I was reading the weekend Australian paper front page as I dropped into my local newsagent.   

The Nations Weight Divide – Personal Problem or Society’s Fault? 

I had to buy it.  I wanted to know what mainstream media was saying about what we need to do regarding the amount of obese people in Australia. 

Personally, I’d like to blame the Australian Dietary Guidelines vested interests and lobby groups for the obesity crisis along with a food industry which is more interested in profit than health. I would also like to call out an agricultural industry that uses far too many chemicals to grow food, and drug companies that want to make a fortune on the demise of our health.  All in all, destroying our microbiome, our ability to be healthy and our ability to consume a variety of foods without health issues. 

When most of the supermarket is stocked with ultra-processed foods and/or foods filled with dubious agricultural and food manufacturers’ chemicals, combined with the fact that many people believe that what is on the shelf of a supermarket can’t hurt them, then we have a good explanation for why obesity is now a challenge in Australia. 

Look at any photo of beach goers in the 1970’s in Australia and you will not witness what I witnessed walking on a local beach recently. 6 people exiting the water, 4 men with big bellies and 2 women who very much overweight.  What you would have seen in the 1970’s is a group of 6 people exiting the water look svelte and lean. 

Come back to 2023 and two thirds of the adult population is overweight or obese. 

Enter three strategies for weight loss:  

• Lifestyle management  

• Bariatric Surgery 

• Drugs – GLP-1 agonist (diabetic drug) 

The national clinical treatment guidelines are up for review and dietitian and academic lead of the review Dr Judi Porter said – “the advent of effective weight loss drugs was an enormous development in obesity treatment and a scientific committee would examine the evidence of drug benefits and risk amid a massive overhaul of how we manage obesity and overweight”. 

I believe that this dietitian does not believe that the current dietary guidelines are worthy of dealing with the health, obesity and diabetes issues we see today.  Sadly, neither do I but I also don’t have much hope in the new dietary guidelines being drafted nor the use of a drug to be the silver bullet that helps in the pandemic we see of eating the wrong foods and obesity. 

It’s easier said than done for many people to drag themselves away from ultra-processed, highly palatable foods.  But in essence this is the root cause of the issue.  Whether it’s hormonal, thyroid, genetic manifestations of dis-ease, it all comes down to how we live our life and the foods we choose to put on our plate.  It is not just about weight, it is about health! Further, it doesn’t help society’s cause that ultra processed food is subsidised and cheap whilst meat, eggs, organic fruits and vegetables are out of reach financially for many people. 

I feel like I’m hitting my head against a wall and getting nowhere.  I’ve been saying quality of food and looking for health, rather than quantity of food and weight loss should be our goal, but I’m fighting against an establishment that favours sickness over health.  

I rarely spend medicare. I had to pay for my legal vaccine exemption to travel of $75.00 – no medicare rebate there. I’ve never used the prescribing benefits (PBS – subsidised drugs). I rarely see a doctor unless I need a splinter (farm life!) out of my foot (last time I saw my GP was 35 years ago).  Yet, I’m given no rebate from medicare for the work I do to stay healthy.  On the flipside, someone who doesn’t put the work in – doesn’t exercise, doesn’t educate themselves, doesn’t get up to see the sun rise, doesn’t do anything that their body needs to be healthy may receive a drug worth thousands of dollars subsidised to help them with their weight and/or health issue.   

Perhaps annual financial medicare rebate incentives for the healthy may be a better system?  Reward health and penalise sickness, especially self-imposed sickness?  I know someone reading this is going to come back at me with “but what about a child with a brain tumour?” or what about the person who nearly drowns and has a brain injury?”. This, however, is not my beef.  My focus is on those who eat the wrong foods, drink alcohol to excess, smoke like a chimney and do nothing to help themselves.  A simple case study will reveal this fact. 

There is a current discussion about a social credit score, why not a health credit score.  If we use credit cards and eftpos cards and all our groceries are scanned, then surely a smart government would realise who is eating real foods and who is eating ultra-processed foods? 

I know that this is not going to happen, because we can’t even agree on dietary guidelines and things that make us healthy.  When I say butter, they say margarine, when I say salt, they say low salt, when I say meat they say vegan, when I say no breakfast cereal, they say it’s the best start to the day, when I say whole milk they say skimmed or oat milk, when I say raw milk they say poison and make it illegal.   I believe the opposite of what the dietary guidelines say, so a health credit score may divide the nation as does the obesity epidemic solution. 

So, the best I can do, is do the best for myself and my family and then spread the word for those who want to partake in a different culture and lifestyle. Even though we may not get a hand out from the government, for not wasting tax payers money, we will be the ones that win in the end, with wonderful health both physically and mentally and a more robust life, being able to do all that we want to do in our life. 

