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“Many patients can benefit enormously. But we have to accompany them”
Diabetes expert Stephan Martin also prescribes the weight loss injection to many patients. But not everyone. When she can help and whoever tries better with classic weight loss.
Sprays such as Wegovy and Ozempic were praised as miracle cures, as soon as the data were presented for their effectiveness. Was their hope great to be able to help patients better now?
I have always said: We have to work more on the weight if we want to help people with type 2 diabetes. When it was actually shown that, like insulin, only blood sugar does not go down, but also the weight and thus the risk for secondary diseases, the joy was also great for me. Finally we have medication that also lower the heart attack rate.
That sounds like “but”.
Already with Liraglutid, the predecessor of Ozempic, we noticed: If you don’t combine it with a healthy lifestyle, it only helps a certain time. After the weight loss, a plateau also occurs with the syringes. Then the patients come and say: “Nothing happens anymore, I won’t take any further.” In this phase, it is important to keep weight with movement and good nutrition. This is especially true if you want to stop taking the funds.
There are still no official prescription figures in Germany. How great is the proportion of your patients who take these funds?
That is certainly 50 percent of our type 2 diabetics.
Does it also happen that you advise against it?
When a patient comes to me and says: “I would like to take the syringe”, then I first ask: “What have you tried?” These remedies are not medication of the first choice. I would always try it with a change in diet and exercise. I have lost two patients who lost 40 kilos – without any medication. However, if a patient decreases five or six kilos and it does not really go on, you can very well support with medication such as Semaglutid or Tirzepatide.
If a patient had a pancreatitis or thyroid carcinoma, I advise against these means. Even with pronounced stomach and intestinal problems, I would be careful because the means can trigger nausea, diarrhea or constipation.
Is dealing with the funds too carefree?
The other day, an overweight patient said to me: “If you don’t write it down, I go to my dentist. He does it!” Unfortunately, there is a lack of explanation in the treatment of overweight. The dangers of these funds are relatively low. Nevertheless, it needs to know. Let’s only take the topic of contraception. Many women who take these means to lose weight are at beyond age. However, very few are aware that the dwindling kilos not only increase the fertility of obese, but also reduce the effect of the anti -Babopill. It is not for nothing that there is already the concept of “Ozempic babies”.
Why does the contraception suffer?
That is related to the side effects. If you pass yourself over after taking it or suffer from diarrhea, the active ingredients are not properly absorbed. The same can happen if the pill remains in the upper digestive tract due to the stomach emptying disorder much longer than intended. Actually, these women would have to switch to another contraceptive method if they don’t want to become pregnant unintentionally.
The much reported sequence of customers of up to 20 percent of body weight comes mainly from clinical studies. Is that also achieved in practice?
As a rule, weight loss is significantly lower. It is rare that someone really takes 20 kilos or more.
Why is that?
There are different reasons. On the one hand, the participants of clinical studies are highly selected. This is a patient collective that is usually highly motivated and is well looked after during this time.
In practice, it happens again and again that side effects prevent people from staying on the ball long enough. In addition, many overweight patients do not increase their doses so consistently because it also increases the costs. After all, you have to pay the funds yourself. If people run out of money, they break off the therapy. I only had an overweight patient in the consultation that was too expensive. A little later, he weighed more than before. A colleague once said at a congress: “Disposal is not an option.”
What side effects do your patients report from?
That is different. There are people who mainly have nausea, but they often lay down again. Others have diarrhea or constipation. Above all, I think the muscle mass loss that often occurs when losing weight occurs. If someone decreases 15 kilograms in a short time just because they eat less, six kilograms of fat -free mass are, including the muscles. If he stops injecting because he is not ready to do this for a lifetime, there is a great risk that he will increase quickly. And especially fat mass. If you are not careful, you swap muscles for fat. If you do this a few times, you may lose so much muscles that stability suffers. It is easier to fall, have a higher risk of broken bones and become more susceptible to a number of diseases. This is something that we do not yet know what we get involved with.
Does that mean that in the worst case, patients later have more health risks than before?
We are in the area of speculation, but this is not excluded. Therefore, I think the use of this syringe outside of a structured nutritional and movement program is ethically highly questionable.
That sounds dramatic.
We shouldn’t demonize these medication. Many patients can really benefit enormously. But we have to accompany you so that you lose less muscles and learn to keep the new weight.
What does such a program look like?
Patients should know that they have to train their muscles. The following applies to nutrition: you need many proteins! We also advise our patients to a low insulin diet.
What is that?
It is about consistently reducing everything that leads to your body excessively releasing insulin: sugar, sweets, but also starchy foods such as potatoes and rice.
Why is it so important, potatoes and rice are considered healthy?
Because insulin inhibits fat burning. This is not a problem with slim people. But very well with overweight diabetics. Unfortunately, far too often you are advised to eat low in fat. This means that you often eat more carbohydrates.
Can’t you prescribe such programs to your patients?
Unfortunately no. On the one hand, there are hardly any long -term, structured programs, on the other hand, many offers are not a cash benefit. This means that the patients have to pay for it themselves. We thought about helping people: training videos with instructions. We turned them ourselves and made QR codes. Our patients can now look at them at any time.
Source: Stern
I’m Caroline, a journalist and author for 24 Hours Worlds. I specialize in health-related news and stories, bringing real-world impact to readers across the globe. With my experience in journalism and writing in both print and online formats, I strive to provide reliable information that resonates with audiences from all walks of life.
