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  #1   ^
Old Sun, Feb-18-24, 01:56
Demi's Avatar
Demi Demi is offline
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Plan: Muscle Centric
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Default Weight-loss injections are running low. Enter the world’s biggest drug firm

Quote:
Weight-loss injections are running low. Enter the world’s biggest drug firm

Eli Lilly’s Mounjaro is entering the market amid shortages of Wegovy and Ozempic


A race is under way to conquer the lucrative slimming jab market, after the world’s biggest drug company launched a new weight-loss drug in Britain.

Eli Lilly’s new treatment Mounjaro arrived in pharmacies on Thursday, providing the first competition to Novo Nordisk’s Wegovy, which has been subject to runaway demand since it was launched last September.

Novo Nordisk, which is based in Denmark, last year saw its pretax profits soar 52 per cent on the back of sales of Wegovy and its associated diabetes treatment, Ozempic. But it has struggled to meet demand, despite scrambling to invest in new manufacturing plants, and many patients have been unable to secure stocks.

There are already signs that patients are turning away from the Danish drugs in favour of Eli Lilly’s alternative. Analysts said Eli Lilly, which is far bigger than Novo Nordisk, is in a strong position to use its manufacturing strength to flood the market.

Interest in Wegovy has been inflated by use by celebrities such as Oprah Winfrey, Sharon Osbourne and Elon Musk. But a Novo Nordisk spokeswoman said: “With over 800 million people living with obesity worldwide, we simply cannot meet the demand for those that meet the approved criteria for usage.”

Eli Lilly, which is based in the US, put its stock on sale at private pharmacies in the UK for the first time last week, including at high street chemist Superdrug, where the jabs are available for £215 for a four-week course. The treatment is similar to Wegovy — they are both GLP-1 agonists, which mimic the hormone released by the stomach when it becomes full.

Pharmacist Sharn Dev, who runs a weight loss clinic in Epsom, Surrey, has been so worried about uncertain supplies of Wegovy that he has put patients on lower doses. He checks stock of Wegovy on a wholesaler’s website every night after closing his clinic to try to find more, but is often disappointed.

He said the arrival of Mounjaro is a relief. “It sounds like there will be less of a supply issue with them. It will take pressure off. It will give us more flexibility and certainty.”

The online weight-loss company Juniper, which has already provided Wegovy to 13,000 patients — with a combined weight loss of 85,000kg — said 30 per cent of its patients have expressed an interest in switching to Mounjaro. Rebecca Holdt, its head of the UK operation, said: “We think we will be able to bring on thousands more patients every month with Mounjaro now available.”

Holdt said that the drugs are not a holy grail and can come with severe side-effects. “One of the main reasons we designed our programme the way we did is that we see 20 per cent of the weight loss on these drugs can actually be muscle. That can be dangerous if a woman is going through menopause, for example, and losing bone density and muscle mass. Going into later life it is really important that you maximise the fat you’re losing but retain your lean muscle.”

Others have warned that when people stop taking the drugs, they often put the weight back on.

Deidre White, 70, a retired library clerk from Surrey, started taking Wegovy last year, paying £280 a month, and has lost more than three stone. “I just feel so well using it. It seems to take away all those awkward cravings,” she said. “It took away the urge to nibble at things, which, if you are in the house all day, can overtake you every time you go into the kitchen to grab a piece of cheese.”

The demand for Wegovy has been so high in the UK that many patients have turned to the Novo Nordisk diabetes treatment Ozempic, which contains the same active ingredient — semaglutide — but at a different dose. The company says the two treatments should not be interchanged, but that has not stopped slimmers snapping up doses. In July, the NHS issued a national patient safety alert warning of the shortage of Ozempic, with some diabetes patients switched to insulin because supplies could not be guaranteed.

Both Novo Nordisk drugs are available on the NHS and privately. The Eli Lilly drug is now available for type 2 diabetes on the NHS, but is only available for weight loss privately. It is currently being assessed for weight-loss use on the NHS by the health watchdog Nice. All require a doctor’s prescription.

Eli Lilly is the world’s most valuable drug company, around 25 per cent bigger than Novo Nordisk. It has ploughed investment into beefing up its manufacturing in preparation for the launch of Mounjaro — with production of the drug centred at its plant in North Carolina, and new facilities planned elsewhere in the US, as well as Germany and Ireland.

Novo Nordisk, which first started making insulin 100 years ago, saw its pre-tax profits jump to £12 billion last year on the back of its sales of Wegovy and Ozempic. In September it became the largest company in Europe by stock market value, a figure that made it worth more than the entire output of the Danish economy.

A Novo Nordisk spokeswoman said the company is prioritising supply of Wegovy for NHS patients but added: “We expect private market supply to be constrained for the foreseeable future” and that shortages of Ozempic for diabetes patients will “continue in the UK throughout 2024”.

