New Peptides for Insulin Sensitivity
In our series of VitaLifeMD blogs focusing on health span and “anti-aging,” we started talking about the importance of maintaining a good weight as we get older in order to avoid the health risks linked to insulin resistance and/or leptin resistance. We reviewed some lifestyle modifications that can help optimize metabolic functions.
This month we will address the role of your providers to help you achieve your goal, with a particular focus on some new peptides that positively impact insulin sensitivity and satiety, and we will present some of our success stories.
We addressed last month the two major metabolic issues that make us put weight on as we get older: insulin and leptin resistance.
Several injectable medications called “glucagon-like peptides” have been put on the market for chronic weight management as an adjunct to a reduced-calorie diet. These products bind to some receptors in our body and mimic the action of the natural glucagon, a hormone that is produced in our body to reduce hunger by improving both insulin and leptin sensitivity.
The first line of products was injected on a daily regimen. Although they were helping somewhat for weight loss, they had several side effects; most patients could not use them for very long.
The use of the new generations of these products has improved a lot once they became weekly subcutaneous injections and presented less side effects. The dosage will increase progressively and may vary depending on each patient’s needs. Your provider will guide you through the process.
The first product that we will mention here is Semaglutide
How does Semaglutide work?
Semaglutide works at the level of one kind of glucagon receptors called GLP-1 (glucagon like peptide-1) receptors. These receptors are expressed in pancreatic beta-cells, the gastrointestinal tract, and neurons throughout both the central and peripheral nervous systems. The Semaglutide molecule activates these GLP -1 receptors with the following beneficial effects:
It improves glucose control by enhancing insulin secretion from the pancreas. and it blocks glucagon, a hormone that increases blood sugar levels. As a result, your blood sugar levels are controlled, especially after a meal.
Insulin sensitivity is improved which supports energy expenditure in the muscles.
It delays gastric transit and patients feel “full” longer.
It reduces body weight by activating anorexigenic pathways in the brain with considerably helps with appetite control.
Semaglutide is a great product and many patients who take this peptide have been very successful with their weight loss program. It can cause a few side effects, mostly digestive issues such as nausea, constipation, or diarrhea. These side effects are usually mild; however, some patients might experience them more than others.
A VitaLifeMD success story of Semaglutide:
NM, 59-year-old female: Had chronic weight issues in past 10 years, was not able to lose weight or experiencing fluctuations of a few pounds. Had some injuries and was inactive for a few months in 2020. Put more weight on and reached her maximum weight of 202lbs with 49.9% of body fat in May 2021. Had chronic inflammation and pain “everywhere in her body.” Was told by her primary care physician that she needed to have gastric bypass. She then enrolled in our VitaLifeMD program using Semaglutide and a few other products to support insulin sensitivity and boost metabolic functions. She is now at 135lbs. Her energy is back. She changed her diet drastically and does not eat sugar at night the way she used to, exercises daily and her pain and aches have almost subsided.
We all know that, as always in medicine, research continuously brings new products that have even better efficacy and less side effects. This is the case for this family of the glucagon-like peptides.
How does Tirzepatide work?
In addition to its action on the GLP-1 receptors similarly to Semaglutide, Tirzepatide also works on a different kind of receptor called The GIP receptors (glucose-dependent insulinotropic polypeptide) receptors. These receptors are expressed in pancreatic beta-cells, they are specifically abundant in the adipose tissue, and found in areas of the central nervous system different from the previous receptors to GPL-1. Tirzepatide activates the GIP receptors with the following beneficial effects:
It regulates glucose uptake at the intestine lining.
It activates lipolysis (burning fat) and reduces ectopic fat deposition especially in the visceral area. It decreases the risk of fatty liver.
It stimulates in the brain chemicals that decrease appetite but at different neurons from the ones with GLP-1 receptors. This enhances the action of appetite reduction.
It reduces cholesterol levels.
These combined effects result in significant weight reduction. An overwhelming body of clinical evidence suggests that Tirzepatide is superior to Semaglutide with regards to improving blood sugar levels and reducing body weight.
Another benefit of Tirzepatide resides in the fact that its side effects (same digestive issues than with Semaglutide) are very uncommon and usually milder than with Semaglutide.
A VitaLifeMD success story of Tirzepatide:
CL, 43-year-old male: Had put weight on, had fallen into poor lifestyle habits and was sedentary. Weight went up to 199.3lbs. Body fat was 26.9%, and he needed to lose 30lbs. CL Enrolled in our program and start first with Semaglutide in June 2022 before switching to Tirzepatide in September 2022, as he had reached a plateau on the first medication. He is now 161.9lbs with 11.9% of body fat.
When contacted recently after running several Ironman races, CL wrote:
“I’ve lost 35+ Pounds and 15% less Body Fat in 5 months 💪🏻💪🏻 And best part is I actually “Gained Muscle mass”. My Goal is 10% Body Fat. I’m at 11.9% now. So happy, running 7 minute per mile now 🎉🎉 Swam a Full Distance (2.4 miles) time trial in under 1 hour and 10min a few days ago too!! So happy!”
At VitaLifeMD, we have had many success stories of weight loss over the past few years by prescribing these new products to our patients. What is very important to keep in mind is that prescribing the products without any nutrition, lifestyle and behavior modification recommendations might work for the short term but will not last overtime. A lot of patients ask us questions about this, often after reading cases they have seen online where the subject had failed to keep the weight down.
Our clinic offers a full weight management and weight maintenance program that will assure success on the long term. We do not “just prescribe” the products, as it is done sometimes elsewhere, without any support and follow-up. Most of our patients lose and keep the weight down for months or years after they reach their goals. Of course, there will be events in life that Dr. Dominique Fradin-Read calls “at weight gain risk” such as Christmas, Thanksgiving, birthdays, anniversaries. If the weight starts to go up this will be the time to ring the bell and come for a little “booster/refresher” to get a few pounds down before the weight gets too high.
Some patients are afraid that they would lose muscle mass. Again, if the correct recommendations are given with the nutrition plan adapted to each case this will not happen. In our last newsletter we addressed the importance of adding more protein to the diet and this will be a crucial point if patient want to preserve their muscle mass at a good place while losing weight.
What is coming in research for these Glucagon-like Peptides in the future?
Not only do we have a few new molecules in trials with even better weight loss potential, but these peptides might also exert a beneficial effect on the cognitive impairment induced by insulin resistance and obesity, improving learning and memory by modulating the plasticity of the brain cells. Moreover, some of these peptides reduced hippocampal neurodegeneration, and there is growing evidence on neuroprotective effects of these agonists in animal models of neurodegenerative diseases such as Parkinson and Alzheimers, regardless of diabetes.
In Parkinson’s disease animal models, the peptides were able to protect motor activity and dopaminergic neurons, whereas in Alzheimer’s disease animal models, these molecules seemed to improve nearly all neuropathological features and cognitive functions. Although further clinical studies in humans are needed, they seem to be a promising therapy for neurodegenerative diseases and cognitive decline.
Contact our office to become a VitaLifeMD weight loss and nutrition program patient.