Modern Metabolic Health with Dr. Lindsay Ogle, MD

How Wegovy And Zepbound Impact Hunger, Fullness, And Weight

• Lindsay Ogle, MD • Episode 13

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Check out YouTube for demonstration of how GLP-1 pens work: https://youtu.be/J4LzMNEzyTs?si=WPtv6s-iekjlkXfz


We explain how weekly injectables like Wegovy and Zepbound reduce hunger, increase fullness, and support weight maintenance while clarifying names, mechanisms, side effects, and safety. We share practical tips for easing GI symptoms, how pen injectors work, and the key thyroid cancer contraindication.

• why GLP-1 and GIP meds quiet food noise
• how fullness and slower gastric emptying aid portion control
• semaglutide and tirzepatide naming and approvals
• average weight loss outcomes and variability
• common GI side effects and simple mitigations
• ease of weekly pens and dosing clarity
• important contraindication for medullary thyroid cancer
• the role of lifestyle alongside medication

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Dr. Lindsay Ogle:

Welcome to the Modern Metabolic Health Podcast with your host, Dr. Lindsay Ogle, Board Certified Family Medicine and Obesity Medicine Physician. Here we learn how we can treat and prevent modern metabolic conditions such as diabetes, PCOS, fatty liver disease, metabolic syndrome, sleep apnea, and more. We focus on optimizing lifestyle while utilizing safe and effective medical treatment. Please remember that while I am a physician, I am not your physician. Everything discussed here is provided as general medical knowledge and not direct medical advice. Please talk to your doctor about what is best for you. Today I am going to continue my conversation about medications that we use for weight loss and weight maintenance. Last week we talked about some of the medications that have been around for a longer period of time. Those medications include fentermine, kusemia, contrave, and then a bonus medication metformin. And today we are going to talk about the newer medications that have gotten a lot of press recently, and for good reason. These are the injectable medications. The most common ones that are used right now are Weakovi and Zipbound. But the one that has been around longer is called Saxinda. And I will say the reason that Saxenda is not used as often. Really, two reasons. One, it's not as effective as Weakov or Zipbound, and two, it's a daily injectable, whereas the new options, Week O V and Zipbound, are weekly, so that is just much easier for patients to use and tolerate. So I'm really going to focus on the weekly injectables, Week OV and Zipbound. So why are these medications so effective? The reason that they are so much more effective than our other options is that they help with weight loss and weight maintenance through three mechanisms. The first is by decreasing the hunger hormones or blocking the hunger hormones that um reach the brain that tell us that we are hungry. And my patients who are on these medications, they really say that they no longer have what we call food noise. So they are no longer constantly thinking about how hungry they are or what they're gonna eat next or thinking about those foods that they crave or used to crave so often. In addition to blocking those hunger hormones and signals to the brain, these medications also impact how full we feel we feel, and so they help us feel full on less food and for a longer period of time. And the combination of the decreased hunger and the increased fullness really help with portion portion control, and that can help patients to be in a calorie deficit so that they're able to lose weight. They're able to really stick to that nutrition plan, that diet that they have created for themselves, whether that is with the help of their obesity medicine physician or a dietitian or a coach or just something that they know is a better fit for them than what they've been doing before, but haven't been able to stick with it because the hunger cravings were so strong, the medication helps offset that, and then they can just follow that plan and have that success moving forward. The third way that it helps with weight loss and weight maintenance is that it affects hormones and specifically insulin levels. So these medications started off as type 2 diabetes medications, and the names of those medications, um the original ones were trucity, the most common or the most popular version for diabetes right now is Ozimbic and Monjaro. Semaglutide is the active ingredient or the generic name of Ozimpic, and Ozimpic is the medication for type 2 diabetes, and sometimes people use that medication off label for weight maintenance, but the FDA approved version of semaglutide it for weight maintenance and weight loss is weak, and then the kind of next generation of that medication is trisepatide, and trisepatide is the active ingredient or the generic name, and then for type 2 diabetes, the brand name is Monjaro, and the FDA-approved version of trisepatide for weight loss and weight maintenance is ZeppBound. And for Recolvi, we see that on average, patients lose about 15 to 20 percent of their body weight, and then for Mongiaro, many patients lose 20 or more percent of their body weight. And again, these are averages, some people lose less, some people lose more, but that's what we tend to see on average. The side effects of these medications really relate to that fullness factor. So the way that it helps people feel full is that it slows the emptying of the stomach, and with that slowing, people may feel more nausea, more upset stomach, maybe increase acid reflux. Some people get constipation, some people get loose stools or diarrhea. This doesn't happen to everybody, but these are the most common side effects with these medications. Some ways to offset that. Um, I think it would be best to go over those in detail in a specific video, but quickly um making sure that you are staying very well hydrated, making sure that you are still eating when on these medications, so avoiding an empty stomach, making sure that you're getting enough protein when you're taking the medications, and then uh many of my patients say if they tend to inject in their thigh, they have less side effects, which I find really interesting. But many people have told me that um individually, so definitely something to try if you are having side effects with the medication. Other things that I hear while on the medication may be fatigue, um, hair loss, um, but those are really more a result of weight loss in general rather than the medication. And some people are intimidated with an injectable medication, but the truth is it's very, very easy to give yourself these injections. So I have these samples here, and this is actually a sample of Ozempic. Um, so the weigovi would look a little bit different, but um, I just want to show you how small the needle actually is. So it just goes right under the skin, it's nothing like um a shot or a vaccine, uh, it's very, very small, painless, um, and very easy to give yourself. Um, here is a sample of Monjaro, which again is a diabetes medication, but the um there's a version called Zipbound that is very similar to this. And the uh Weakov and Zipbound, they are um there's one dose of the medication per week in the pen. So you don't have to draw up medication and give it yourself. You know that you're getting the right dose with each injection. So, again, very very simple and straightforward to do. One very important uh contraindication or reason that you can't take these medications is if you have a family history of medullary thyroid cancer. And this type of thyroid cancer is pretty rare, but definitely worth asking your family members if anyone in the family has had thyroid cancer, but specifically medullary thyroid cancer. And there's a lot of misinformation out there about side effects of these medications and concerns. I would love to address those individually in a future video. Thank you for listening and learning how you can improve your metabolic health in this modern world. If you found this information helpful, please share with a friend, family member, or colleague. We need to do all we can to combat the dangerous misinformation that is out there. Please subscribe and write a review. This will help others find the podcast so they may also improve their metabolic health. I look forward to our conversation next week.