She added: “We are taking significant steps to scale up our manufacturing to better meet the high demand, with factories running 24 hours a day, seven days a week. Last year, we announced investments totalling more than DKK 75 billion [£8.6 billion] in the expansion of our production sites to increase supply, both short and long-term.”

Eli Lilly said it had assessed its manufacturing capacity before it launched the drug, “considering many factors including demand and competitive supply” and is planning to “significantly expand manufacturing over the coming years, helping us to achieve our goal to supply the long-term global demand we expect”.

Analysts said by the time Novo Nordisk has sorted out its manufacturing problems it may have lost its leading position. Martin Hall, a pharmaceutical analyst at the investment adviser Hardman, said: “There is room for Nordisk to continue growing, it will just be limited by its ability to supply the market, which basically leaves the door wide open for Lilly.”

https://www.thetimes.co.uk/article/...-firm-80crw36r2
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  #2   ^
Old Sun, Feb-18-24, 06:44
JEY100's Avatar
JEY100 JEY100 is online now
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Plan: P:E/DDF
Stats: 225/150/169 Female 5' 9"
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Quote:
Holdt said that the drugs are not a holy grail and can come with severe side-effects. “One of the main reasons we designed our programme the way we did is that we see 20 per cent of the weight loss on these drugs can actually be muscle. That can be dangerous if a woman is going through menopause, for example, and losing bone density and muscle mass. Going into later life it is really important that you maximise the fat you’re losing but retain your lean muscle.”


I have read muscle loss is much more than 20%, but kudos to her for admitting one of the dangerous side effects!

Quote:
Muscle loss
Weight loss (~16%) in adults and adolescents over 68 weeks, consisted of an almost equal amount of loss in muscle mass, which some doctors say is “alarming.”
The problem is two-fold. First, muscle is essential for metabolic function. Skeletal muscle is mainly where your body processes sugar, so you don’t want to reduce that metabolic ‘sink’. Second, when the person stops the drug and their weight rebounds, they only regain fat (not muscle), leaving them with a net muscle loss.
In the end, the person is metabolically ‘fatter,’ or sometimes referred to as “skinny fat” – a phenomenon where you have increased visceral fat, but little muscle mass so you are ‘normal’ weight, but metabolically unhealthy.

From MaryAnn Demasi
https://forum.lowcarber.org/showpos...83&postcount=64

Last edited by JEY100 : Sun, Feb-18-24 at 07:11.
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  #3   ^
Old Mon, Feb-19-24, 14:19
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GRB5111 GRB5111 is offline
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Plan: Very LC, Higher Protein
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Agree that muscle wasting and loss are common and not often noticed at the beginning by the patients. I'm sure this piece of information is being rigorously suppressed by the industry that controls a larger portion of our economy. Their tentacles run long and deep. Unfortunately, when those patients look in a mirror after a few weeks, it's hard to convince them of negatives unless they're the ones with severe side effects.
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  #4   ^
Old Tue, Feb-20-24, 03:52
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Demi Demi is offline
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Plan: Muscle Centric
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From today's Times:

Quote:
How to combat the downside of rapid weight loss ‘miracle’ drugs

If you shed pounds too fast, you risk losing muscle mass — the experts tell Peta Bee ways to avoid the problem


There’s a price to pay for every drastic approach to dieting, and the “miracle” weight-loss drug semaglutide — known by the brand names Wegovy and Ozempic — is no exception. Administered weekly with an injection pen similar to an EpiPen into the thigh, arm or stomach, it works by mimicking the hormone glucagon-like peptide-1 (GLP-1) and helps to control blood sugar levels while slowing down stomach emptying, suppressing appetite and, anecdotally, even dulling the appeal of alcohol.

It’s an open secret that semaglutide is behind the red-carpet svelteness of many A-listers, but not all the publicity surrounding the drug has been positive. It has been associated with what has been nicknamed “Ozempic face” (the gaunt, deflated appearance caused by a rapid loss of facial volume) and “Ozempic butt” (loose, sagging skin on the buttocks). Clinical trials of semaglutide have found unwanted side-effects to include constipation, nausea, vomiting, headaches and diarrhoea, while some studies, including a paper in The New England Journal of Medicine and another in the Journal of the Endocrine Society, have highlighted possible long-term health risks related to muscle wastage and thinner bones.

Roy Taylor, professor of medicine and metabolism at Newcastle University, has studied the effects of very low calorie diets in people with type 2 diabetes. He says that some muscle loss is inevitable when overweight people shed pounds very quickly. If calorie intake is slashed so that you burn more energy than you consume, the body attempts self-preservation by breaking lean muscle tissue as well as fat to survive. “When a very overweight or obese person loses excess weight very quickly, most of it will be body fat but some of it will be muscle,” Taylor says. “It’s not necessarily alarming as these previously obese people gradually need less muscle to support the weight of their body in everyday activities and the positive outcomes for their metabolic health are more important.”

