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Dr Sohaib Imtiaz our Clinical Lead and Board certified Lifestyle Medicine Doctor went live with our community. Here are some of the questions we were asked. 
As the landscape of weight management medications evolves, questions arise about specific drugs, their effectiveness, and potential side effects. Today, we'll delve into some common queries surrounding GLP-1 medications.

1. Will there be shortages of Mounjaro like we had with Ozempic/Wegovy?

Supply chain disruptions can happen with any medication, but it's essential to stay informed about potential shortages. If we do run out of stock we will do our best to inform you in advance. The good news is that you can stay in the same dose as long as you don’t stop for more than 2 months. We will aim to communicate with you if we expect shortages. 

2. Can you get GLP-1 medications if you’re at a healthy BMI now but have used GLP medications before in the past?

While BMI is a factor, individual health conditions and medical history play crucial roles in determining medication suitability. If you have been on medication we recognise the importance for weight maintenance. If you have been on the medication and you can show us evidence in the last 2 months we can continue it for you at the same dose. If you have been on medication recently but beyond 2 months we may have to start at the lowest dose depending on how long has elapsed since you started treatment. 

3. Can I use this medication if I have gall bladder problems? 

It can be used with precaution and our team will contact you to discuss the details and why you may need some additional monitoring as well as informing your doctor. 

4. I’ve had a gastric sleeve and put weight on, but I’m struggling to eat my protein/calories. What do you suggest I do? Should I change from Wegovy to Mounjaro? Is that better?

Managing weight after bariatric surgery can be challenging. It's crucial to work closely with your healthcare provider and possibly a registered dietitian to optimise your nutrition. For protein intake trying protein drinks can help get the adequate protein required. 
New research has found that glucagon-like peptide-1 (GLP-1) receptor antagonist drugs may improve outcomes in individuals who underwent bariatric surgery but didn’t achieve their metabolic and weight loss goals within a year after the procedure.
You can be on either Wegovy or Mounjaro. 

5. Do you gain all the weight back after you come off?

Weight management is a complex process influenced by various factors, including lifestyle, diet, and genetics. While discontinuing medication may result in some weight regain, adopting sustainable lifestyle changes can help maintain weight loss achievements. Many patients gain 2/3 of their weight back if they haven’t made the lifestyle changes and therefore we want to equip you to sustain weight loss. The data shows that if you can maintain your weight for 2 years you are less likely to gain the weight back. 

6. What do you think people should avoid while being on GLP-1?

Avoiding excessive alcohol consumption and certain high-fat foods may help manage potential gastrointestinal side effects.

7. Why do GLP-1s increase fertility?

Weight loss and return to a normal body mass index increases the likelihood of cycle regularity and, as a result, the likelihood of conception. 

Many women who are overweight or obese do not ovulate regularly. Their menstrual cycles become more regular with weight loss due to improved pulsatility from the hypothalamic-pituitary axis, a system that regulates stress response. With improved pulsatility, there is the better release of gonadotropin-releasing hormone, which stimulates the release of follicle-stimulating hormone and luteinizing hormone, both of which are essential for follicle recruitment and ovulation. GLP 1s have the potential to impact the absorption of oral medications due to delayed gastric emptying. The patients on oral hormonal contraceptives are advised to switch to a non-oral contraceptive method or add a barrier method of contraception for four weeks after starting the drug or increasing the dose. We recommend stopping the drug 2 months before you get pregnant. 

 

In conclusion, GLP-1 medications offer promising options for promoting weight loss, but individual considerations are paramount in determining their suitability and optimising outcomes. Stay informed, stay proactive, and prioritise your health journey. We loved answering your questions and will be hosting further sessions to take more questions. 
Stay tuned! 

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