Diabetes-lowering drugs have "crossed over" into the weight-loss circle! Is it "IQ tax" or "black technology"?

Tuchong Creative

There are so many friends around me who want to lose weight. Every time we chat, the topic will inevitably turn to weight loss within three sentences.

Their heads shook like rattles, and they felt like they were going to die. But it was understandable, after all, many people would rather ride an electric bike even to go to the toilet.

However, this situation has changed recently, and these friends have started to inquire about the Internet celebrity "weight loss injection". It is said that you don't need to control your diet and move your legs, and all you need to lose weight successfully is one injection a week. Can you who want to lose weight in front of the screen resist this temptation?

Hey! Don't be in a hurry, it's not too late to make a decision after reading it patiently. I suggest you forward it to your friends who have the same idea.

The "drug that can help you lose weight while lying down" mentioned above actually refers to "semaglutide". It first appeared in the public's field of vision as a hypoglycemic drug, mainly used for blood sugar control in patients with type 2 diabetes. For example, when blood sugar is still not good after controlling diet and exercise, or when blood sugar is not well controlled by taking metformin, this drug can be added.

Do you feel more and more confused the more you listen? How did a blood sugar-lowering drug " cross the border " into the weight loss circle?

This is actually what happened. Semaglutide is a GLP-1 receptor agonist. GLP-1 is called "glucagon-like peptide-1" in Chinese. After a normal person has eaten a full meal, the intestines will secrete this substance. It can lower blood sugar when blood sugar rises and produce a feeling of fullness. But the life span of glucagon-like peptide-1 is particularly short, only 2 minutes. Therefore, the researchers changed its chemical structure and created a variant. The modified glucagon-like peptide-1, also known as semaglutide, has a life span in the body from 2 minutes to several days to a week. Moreover, after semaglutide is injected into the body, it can make people feel full for a long time and not want to eat. In this way, blood sugar will naturally drop, and the person will start to lose weight slowly.

However, weight loss was not the original intention of the drug, at least not the main purpose. Because when it was approved by the US Food and Drug Administration in 2017, its indication was only the treatment of type 2 diabetes in adults. In 2021, the drug's blood sugar lowering indication was also approved in China, but many people obtained this drug through various channels for the purpose of losing weight.

Can you still lose weight by taking an injection once a week ? Of course you can, but don't use it casually.

In 2021, semaglutide for weight loss was approved for marketing in the United States, and was also approved in my country in 2024. In addition, some domestic companies have begun to develop biosimilars, and weight management trials for the oral version of semaglutide are also underway. If approved, weight loss can be achieved without injections.

But even if it can help you lose weight easily, it doesn't mean that anyone can use it casually. First of all, your body mass index, which is your weight (kg) divided by the square of your height (m), must be 27 or above, and you must have at least one weight-related disease, such as high blood sugar, high blood pressure, dyslipidemia, obstructive sleep apnea or cardiovascular disease. Or if your body mass index is 30 or above, in these two cases, semaglutide is recommended.

Some people may think that as long as the weight loss effect is good, it’s enough, why set such strict standards?

Because medicine is not food, if you eat too much food, you can just skip two meals and go to the toilet, but the side effects and adverse reactions of medicine are real. While you see the effect, have you noticed the hidden safety risks behind it? If the indication for medication is not met, the risks brought by the drug may far outweigh its benefits.

Moreover, even if it is used normally, semaglutide may cause adverse reactions such as gastrointestinal discomfort, hypoglycemia, and acute pancreatitis. People with a history of acute pancreatitis or some gastrointestinal diseases should be more cautious and not suitable for use. As the saying goes, only those who feel uncomfortable know it. I guess no one will tell you about the discomfort after taking the medicine.

How do you view the use of " weight loss injections " to lose weight?

If you are really overweight, you must control your weight. However, medication is not the first choice, nor is it a necessary choice. The root cause of obesity is excess energy. If there is no place for excess energy to go, it will be stored in fat cells in the form of fat for emergency use.

If the problem of excess energy is not solved, and only the little stock in fat cells is consumed, then weight loss is just "seeing flowers in the fog, catching the moon in the water". After all, medicine cannot be used for a lifetime. If the unhealthy lifestyle is not changed, energy will still be in excess, and weight gain is a matter of time. What's more frightening is that the body has memory. After experiencing "hard times", when diet and appetite are restored, it will desperately absorb nutrients and store energy, which may make the weight gain worse.

As the saying goes, injections are good for a while, but weight gain is a pain. When it comes to losing weight, medication is only a supplement. You have to rely on yourself to be the main attacker. Develop good habits so that the fat you lose won't come back. If you take medication, remember to follow the doctor's advice and don't blindly believe in misleading information.

This article is a work supported by the Science Popularization China Creation Cultivation Program. Author: Zhang Yu, PhD in Nutrition

Reviewer: Dou Pan, deputy chief physician, Department of Clinical Nutrition, Peking University First Hospital

Produced by: China Association for Science and Technology Department of Science Popularization

Producer: China Science and Technology Press Co., Ltd., Beijing Zhongke Xinghe Culture Media Co., Ltd.