Every January, I am flooded with prospective new patients seeking help to reach their New Year’s weight loss goals. In general, my January weight-loss patients have more weight to lose than their midyear counterparts, so in this article, I would like to discuss weight loss specifically for those who have more than fifty pounds to lose or a BMI of 30 or higher and how they can best achieve that long-term goal based on what I am seeing in my practice.
The Trouble with Semaglutides
Drugs like Ozempic and other semaglutides are classified as GLP-1 receptor agonists and are currently being touted by conventional medical practitioners as the ultimate solution for weight loss, especially for those with a BMI of at least 30. But let’s talk frankly about the actions, benefits, and risks of taking semaglutides and some possible alternatives for anyone on the fence.
These drugs, classified as GLP-1 receptor agonists, were primarily designed and used for type 2 diabetes. A GLP-1 agonist is a substance that mimics the action of glucagon-like peptide 1 (GLP-1) in the body. GLP-1 is a hormone that helps regulate blood sugar levels, insulin production, and appetite. By acting as GLP-1 agonists, semaglutides help improve blood sugar control and can potentially protect against some of the complications of diabetes. And GLP-1 agonists have been found to promote weight loss.
In the weight loss world, semaglutides seem like miracle drugs. They “just work,” and they work fast. By stimulating insulin secretion after meals, increasing satiety, and slowing stomach emptying, Ozempic will help you feel full more quickly, and you won’t get hungry again nearly as fast. Appetite and temptations are so vastly reduced as to make “dieting” easy, and excess weight just falls right off without much effort. These drugs generally also improve blood sugar regulation, so they have quickly become the go-to for prescribing practitioners who treat overweight patients with diabetes. or prediabetes.
So, What’s Not to Love?
For starters, these drugs are associated with a long list of potential complications. Semaglutide use requires you to give yourself weekly injections, which carries its own risks, including potential reactions and injection site infections. It is also worth mentioning that any injectable carries an inherent risk of contamination.
Some people get what’s come to be known as “Ozempic face”—the telltale facial fat loss that gives a sunken look. Others experience “rebound weight gain” when they stop taking the drug, often gaining as much or more than they lost. They regain their appetite and revert to previous eating habits, having never addressed the underlying lifestyle factors that contributed to their original weight gain.
Common digestive complaints include nausea, vomiting, bloating, diarrhea, constipation, heartburn, reflux, and stomach pain. Less common but definitively correlated with semaglutides is a form of stomach paralysis and intestinal blockage. In addition, this class of drugs carries an increased risk of muscle loss, lowered bone density, and thyroid cancer. One of my patient’s friends, a young mother, was using Ozempic to lose weight and lost her life to an intestinal blockage. These risks should not be taken lightly.
Natural Alternatives to Simpler Weight Loss
If you have been reading my articles over time, you may have noticed that most reflect my focus on gut health, an anti-inflammatory diet and lifestyle, and modulating the microbiome with specific strains of probiotics to achieve specific health goals. This also applies to weight loss.
When the gut biome is disrupted, it can lead to weight gain and other health issues. Conversely, correcting the gut biome plays a significant role in weight management and overall health.
Specific probiotic strains have been studied for their potential role in promoting weight loss, and several strains have shown a high correlation with successful slimming (see the table). It is important to note that the effects of probiotics on weight loss can vary depending on individual factors such as diet, lifestyle, and the amount of inflammation in the body. In my practice, I typically address food sensitivities and lifestyle first as anti-inflammatory interventions to ensure a good foundation for losing weight and keeping it off.
| Phytonutrient with blood sugar regulating effects similar to GLP-1, promotes weight loss. | |
| Mineral that promotes insulin sensitivity and glucose metabolism to support weight loss. | |
| Improves insulin sensitivity and reduces blood sugar, beneficial for weight management. | |
| Contains catechins, shown to increase GLP-1 to enhance metabolism and break down of fat. | |
| Herb that helps regulate blood sugar and improves insulin sensitivity. | |
| Helps shift body composition toward fat loss, improves glucose metabolism, reduces inflammation. | |
| Associated with weight reduction, fat loss, and waist circumference. Reduces inflammation. | |
| Studies show it reduces abdominal fat and inflammation, and improves insulin sensitivity. | |
| Improves gut integrity, reduces inflammation, enhances insulin sensitivity, GLP-1 production. | |
Probiotic Strains and Natural Supplements That Promote Weight Loss
Once a stable foundation has been laid, it’s time to “prime” the organs of elimination to ensure weight loss that increases health and vitality in the process – a side benefit, if you will. I typically address the gut-brain and gut–liver axes by working with specific probiotic strains that have been studied for their potential role in promoting weight loss.
