I have seen medical and holistic fads come and go over my 40 years of being in practice which is why I gravitated towards functional medicine. Functional medicine focuses on identifying and addressing the root causes of diseases. This approach often involves personalized treatments that not only target symptoms but also promote overall health and well-being. 

My preference is to try the functional medicine approach first then add on pharmaceuticals as needed. Weight loss is always a hot topic. Everyone is searching for a “miracle drug.” They take the drug, lose weight, continue the unhealthy habits and after years and millions of people trying the miracle drugs, disappointment sets in and side effects become apparent. Remember Phen-fen? It was a “miracle” drug that turned into a nightmare resulting in damage to heart valves. Studies are for short periods and smaller numbers of people. It is only when a drug is on the market for extended periods of time that the real problems show up because a wider range of people with different genetics, environment and lifestyle start taking it. Only when problems arise does the FDA act. There were others such as amphetamines and orlistat among others. The question is: Are the GLP1 inhibitors next?

What hasn’t changed is our DNA and how the body works. So, before you jump on the GLP-1 inhibitors bandwagon, consider the side effects, and consider a holistic lifestyle approach such as a metabolic reset diet first. Both have their place in managing conditions like obesity, diabetes, and metabolic syndrome, but they come with their own set of advantages and disadvantages.

GLP-1 Inhibitors: Ozempic, Wagovy A Closer Look

GLP-1 (Glucagon-like peptide-1) inhibitors such as Ozempic and Wagovy are a class of medications that mimic the action of the natural hormone GLP-1, which is involved in regulating blood sugar levels and appetite. By enhancing the action of GLP-1, these drugs help lower blood sugar levels, promote weight loss, and have been shown to reduce cardiovascular risk in patients with type 2 diabetes.^1,2

Pros:

1. Effective Blood Sugar Control: GLP-1 inhibitors have been proven to significantly lower blood sugar levels, making them a powerful tool in managing diabetes.^1,3

2. Weight Loss: These medications can lead to substantial weight loss, which is beneficial for patients with obesity or metabolic syndrome. Average weight loss is reported as 7.9% of body weight or 15.6 pounds.⁴

3. Cardiovascular Benefits: Some GLP-1 inhibitors have been shown to reduce the risk of heart attack, stroke, and cardiovascular death in people with type 2 diabetes.⁵

4. Convenience: GLP-1 inhibitors are typically administered through weekly injections, which may be more convenient than daily pills or multiple daily insulin injections.

Cons:

1. Side Effects: Nausea, vomiting, diarrhea, and a potential increase in pancreatitis risk are among the side effects associated with GLP-1 inhibitors.⁶

2. Cost: These medications can be expensive, potentially making them inaccessible to some patients without adequate insurance coverage.

3. Not a Cure: While GLP-1 inhibitors can manage symptoms and reduce risks associated with certain conditions, they do not cure the underlying disease.

4. Treatment Length: These drugs must be taken forever. Once you stop them, you will regain the weight. Studies show 2/3 of the weight lost is regained and the positive cardiometabolic effects return to baselin.⁷

Metabolic Reset Diet: An Overview

A metabolic reset diet aims to restore the body’s optimal metabolic functioning by altering dietary intake. This approach often involves eating whole, nutrient-dense foods, eliminating processed foods, and sometimes incorporating intermittent fasting.

Pros:

1. Holistic Approach: This diet addresses the root causes of metabolic dysfunctions, promoting long-term health improvements. ⁸

2. Weight Management: By improving metabolic health, individuals may find it easier to achieve and maintain a healthy weight. Participants reported muscle was maintained and fat was lost and weight loss was an average of ½ a pound a day for women and 1 pound a day for men. ⁹

3. Improved Insulin Sensitivity and Overall Health: A metabolic reset can enhance insulin sensitivity, reducing the risk of developing type 2 diabetes. Participants also reported reduced blood pressure, cholesterol, cravings, GI upset, pain, skin conditions, brain fog, inflammation and more. ¹⁰

4. Accessibility: Unlike medications, dietary changes do not require a prescription and can be a more cost-effective approach to managing health.

5. Treatment Length: 40 days of a low fat, low carb diet and healthy, Mediterranean style diet thereafter.

6. Personalization: With professional guidance, you can determine the foods that cause inflammation and weight gain and limit and avoid them to maintain weight.

Cons:

1. Requires Lifestyle Changes: Adhering to a 40 -day metabolic reset diet can be challenging, however it is temporary. To maintain the weight, a Mediterranean style diet that is personalized helps maintain the weight.

2. Time for Results: It takes about 30-40 days to reset the metabolism and weight loss can be dramatic within that time frame.

3. Temporary side effects: The first week while adjusting to the change in diet, people can experience headache, fatigue, muscle cramps and constipation that can easily be managed. 

Conclusion

In functional medicine, the choice between using GLP-1 inhibitors and implementing a metabolic reset diet—or combining both—depends on individual patient needs, preferences, and specific health conditions. GLP-1 inhibitors offer a powerful, albeit more expensive, tool for managing certain metabolic disorders with the convenience of medication. On the other hand, a metabolic reset diet provides a holistic, accessible approach to improving overall health in people who are willing to make a change for 40 days.

Ultimately, the best approach is one that is personalized, taking into consideration the patient’s unique health profile, lifestyle, and goals. Consulting with a functional medicine practitioner can help individuals navigate these options and develop a comprehensive plan that addresses the root causes of their health issues while promoting long-term wellness. Consider a Group Metabolic Reset that is more fun, supportive and cost effective or a more personalized individual Metabolic Reset. 

1. Drucker DJ. Mechanisms of Action and Therapeutic Application of Glucagon-like Peptide-1. Cell Metab. 2018;27(4):740-756. doi:10.1016/j.cmet.2018.03.001
2. Aldhaleei WA, Abegaz TM, Bhagavathula AS. Glucagon-like Peptide-1 Receptor Agonists Associated Gastrointestinal Adverse Events: A Cross-Sectional Analysis of the National Institutes of Health All of Us Cohort. Pharmaceuticals (Basel). 2024;17(2):199. doi:10.3390/ph17020199
3. American Diabetes Association Professional Practice Committee. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(Suppl 1):S125-S143. doi:10.2337/dc22-S009
4. Rubino D, Abrahamsson N, Davies M, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity. JAMA. 2021;325(14):1-12. doi:10.1001/jama.2021.3224
5. Marso SP, Daniels GH, Brown-Frandsen K, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2016;375(4):311-322. doi:10.1056/NEJMoa1603827
6. Filippatos TD, Panagiotopoulou TV, Elisaf MS. Adverse Effects of GLP-1 Receptor Agonists. Rev Diabet Stud. 2014;11(3):202-230. doi:10.1900/RDS.2014.11.202
7. Wilding JPH, Batterham RL, Davies M, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022;24(8):1553-1564. doi:10.1111/dom.14725
8. Pizzorno L. Jeffrey S. Bland, phd—The Disease Delusion: Conquering the Causes of Chronic Illness for a Healthier, Longer and Happier Life. Integr Med (Encinitas). 2014;13(5):52-56. Accessed March 9, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684103/
9. Gardner CD, Trepanowski JF, Del Gobbo LC, et al. Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial. JAMA. 2018;319(7):667-679. doi:10.1001/jama.2018.0245
10. Ludwig DS, Ebbeling CB. The Carbohydrate-Insulin Model of Obesity: Beyond ‘Calories In, Calories Out.’ JAMA Intern Med. 2018;178(8):1098-1103. doi:10.1001/jamainternmed.2018.2933