Gastro weight


Roundup: Weight-Loss Drugs Linked to Serious Gastro Problems; Effects of Diabetes Diagnoses at Ages 30 to 50; and More News

Popular Weight-Loss Drugs Can Produce Serious Gastrointestinal Conditions, Finds New Study

Demand is still surging for medications known as GLP-1 agonists -- including brands such as Wegovy, Ozempic, Rybelsus and Saxenda – that are primarily meant for blood sugar control and to help diabetics lose weight. But these medications also raise risks of serious gastrointestinal problems.

In recent years, these drugs have become the subject of controversy since they’ve gone viral on social media as a weight-loss solution – even for those who do not have diabetes.

A major new study, published in JAMA, is the first to examine adverse gastrointestinal conditions in non-diabetic patients using the drugs specifically for weight loss. (These are prescribed medications. Consult your physician about any possible side effects.)

Researchers with the University of British Columbia (UBC) examined health insurance claim records for about 16 million U.S. patients, and focused on those prescribed either semaglutide or liraglutide, two main GLP-1 agonists, between 2006 and 2020. They included patients with a recent history of obesity, and excluded those with diabetes, or those who had been prescribed another anti-diabetic drug.

They evaluated records to determine how many patients developed one of four gastrointestinal conditions, and they compared that rate to patients using another weight-loss drug, bupropion-naltrexone.

According to the UBC researchers: Compared to bupropion-naltrexone, GLP-1 agonists were associated with a 9-times higher risk of pancreatitis, or inflammation of the pancreas, which can cause severe abdominal pain and, in some cases, require hospitalization and surgery.

Additionally, GLP-1 agonists were linked to a 4-times higher risk of bowel obstruction, whereby food is prevented from passing through the small or large intestine, resulting in symptoms like cramping, bloating, nausea and vomiting. Depending on the severity, surgery may be required. And the GLP-1 agonists were associated with a 4-times higher risk of gastroparesis, or stomach paralysis, which limits the passage of food from the stomach to the small intestine and results in symptoms like vomiting, nausea and abdominal pain.

“Given the wide use of these drugs, these adverse events, although rare, must be considered by patients thinking about using them for weight loss,” said the study’s first author, Mohit Sodhi, a graduate of UBC’s experimental medicine program and fourth year UBC medical student, in a statement. “The risk calculus will differ depending on whether a patient is using these drugs for diabetes, obesity or just general weight loss. People who are otherwise healthy may be less willing to accept these potentially serious adverse events.”

No one should take any of these medications unless prescribed by a doctor who can supervise treatment. Research has found that those who are prescribed the medication and stop using it can regain weight, especially if they didn’t make any lifestyle changes.

Global Study: Diabetes Diagnosis at 30 Can Shorten Life Expectancy by 14 Years

A person diagnosed with type 2 diabetes at age 30 could see their life expectancy fall by as much as 14 years, an international team of researchers has determined. Moreover, rates of diabetes are rising among adults ages 20 to 44 in the U.S., previous studies have found.

In the new study, researchers determined that people who do not develop the condition until later in life – with a diagnosis at age 50  – could see their life expectancy decrease  by up to six years.

The study, published in The Lancet Diabetes & Endocrinology, is based on a review of data from 19 “high-income countries.”  A team led by scientists at the University of Cambridge and University of Glasgow in the U.K. analyzed data from two major international studies – the Emerging Risk Factors Collaboration and UK Biobank – covering a total of 1.5 million individuals.

Increasing rates of obesity, poor diet and lack of regular physical activity are fueling rising diagnoses of diabetes in the U.S. and worldwide.

When analyzing only U.S. data, researchers estimated that individuals with type 2 diabetes diagnosed at ages 30, 40, and 50 years died on average about 14, 10, and 6 years earlier, respectively, than individuals without diabetes. These estimates were slightly higher in women (16, 11, and 7 years, respectively) than they were in men (14, 9, and 5 years, respectively).

The findings were broadly similar when reviewing European Union (EU) data, with corresponding estimates being about 13, 9, or 5 years, on average.

People with diabetes do make enough insulin or can’t use it as well as it should. When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream. Over time, that can cause serious health problems, such as heart disease, vision loss, and kidney disease, according to the U.S. Centers for Disease Control and Prevention (CDC).

In the U.S., 96 million adults — more than 1 in 3 — have prediabetes. And more than 8 in 10 of them don’t know they have it. With prediabetes, blood sugar levels are higher than normal, but not high enough for a type 2 diabetes diagnosis.

“Our findings support the idea that the younger an individual is when they develop type 2 diabetes, the more damage their body accumulates from its impaired metabolism,” explains study co-author Naveed Sattar, professor at the Institute of Cardiovascular & Medical Sciences, University of Glasgow, in a statement. “But the findings also suggest that early detection of diabetes by screening followed by intensive glucose management could help prevent long-term complications from the condition.”

People With Fatty Liver Disease, Which is Increasingly Common, are More Likely to Suffer Personality Disorders

People who have non-alcoholic fatty liver disease, or NAFLD, are more likely to suffer from a personality disorder, compared to those without NAFLD, a new study has found.

Researchers also concluded that individuals with NAFLD -- who need to watch their diet and exercise to keep the disease in check -- “frequently exhibit uncontrolled eating behaviors,” states a news release on the study from the University of Birmingham in the U.K., which led the research. The findings were published in BMC Gastroenterology.

NAFLD patients are about three times more likely to have a personality disorder, compared to people without the disease, the study states. Personality disorders refer to mental health conditions that involve long-term, disruptive patterns of thinking, behavior, mood and how an individual relates to others.

Study co-author, Jonathan Catling, M.D., from the University of Birmingham, said in a statement: “Finding an increased prevalence of personality disorders in NAFLD patients is particularly striking - signifying that it’s not an issue associated with all liver disease, but just those with NAFLD.”

Dr. Catling added that study’s findings indicate an “urgent need to examine attitudes towards diet and exercise so that we can better understand how to motivate NAFLD patients …”

NAFLD has become the most common cause of chronic liver disease worldwide. About 100 million adults in the U.S. are estimated to have NAFLD — a figure which has doubled over the past 20 years – primarily fueled by epidemics in obesity and diabetes. NAFLD tends to develop in people who are overweight or obese or have diabetes, high cholesterol or high triglycerides. The American Liver Foundation estimates that NAFLD affects up to 25 percent of people in the United States.

NAFLD refers to a build-up of extra fat in liver cells that is not caused by alcohol. It is normal for the liver to carry some fat. But if more than 5 percent to 10 percent of the liver’s weight is fat, then it is called a fatty liver. In the most serious cases, NAFLD can cause the liver to swell (steatohepatitis), which can lead to scarring, or cirrhosis, over time — and may even lead to liver cancer or liver failure.

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