Use of the drugs is much more concerning in people who have only moderate amounts of weight to lose, according to Dr Duane Mellor, a dietician and senior teaching fellow at the Aston Research Centre for Health in Ageing in Birmingham. Because they have less body fat to spare in the first place, muscle loss is relatively more pronounced unless they take precautions to stem the decline. “Sarcopenia, the natural loss of muscle from the body as we age, hits hard from our forties and fifties onwards,” Mellor says. “Drastic weight loss from any type of extreme dietary approach can exacerbate this unless you counter it with adequate protein intakes and resistance exercise.”

A recent report in Men’s Health magazine described a worrying new trend for men taking semaglutide and testosterone jabs simultaneously to lose fat and build muscle in a bid to look lean and shredded. Mellor says that it’s most risky when the drugs are used inappropriately and without adequate guidance from a medical professional.

Neglecting muscle health can have catastrophic repercussions, particularly as we get older. It is now known that the state of our muscles influences not only our metabolism and fat-burning ability, but the efficiency with which our bodies control blood sugar and offset conditions including type 2 diabetes, cardiovascular disease and strokes. Then there’s the effect on bones. A peculiar quirk of obesity is that by hauling around a heavy body we are loading our skeleton in a beneficial way. “When weight is shed rapidly, there is also usually a corresponding decrease in bone density,” Mellor says. “That predisposes people to a greater risk of osteoporosis and fractures.”

As yet, scientists are unsure whether it is extreme dieting or the weight-loss injectables themselves that are responsible for muscle wastage. Studies in journals including Current Diabetes Reviews have identified loss of lean muscle tissue as a side-effect of the drugs. Meanwhile, in The New England Journal of Medicine’s study, which involved 1,961 obese adults, almost 40 per cent of the weight some people lost came from lean mass, which includes some muscle alongside bone and organ tissue. In the same study, a sub-group of 140 obese adults in their fifties suggested they shed about 15 pounds of lean tissue and 23 pounds of fat during the 68-week trial. However, other researchers have suggested that semaglutide has no effect, with one study in the journal Frontiers in Endocrinology last year suggesting it preserved lean mass and muscles. “Drugs like semaglutide might have some additional effect on accelerating muscle loss but the jury is still out,” Taylor says. “More qualitative studies are needed to know about the full effects.”

There’s no doubt, however, that semaglutide works when prescribed for medical reasons. The New England Journal of Medicine’s study showed that people using the weight-loss drug lost 14.9 per cent of their starting body weight over 68 weeks compared with a 2.4 per cent weight loss for a group receiving placebo injections.

Despite public perception, neither Wegovy nor Ozempic is marketed as a slimming aid for the masses. Ozempic is recommended by the National Institute for Health and Care Excellence only for the treatment of type 2 diabetes and Wegovy for the treatment of high blood pressure, type 2 diabetes, heart issues or a body mass index near the top of the obese range. But some private medical clinics do offer semaglutide jabs as a slimming aid, and monthly dose injection pens can be bought online for less than £200.

Dalton Wong, founder of TwentyTwo Training, says he works with an increasing number of clients to help them keep muscles strong after they have been prescribed semaglutide for medical reasons. “Because the drugs kill the appetite and people are not eating much, their energy levels are low, which makes gym work and training difficult,” he says. “We cut workouts in half from 60 to 30 minutes’ duration, focus only on strength and steer away from cardio activity, which will accelerate weight loss.” His concern is that when clients lose too much muscle mass in their forties and fifties because of Wegovy-related weight loss, it may be irreversible. Still, he says, he sees people who have obtained the drugs privately. His message is that dramatic weight loss comes at a cost. “As we age and lose muscle mass it is incredibly difficult to put it back on. I tell my clients that if they take Wegovy and don’t really need it, there will always be a trade-off.”

The three rules of preserving muscle health

1. Get enough sleep

Sleep plays a vital role in preserving muscle mass. A study of 19,770 adults published last year in the journal BMC Public Health found that muscle mass dropped and fat mass increased when sleep duration and quality deteriorated. “Ideally you should aim for seven to nine hours’ sleep a night, but generally not getting too little or too much is beneficial for bones and muscle,” Wong says. “Your muscles recover and build at night so sleep is essential for repair and strength.”

2. Eat proportionately more protein
Eating more of anything seems to defeat the object of dieting, but you will need to proportionately increase your protein intake in conjunction with resistance training. UK government guidelines suggest that you need roughly 0.75g of protein daily per kilogram of bodyweight, which equates to 47-63g, or 2-3 palm-sized portions, for an adult weighing 63kg (about 10st).

