Today’s blog post is brought to you by one of our female customers who is struggling to lose extra flab around the belly. Sound familiar?
Well to make matters worse for this lady she has PCOS aka Poly Cystic Ovarian Syndrome. It’s a terrible cluster of issues leading to:
- irregular periods or none at all
- pimples
- hair loss on head/hair overgrowth on arms and body
- infertility
- high cholesterol
- diabetes
- weight gain
It’s thought to be a genetic problem in the ovaries and its tough as hell to fix.
One of the indirect ways of dealing with PCOS is losing weight which is the focus of today’s blog.
(Other treatment modalities include: metformin, contraceptive pills to rebalance hormones, hormone blockers like clomiphene)
Saxenda is the new kid on the block and is one of three main players. It’s a surprisingly empty field because like anything complex, there is no silver bullet. Diet and exercise help but if you want something more, read on…
Saxenda is a GLP-1 analogue (if you’re a nerd, search it up on Wikipedia) which basically slows down your stomach contents causing you to feel fuller for longer; it also acts at the brain level to alert you to feel that enough is enough; finally, it tells your pancreas to pump more insulin for each meal you have.
It’s an injection done to the thigh, abs or upper-arm ONCE per day (there’s actually another one on the market called Byetta but that’s twice daily with similar results). A pack will set you back $400-500/month (not on the
To be eligible for a script from your GP you have to have a BMI of 30+ (or 27 with diabetes, heart problems, and/or PCOS)
So how long does it take to work? Best results happen at the beginning thankfully…with most of the weight loss during the initial 20 weeks or 5 months. People tend to lose 5-10% of their starting weight.
If you haven’t lost at least 5% by week 12, then chances are it won’t work much further-stop and save your money.
Side effects include nausea and vomiting-50% of people experience this as mild to moderate in severity. In studies people actually have vomited-which ironically for the drug company…is probably a factor in helping with weight loss. Thankfully for us mere mortals it does improve with time. Other side effects can include: irritation, pain, bruising at the injection site. Other things like gall stones and allergies are quite rare.
Risk of pancreatitis (inflammation of pancreas) is very, very rare but hey we don’t know the complete picture because it’s a relatively new drug. There is concern that it may be associated with cancer of the pancreas. Watch this space.
Apart from the weight loss benefits, it also helps to reduce your chances of diabetes by reducing things like your HbA1c and your sugar spikes after a meal.
I hope this has been informative for our customer and for others like her who are going through PCOS which is a dreadful disease.
As always speak to doc about your personal situation.
Best
xoxo Vien
Just wondering why people lose the most in 5 months. Do they change their eating habits after that time so it doesn’t work as much? Why would people do it for 12 months if most of the change is in 5 months? Dependent on the answer ‘why’ I guess?
Hi Kim congrats on your journey thus far! If I recall
correctly you’ve lost 11kgs which is a 10% weight loss!
well done!
You asked a great question and unfortunately I haven’t
find the nitty gritty data to show when and where the
weight loss happens.
I can say from a quick look online that most people
tend to lost about 6-10% of the starting weight and
this is from trials ranging between 26 weeks to two
years.
So it would seem that once one has hit the 10% mark
that further losses reach a plataeu. So one would want
to weigh the benefits with the risk of side effects and
costs.
Take care, xoxo Vien.
Here are the data I came across:
2yr trial
Completers on liraglutide 2.4/3.0 mg (n=92) maintained
a 2-year weight loss of 7.8 kg from screening.
https://www.nature.com/ijo/journal/v36/n6/full/ijo20111
58a.html
56 week trial
From randomization to week 56, weight decreased an
additional mean 6.2% (s.d. 7.3) with liraglutide and
0.2% (s.d. 7.0) with placebo
https://www.nature.com/ijo/journal/v37/n11/abs/ijo20131
20a.html
56 week trial
Baseline weight was 105.7 kg with liraglutide (3.0-mg
dose), 105.8 kg with liraglutide (1.8-mg dose), and
106.5 kg with placebo. Weight loss was 6.0% (6.4 kg)
with liraglutide (3.0-mg dose), 4.7% (5.0 kg) with
liraglutide (1.8-mg dose), and 2.0% (2.2 kg) with
placebo
Weight loss of 5% or greater occurred in 54.3% with
liraglutide (3.0 mg) and 40.4% with liraglutide (1.8
mg) vs 21.4% with placebo
Weight loss greater than 10% occurred in 25.2% with
liraglutide (3.0 mg) and 15.9% with liraglutide (1.8
mg) vs 6.7% with placebo
https://jamanetwork.com/journals/jama/fullarticle/24289
56
26 week trial
weight losses (liraglutide −3·24 kg
http://www.sciencedirect.com/science/article/pii/S01406
73609606590
20 weeks+
weighted mean difference −2.9 kg,
http://www.bmj.com/content/344/bmj.d7771.short
I was very upset because of my day by day increasing belly fat but I now after reading this I am relaxed. Appreciate your efforts for writing this post.
Hey Phenq, it starts with having great allies on your side cheering for you. Find a fantastic doctor that will listen to your needs first. GL. Vien