Hype or Hope? Semaglutide Changes the Weight Game

Dr. Robert Kushner

Understanding how gut hormones regulate obesity paves the way for new research and new solutions.


In this Episode of The Human Upgrade™...


 …you’ll learn about semaglutide, a new weight loss drug that’s been getting a lot of attention.

Highly respected obesity expert Dr. Robert F. Kushner joins the show to talk about new research findings. He was part of a team that published semaglutide study results in the New England Journal of Medicine this past year. Looking into semaglutide, typically used for Type 2 Diabetes, showed that it also reduced body weight.

We talk about how you might use semaglutide, both from an aging perspective and from a weight loss perspective. You look at risk reward for everything you can do, and then you decide what’s going to work best for you. There’s some interesting knowledge to be gained from the research on semaglutide.

Here’s the short version of how it works: “Semaglutide mimics our naturally occurring hormone called GLP-1,” explains Dr. Kushner. “When you give it back to a person in pharmacologic doses or high doses, but it mimics what we normally have, it augments or highlights this feeling of, “You know what, I am really not as hungry as I was before. I’m more full than I was before, so I don’t need as much food.” It’s actually the change in appetite that causes a weight loss that we see with this kind of a drug.”

“One of the things we've learned over the past few decades is that obesity, as a disease, is characterized by appetite dysregulation.”

Dr. Robert Kushner

A clinician, educator and researcher, Dr. Kushner has spent his decades-long career on adult weight management for adults. Board certified in both internal medicine and nutrition, he maintains a medical practice, teaches students and medical professionals, and presents around the world. He’s written more than 250 original articles, as well as reviews, books and medical book chapters.

He’s Medical Director of the Center for Lifestyle Medicine at Northwestern Medicine in Chicago; a professor of Medicine in the Division of Endocrinology and a professor of Medical Education at Northwestern University Feinberg School of Medicine. Dr. Kushner also founded of the American Board of Obesity Medicine (ABOM) that certifies physicians in the care of patients with obesity.

He’s seen a lot change over his time in this health arena. “What we’ve learned in the past 50 years or so is that obesity had always been thought of as just excess body fat and didn’t cause any problem,” Dr. Kushner says. “But if you got sick enough or you got overweight enough, you then developed diabetes. We now know for the past decades that obesity in itself as a disease.”

“What makes semaglutide and other drugs in this area that are emerging so different and new generational is that we now have a much better understanding of obesity,” he says.” The role of these gut hormones that come from the pancreas, from the intestine that help us in a more natural way, give us signals that we’re full, we’re less hungry, we’re more content between meals, we have less cravings, less thoughts of food. A lot of people think that’s all under your own consciousness, your own willpower, and it’s not, it’s actually biologically driven.”

This episode’s conversation includes the role of lifestyle in weight management. It’s shortsighted to view semaglutide as a wonder drug isolated from diet, exercise and even mental health. It’s all related. And new understanding of obesity as a disease and its biological drivers helps the search for lasting solutions, including training for healthcare professionals.

Listen on to find out more about semaglutide and six factors that might be causing your weight gain or making it difficult for you to lose weight.

Enjoy the show!

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  • Haven’t overweight people always been at statistically higher risk of dying from all infections, bacterial, viral, everything else just because they have poor immune function and higher inflammation?  – 2:16
  • If a woman loses too much body fat, let’s say she’s a marathon runner and she gets very lean or she has a disease like anorexia nervosa where body fat drops below a threshold for health, you start having ramifications in her health.  – 6:52
  • Can you tell me about the study and what Semaglutide is and what you found?  – 9:55
  • Semaglutide. It’s a mimic, it mimics our naturally occurring hormone called GLP-1. – 11:41
  • How does Phentermine work? The so-called Phen-Phen that people talked about before it reached out to the market?  – 19:57
  • People on placebo lost about two and a half percent of their body weight at the end of the year, so minimal. People on drug on average lost 15% of their body weight.  – 25:31
  • That the goal of weight loss is not to make people thinner, it’s all with an eye towards health.  – 31:22
  • That the goal of weight loss is not to make people thinner, it’s all with an eye towards health.  – 36:31
  • We are trying to train the next generation of healthcare professionals to be part of the solution.  – 42:22
  • The one medical, no side effects, but the one medical effect that was seen is that individuals in the drug trial developed slightly more gallstones or gallbladder related problems. – 46:51
  • We are now being much more aggressive in working with individuals with prediabetes. Along with lifestyle counseling, using medication when indicated to prevent the occurrence of diabetes.  – 50:33

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