However, research from McMaster University in Ontario has shown that intakes of up to 1.6g per kg for an active person are needed to support muscle health from middle age onwards. “A relatively higher protein intake in the form of healthy foods such as eggs and yoghurt will support muscle maintenance,” Wong says.

3. Do some form of resistance exercise
Weights are gold standard but any sort of resistance training will be beneficial, from bands to body-weight training. “The aim is to prevent your body from using at least some of its lean tissue by maintaining decent levels of muscle mass,” Wong says. “Focus on using the body’s largest muscle groups for biggest effect — so deadlifts, squats and lunges — and do them several times every week.”

https://www.thetimes.co.uk/article/...drugs-832w0mpk5
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  #5   ^
Old Tue, Feb-20-24, 05:27
JEY100's Avatar
JEY100 JEY100 is online now
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Plan: P:E/DDF
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Cut workouts and get more sleep?!? Even 1.6 g Protein per kg is low!
Ridiculous advice especially for a menopausal woman who has already lost muscle, which in turn reduces the tension on bones, and its strength. Some squats a few times a week is not going to reverse muscle loss!

I am trying to rebuild the muscle lost last summer after injuring my back on a crunch machine in the gym… so know how hard it is!
Demi's has a great program in her journal, weekly body weight and machine lifting, daily cardio, etc. and a healthy nutrient dense diet.

Last edited by JEY100 : Tue, Feb-20-24 at 06:12.
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  #6   ^
Old Tue, Feb-20-24, 16:06
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GRB5111 GRB5111 is offline
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Plan: Very LC, Higher Protein
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Quote:
“As yet, scientists are unsure whether it is extreme dieting or the weight-loss injectables themselves that are responsible for muscle wastage. Studies in journals including Current Diabetes Reviews have identified loss of lean muscle tissue as a side-effect of the drugs.”

Probably one of the most meaningless comments I’ve read in a long time. Equivalent to “It wasn’t drinking the whole liter of whisky that killed the alcoholic, it was the concussion suffered resulting from the subsequent fall.” The potential damage from taking these drugs has yet to be tallied. I’m convinced there’s a much better way, but the seduction of achieving rapid weight loss and the massive profits to be made obscure clear thinking.
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  #7   ^
Old Tue, Feb-20-24, 23:01
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deirdra deirdra is offline
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I doubt that people who think a miracle drug will solve all their problems would prioritize protein, but that is the least they should do. I suspect they are eating their junky favourites, instead, when they do feel like eating. Or things like saltines if they are nauseous.
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Old Wed, Feb-21-24, 07:34
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Calianna Calianna is offline
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Quote:
Originally Posted by deirdra
I doubt that people who think a miracle drug will solve all their problems would prioritize protein, but that is the least they should do. I suspect they are eating their junky favourites, instead, when they do feel like eating. Or things like saltines if they are nauseous.


The saltines when they're feeling nauseous is true.

Once the nausea passes, some of them do actually try to make sure they get enough protein.

Although given their diminished appetites and the fact that no food is off-limits (although the drug itself makes it very difficult to digest more than minimal fats), I can't imagine they're getting anywhere near enough protein.

What seems to happen is if they're eating a sandwich (made with 2 big thick slices of bread) and it has a meat and/or cheese filling, they'll only be able to eat half the sandwich before being too full to eat any more. They don't ditch the bread (or even half the bread) so they have room in their stomach for all the protein, they just eat half the sandwich. Even if that sandwich had a LOT of meat/cheese in it (and it's highly unlikely there's even 4-6 oz combined in it), they're only getting half the protein from that sandwich, because once they're full, they can't stomach the idea of another bite, even if it is much needed protein.

The same thing would happen if they were eating something like an Asian chicken stir fry - they'd have the full serving on their plate on a bed of rice, but you don't normally pick out the pieces of chicken to eat first since the attraction to it is the combination of ingredients and flavors. So they'd just eat it like they normally would, and stop when they were full, which would probably be at about the halfway mark, meaning they'd still only consume half the protein.

In a situation where they really, really need all the protein they can get to help prevent muscle loss, even if they're actively trying to make sure they get enough protein, the concept that they can eat anything they want (but can only manage half the serving), it's automatically cutting down on the protein.

It's going to be like that with any food - unless they intentionally pull the protein out of the meal and eat that, they're not going to get anywhere near enough protein.

Exercise helps with retaining muscle, but feeling like you have an over-full stomach on half your usual food, while not getting nearly enough protein to help preserve muscle, it can be very difficult to exercise - especially if they're going through a bout of nausea from the drug.
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