrutide for Obesity — A Phase 2 Trial. Retrieved January 12, 2024.}
4. _{Li, Y., Cheng, Z., Lu, W., Li, P., Jiang, H., Yang, J., Xu, J., Zhang, C., Zhang, L., Wang, Y., Bian, F., Guo, W., Yu, X., Chen, X., Zhao, D., Feng, B., Qu, S., Qin, J., Zhang, Y., Wang, L., … Mu, Y. (2024). Efficacy of noiiglutide injection on body weight in obese Chinese adults without diabetes: A multicentre, randomized, double-blind, placebo-controlled, phase 2 trial. Diabetes, obesity & metabolism, 26(3), 1057–1068.}