On an almost daily basis we read about Ozempic (semaglutide), which was licenced for diabetics, then Wegovy (also semaglutide), which was licenced for weight loss, and now Mounjaro (tirzepatide).
These drugs cause weight loss by increased insulin levels, appetite suppression, and burning fat. In addition to lifestyle improvements in sleep, diet and exercising, they will play a long-term role in the future of anti-ageing medicine. They may work in anti-ageing by improving mitochondrial function and reducing oxidative stress.
So, what is Semaglutide?
Es un análogo del GLP (péptido similar al glucagón)-1, que actúa en los receptores del páncreas, el estómago, el intestino y el sistema nervioso.
El GLP-1 aumenta la insulina. La insulina permite a las células, incluidos los músculos y el hígado, absorber la glucosa y almacenarla en forma de glucógeno. El GLP-1 también inhibe la producción de la hormona antagonista de la insulina conocida como glucagón, que de otro modo provocaría la liberación de glucosa en el torrente sanguíneo.
El GLP-1 ralentiza el vaciado gástrico, por lo que se siente saciedad durante más tiempo. Esta es probablemente la causa principal de los efectos secundarios comunes de las náuseas y el estreñimiento. El GLP-1 también actúa a nivel central en el cerebro, indicándole que estamos saciados. Esto reduce el hambre y el apetito.
¿Qué es la Tirzepatida?
Además de actuar sobre los receptores del GLP-1, actúa sobre los receptores del GIP (polipéptido insulinotrópico dependiente de la glucosa). Estos receptores se encuentran en el páncreas, en las células grasas y en otras zonas del sistema nervioso.
Los efectos adicionales se deben a la quema de grasa conocida como lipólisis, incluso en los depósitos centrales de grasa como el hígado.
Actúa sobre los receptores de GLP-1 y GIP en el cerebro, aumentando aún más la supresión del apetito.
Reduce los niveles de colesterol.
Los efectos secundarios son mucho menos frecuentes que los del Ozempic.
Ozempic/ Wegovy vs Mounjaro
Ozempic can result in weight loss of around 15% of your body weight in 12 months. Mounjaro can result in up to 25%. With increasing availability in the UK, it is superior at reducing blood sugar levels and reducing weight.
The inevitable dietary restriction and the need for exercise focusing on increasing muscle mass as opposed to cardiovascular exercise alone will best augment the metabolic effects associated with these hormonal mechanisms.
Benefits:
Reduce weight and all the complications of obesity. Calorie restriction has been shown to combat ageing.
Improve insulin sensitivity preventing and treating conditions like fatty liver, type 2 diabetes and polycystic ovarian syndrome (PCOS).
Tirzepatide has been independently shown in studies to reduce cholesterol levels.
Semaglutide has been shown to reduce heart attacks and strokes independent of its weight loss properties. This might be due to a direct effect on the blood vessels.
There is interesting documentation of reduction in addictive behaviour including drugs, alcohol and gambling.
Protecting the nervous system: GLP-1RAs can help protect the nervous system, which can help with age-related cognitive decline and neurodegenerative diseases. There is an ongoing study at Imperial University. London looking at the effects of GLP-1 Analogues in Parkinson’s Disease.
Anti-inflammatory properties.
Possible reduction in collagen breakdown implicated in ageing.
We can see these drugs being used long term at low doses (perhaps microdoses). I would like to aim, after initial weight loss, towards long term maintenance keeping weight stable, however maintaining all the beneficial listed above.
Risks:
Gastrointestinal – nausea and constipation. Very little with tirzepatide.
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