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LAST UPDATE | 4 Mar
BARELY A WEEK goes by these days without headlines dedicated to the topic of weight loss drugs like Ozempic.
This week, Kathryn Thomas has explored the topic of the new ‘weight loss wonderdrugs’ in her new two-part documentary, The Skinny Jab Revolution on RTÉ.
It’s true, the understanding of obesity and the complex physiological and emotional underlying causes behind it is changing, and the latest drugs play just one part in moving us along to better health.
Those revolutionary obesity drugs like Ozempic and Wegovy have become widely available, albeit with restrictions on the Irish market. They work in the management of obesity as well as type 2 diabetes, and pre-diabetes combined with risk factors for heart disease.
While the hysteria over these drugs starts to abate and a more balanced approach to a lifetime response to obesity is beginning to emerge, the evidence suggests that these treatments, while transformative for some, are not the holy grail they first appeared.
At the same time, new products are appearing on the takeaway food market that show promising results in the ability to provide really healthy food, entirely devoid of ultra-processing that is both affordable, tasty and very very cool.
Has the prospect of a paradigmatic shift in the unhealthy food market finally arrived?
Many experts in this field are keen to enforce the message that patients must understand that they will need to accept they will be taking these drugs for life, not for a quick journey into weight loss.
One of the biggest challenges with semaglutide (Ozempic and Wegovy being the main brands) and the new wave of obesity drugs, such as tirzepatide (Mounjaro) and retatrutide, is the ‘rebound’ that occurs when patients come off the drug. There is some evidence that ‘weight cycling’ can occur — people go back to where they were before they started medication and further weight gain is accompanied by an accumulation of more fat and less muscle.
The long-lasting benefits of obesity treatment drugs against other chronic illnesses such as cardiovascular disease, and kidney disease, as well as the disruption of cravings for alcohol or opioids are also unclear. Preliminary animal studies suggest that cravings for addictive substances return when obesity treatments are stopped.
The effectiveness of obesity treatments also varies. While average weight loss with semaglutide and tirzepatide is between 15 and 20%, clinical trials show that a proportion of patients will lose less than 5% of their starting weight on semaglutide. Consultant endocrinologist at Galway University Hospital, Francis Finucane, suggests that about one in ten people do not lose any weight at all.
Even when patients continue to take obesity treatments, it appears from early data that most people hit a plateau at about 18 months after commencing treatment, when their metabolism compensates by slowing down and weight loss stops. The evidence suggests that the potency of the GLP-1 drugs wears off and patients may start to regain some weight while still taking the drug.
Finally, the issue of muscle loss while on obesity treatment is a concern. Recent evidence suggests that muscle mass reduction is a significant issue in some participants in clinical trials. This is important in patients as they age because maintaining muscle as well as bone strength is key to healthy ageing and maintaining independence into elder years.
So, obesity treatments are not the holy grail, or at least not yet.
What is urgently needed, in alignment with new wave obesity treatments is realignment with of the food market to ensure that healthy food is accessible and affordable.
Three key steps to make this aspiration vision a reality would include:
These steps are all under consideration, but robust policy is needed to push the food market away from highly processed takeaway food towards healthy sustainable food at an affordable price.
Against all the odds, one country seems to have achieved just that. A relatively new entry on the food scene that is causing a stir in Spain is Honest Greens – marketed as a ‘revolutionary healthy restaurant concept that claims to provide real food, lifestyle and technology.’
It all started with three people whose paths crossed in Spain. Christopher Fuchs from the US, Rasmus B from Denmark and Benjamin Bensoussan from France, all entrepreneurs and lovers of good food, were frustrated by their inability to find food that was healthy and delicious but also quick and affordable. They decided to set out on a journey to create it themselves.
The preparation took three years while they travelled the globe looking for design inspiration. Their diverse backgrounds, ranging from working in the kitchens of the best Michelin star restaurants, founding technology start-ups to working as waiters, all helped to shape the project.
The result is food prepared from scratch with fresh, responsible ingredients.
Fresh, locally sourced food is served in unique locations with warm atmosphere, good music, friendly staff and a welcoming community. Now, Honest Greens are all over Barcelona, Madrid, Valencia, London, Lisbon, Paris and Porto. They have yet to arrive in Ireland. There are a growing number of food outlets in Ireland already operating with similar approaches, offering affordable, organic and healthy takeaway food, and it’s a very positive and welcome change.