Several strains have shown a high correlation with successful slimming. The first two discussed here have been studied specifically for their effects on GLP-1 receptors. These are how we can naturally obtain the benefits of semaglutides without their very real risk profile.
- Akkermansia muciniphila helps shift body composition toward fat loss, improves glucose metabolism, and reduces inflammation. Akkermansia is specifically associated with improved gut barrier integrity and enhanced insulin sensitivity, which contributes to the regulation of GLP-1 production, like the action of semaglutides, but in a gentler way that complements natural function and enhances overall homeostasis.
- Lactobacillus gasseri has been shown to reduce abdominal fat and inflammation and improve insulin sensitivity in obese people by regulating GLP-1 levels, pointing to its potential for preventing and even treating type 2 diabetes.
The next two strains are also associated with fat loss but through slightly different mechanisms.
- Lactobacillus plantarum DR7 is associated with reduced body weight, fat percentage, and waist circumference in some studies. It was also found to modulate the serotonin and dopamine pathways in adults, reducing feelings of stress and anxiety and improving cognition and memory. These effects suggest that DR7 could be beneficial for mental health, and I have used it successfully to help patients manage emotional eating. The funny thing about this one is that it can be given as a postbiotic (killed, not live) and works just as well, or better than, the active bacteria.
- Bifidobacterium lactis BPL1 also helps shift the body composition toward fat loss, improves glucose metabolism, and reduces inflammation. The fat-reducing properties of BPL1 were attributed to its lipoteichoic acid, which acts through the IGF-1 pathway,* suggesting therapeutic use in metabolic syndrome and diabetes-related disorders.
There are also several natural supplements that have been studied specifically for their modulatory effects on GLP-1 expression and secretion and, therefore, their ability to enhance the effects of GLP-1 in the body. Let’s talk about some of them.
- Berberine is found in many plants, including European barberry, Oregon grape root, goldenseal, and goldthread. It is a phytonutrient with blood sugar-regulating effects similar to GLP-1 and promotes weight loss.
- Green tea contains catechins, shown to increase GLP-1 toward enhancing metabolism and the breakdown of fat, and can be especially effective when combined with L-carnitine.
- Chromium is an essential nutrient involved in the regulation of carbohydrate and lipid metabolism. It promotes insulin sensitivity and glucose metabolism and is commonly used by naturopaths for blood sugar regulation. It also supports weight loss. In addition to its effects on glucose, insulin, and lipid metabolism, chromium has been reported to increase lean body mass and decrease body fat percentage.
- Cinnamon is known to improve insulin sensitivity and reduce blood sugar, both beneficial actions for diabetes and weight management. Likewise, fenugreek is an herb that helps regulate blood sugar and improves insulin sensitivity.
A gut health specialist can help you determine which probiotic strains will work best for you. They can also help you pinpoint other herbal and nutritional supplements and target specific diet and lifestyle factors to safely enhance the GLP-1 effects you are looking for.
Although the actions of natural GLP-1 agonists are milder than their pharmaceutical counterparts and require a well-rounded approach, the holistic path avoids harmful side effects and holds the promise of improved health and wellness in the long run.
*IGF-1, or Insulin-like growth factor 1, is a hormone similar to insulin, plays an important role in childhood growth, and has anabolic effects in adults.
Dr. Dana Lapointe is a naturopathic physician, a certified mental wellness coach, and an avid organic gardener. Practicing in Connecticut since 2010, she also offers telemedicine, online coaching, and group wellness programs. She specializes in chronic conditions (especially those involving the gut, skin, weight, and pain syndromes), as well as mental wellness. She founded the Health Empowerment Access League (HEAL), a non-profit organization that aims to empower low-income homesteaders with health challenges by providing online health education and increasing access to effective, noninvasive, natural-care options. Call 860.217.1171.
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