If all this healthy food talk sounds a bit aspirational, prepare to be amazed. Two of my adult children live in Spain and rave about the healthy takeaway options, for little more than the price of a Coke, cheeseburger and large fries. It is an unbeatable formula and one that I would love to see grow further in Ireland.
And it is possible. Since the introduction of the sugary drinks tax in 2018, the sugar content of soft drinks has dropped by about a third and the percentage of drinks falling into the sugar tax has plummeted. In other words, the sugar tax is incentivising the drinks’ industry to reformulate to healthier drinks with less sugar.
The same could happen with a tax on junk food. Ideally, a junk food tax could be used to subsidise the cost of healthier food options and support local producers to both grow and sell these items at affordable prices.
In fact, the supports for this concept of relying on local producers is already in place in Cork. The Cork Food Policy Group (CFPG), chaired by Janas Harrington, Senior Lecturer in the Department of Public Health, UCC is a partnership between representatives of the community, food retail, farming, restaurant/catering, environmental and health sectors as well as local authorities in Cork.
The CFPC aims to create an environment that has nourishing food for all while building a sustainable, resilient food system sourced from a thriving local and diverse food economy.
A key strategy to increase urban food growing include supports for small food producers to be able to access land near the city to grow their own food. All of this is neatly in alignment with the strategy of Honest Greens – supporting local producers to produce quality food within their local community.
The pathway to healthy, sustainable affordable food is here. Companies like Honest Greens are showing that there is a huge market for this kind of innovation once the product and price are right. In Cork, all the supports are already in place to allow an innovative, entrepreneurial foodie to turn this vision into a reality.
We’ve had enough of cheap junk food and relying on drug treatments as the answer to everything. Time to transform the market and people’s health by making healthy takeaway food affordable, accessible and cool.
Dr Catherine Conlon is a public health doctor and former director of human health and nutrition, safefood.
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I know people who used this as basically a quick fix… each to their own but what bothered me was that supplies were running low for people who were actually suffering with diabetes type 2. Two went on to have tummy tuck surgery. I don’t buy into this rhetoric that ‘oh processed foods are far more affordable for my family’. Complete nonsense… look in the frozen aisle of any supermarket and compare it to what you can buy for fresh fruit and veg, rice, pasta etc. Just laziness in my opinion (admittedly, I wouldn’t be the healthiest eater either). Justify spending €30 on a convenient takeaway then moan how you can’t afford basic healthy staples… give me strength.
@Donna Fallon: Exercise gives people a great appetite. The “more exercise” lobby is backed by government eat eat eat means vat vat vat. You can’t tax an empty plate.
@Donna Fallon: this is correct Donna. Also a lot of people use cocaine to stop eating which is more fun but dangerous of course.
@Basildon Joe: Funnily enough I was still obese when I was on coke. You can’t win lol
@thomas molloy: no vat on basic foods
@Donna Fallon: One 100% correct.
@thomas molloy: lol… my excuse is that the gym is too dangerous!!:)
@Fiona Wyse: I hope you’re talking about Coca Cola Fiona!!:)
@Basildon Joe: More fun?! Lol… sure you can’t really afford to eat anyway if you’re on the white!!
@Fiona Wyse: Should’ve tried E’s they’d knock the pounds off ya .
@Fiona Wyse: unlucky but no doubt you had some fun times
@Donna Fallon: Of course you don’t buy i to it, you don’t have to. You can afford to buy the healthy food.
Not everybody can!
@Seanie: Ironically enough the skinniest I ever was, was when I worked in McDonald’s and I was eating it every day!!! However the e definitely are one of the best appetite suppressants out there maybe I should just go back on drugs, like real drugs none of this glp1 nonsense!
@Donna Fallon: I don’t drink fizzy drinks lol! A genuinely don’t, I might have a can of Coke I’d say about twice a year as a treat.
@Basildon Joe: I absolutely did I thoroughly enjoyed my 20s, great times, great memories.
I think the many people who have transformed their lives, finally have control over their appetites, turned off food noise and are now fully sticking to a calorie deficit to loose and maintain weight loss will disagree with you on that one Catherine.
Only a person who doesn’t experience this, can loose weight relatively easy, will say eat less and move more. Your argument is flawed. If that worked the world could follow the same diet plan and then we would all be the same weight…..oh no wait….
@Fiona Wyse: Exactly! Same logic of telling people with depression to “just cheer up”!
@Rui Firmino: You don’t believe depression can be linked to poor dietary choices?
@Fiona Wyse: What if you can move a lot?
@Athena: you missed the point completely
@Fiona Wyse: if you asked 100% of adults who are obese if they exercise vigorously for 60 minutes a day with 130-170 BPM during that hour, they will say no. They don’t want to lose weight, nor do they care about their weight. If they did, they would simply exercise at very high intensity. Going for a walk isn’t going to burn much calories, or doing jumping jacks for 10 minutes. But these people will have an excuse for everything. Their hip, knee, joints, back, neck or toe is stopping them. Always something.
@Joe Willis: Well I’m obese and I have two half marathons under my belt so yeah I regularly do get my heart rate up! I have a bad back I have plantar fasciitis but I still get on with it so please don’t categorize me with your assumption of obese people!! Because I absolutely do not fit that narrative. Just did the Lusk four mile on Sunday as well. And I have a ticket for them full marathon in October, I hope you’re there to wish me good luck and get me over to finish line. You know us fat people need all the support that we can get……
@Joe Willis:
Another ignorant comment from you. Educate yourself on eating disorders, medical conditions that cause weight gain.
Kathryn Thomas looks like she could do with a good feed.
@Rian O’Callaghan: I was thinking more in line of spuds(with butter) fat bacon and green cabbage.
Honest Greens in Lisbon and Porto really does do fabulous food. It would be great to see it expand to Ireland.
Healthy Kitchen in Mullingar does excellent salads.
@Brendan O’Brien: My Goodness in Cork as well, excellent food. Greenes in Galway also a great shout.
@Brendan O’Brien: And the cost of the food?
Just put down the Pizza and go for a jog. Not difficult
@FoxyBoiiYT:
Stupid comment, there are many different reasons for people being overweight.
@Regular John: the thermodynamic laws of the universe are followed by every living thing on this planet. It’s physically impossible to gain weight if you eat less calories than you burn. You could eat 2,500 calories of McDonalds every day, burn 2,800, and you would lose weight. There is no debate against this it is like trying to have a debate on if gravity exists.
@Joe Willis:
You obviously have no idea what you are talking about if you think it is as simple as that.
While many could be healthier and do with losing a few pounds, the messaging around weight is so unhinged that it must be having an effect on people’s perception of what a bit of healthy progress looks like. How many cave in because they’re losing a decent amount of weight but aren’t looking ‘malnourished skinny’?
It was shocking to see several Americans (public + medical) tell Kathryn Thomas that she could do with losing weight last night. The fashion industry and celeb treadmill has an awful lot to answer for. Demanding a look that is simply unhealthy and not at all natural unless you are malnourished is perverse hateful stuff. There’s reaching a healthy weight and then there’s the promotion of a look that is simply unhealthy and downright nasty if you are expecting another human being to starve themselves for it.
@SerotoninWars: if someone gives up on losing weight, even thought it’s working, because they don’t look like someone on a Trocaire box, then there was never any hope for them in the first place.
My stack of pancakes nearly fell off my plate reading thus
I had a gastric sleeve done 6yrs ago, I only lost 25kg from it because I was unable to exercise, I’m in a wheelchair because I’ve got fibromyalgia, chronic osteoarthritis and lipedema which there is no cure for and it started when I was 10yrs old
I now have 10 tumours on my legs one measures 14″ x 10 I’m in agony 24/7 and have no relief I’d like to try the ozempic to see if it would help me. My son is on it for 5mths now and he has lost 32kg and he’s doing great I’d love to try if it meant I could have these tumours removed and get my knees and hips replaced I eat exactly 860 calories a day and I never cheat but my weight still goes up it’s a vicious circle
Really? seems like it is the holy grail tbh, I’m sure you’ve found a hair in the soup tho lol. As we do.
Who said it was (headline)?
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