Now that I’ve had my little rant over the front page of the newspaper, let’s talk about the drug to combat obesity. 

Firstly, the American Association of Paediatrics have just put out their new guidelines. Whilst the report is extensive there are three parts that give us reason to pause at such extreme measures. 

• Offering teenagers 12 and older obesity weight loss medications. 

• Advising that teenagers 13 and older with severe obesity, which they define using Body Mass Index (BMI), be assessed for weight loss surgeries. 

• Proposing that nutrition support, behavioural therapy and exercise guidance aimed at weight loss starting as early as two years old. 

While Australia has not come up with its new guidelines, we know that the academic lead in the national clinical treatment guidelines is very excited about the obesity (diabetes) medication – the GLP1-1 agonist – which is likely to be marketed in Australia as Wegovy. 

This GLP-1 agonist diabetes is drug now being used for obesity. It’s active ingredient is semaglutide, a GLP 1 receptor agonist.  It is a once a week self injectable.  For diabetes the dose is less than for obese people.  It is a drug to be taken for life, yet there is only research for 62 weeks, in which the study showed a decrease in weight of no less than 5%  and no more than 14% of body weight. 

Actions of GLP-1 Agonist

1. GLP-1 Agonist Delays Gastric Emptying 

GLP-1 Receptor Agonist treatment, can delay stomach emptying within the first hour after a meal. This delay in stomach activity means that food remains in your stomach for longer, therefore satiety lasts longer. 

2. GLP-1 Receptor Agonist Reduces Hunger and Appetite 

GLP-1RAs have effects that extend beyond the stomach. They affect specific brain areas involved in hunger and appetite regulation. 

Specifically, GLP-1 receptors are found in the hypothalamus, which regulates food intake.  

Therefore, administering a GLP-1 RA medication reduced feelings of hunger and appetite in obese individuals. 

3. GLP-1 Receptor Increases Satiety and Prevents Overeating 

As a neurotransmitter which signals satiety in the brain, it tells us when we’ve had enough food and are satisfied.  It may also increase satiety by stimulating specific neurons and inhibiting the neuropeptides that control satiety. 

Troubling Issues with the GLP-1 RA

Medullary thyroid cancer – after the product was put onto the market. 

Cases of Medullary thyroid cancer (MTC) have been reported in patients treated with liraglutide (same drug class as GLP-1 RA) in the post-marketing period; the data in these reports is insufficient to establish or exclude a causal relationship between MTC and GLP-1 receptor agonist use in humans. 

Common side effects include anxiety, bloating, blurred vision, chills, cold sweats, confusion, constipation, cool, pale skin, cough, darkened urine, depression, diarrhoea, difficulty swallowing, dizziness, fast heartbeat, fever, headache, increased hunger, indigestion, large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs, loss of appetite, nausea, nervousness, nightmare, pain in the stomach, side, or abdomen, possibly radiating to the back, seizures, skin rash, slurred speech, tightness of the chest, trouble breathing, unusual tiredness or weakness, vomiting, yellow eyes or skin. 

Less common include, acid or sour stomach, belching, excess air or gas in stomach, heartburn, passing gas, stomach discomfort, swelling tenderness or upset.

This is the warning on the packet of GLP-1 RA.

Warning 

Subcutaneous route (Solution) 

Warning: Risk of Thyroid C-Cell TumorsIn rodents, semaglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. It is unknown whether semaglutide causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined. Semaglutide is contraindicated in patients with a personal or family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of semaglutide and inform them of symptoms of thyroid tumors (eg, a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with semaglutide. 

Contraindications (you definitely should not take it) if you have pancreatitis, type 1 diabetes, under 18 years of age (yet the AAP allows it for 12 year olds), pregnant or breastfeeding, diabetic retinopathy, problems with the pancreas or kidneys, family history of medullary thyroid carcinoma (MTC), multiple endocrine neoplasia syndrome 2.

Lawsuits against GLP-1 RA

The first GLP-1 RA lawsuit in the US was filed August 2^nd 2023 with the claim the drug causes gastroparesis, ileum and intestinal blockage and that the drug manufacturers failed to warn of the risk.  Since January 2024, the above case and many subsequent lawsuits regarding gastroparesis, there may well be a federal multi district (class action) litigation against the drug manufacturers. 

Gastroparesis is a severe disorder that causes food to move too slowly through the stomach to the small intestine.  In some cases, food may stop moving altogether causing blockage.  Gastroparesis may cause nausea, vomiting, bloating, pain, dehydration, acid reflux, malnutrition and weight loss.  Undigested food may stay in the intestine and harden.  The FDA added intestinal blockage, obstruction and ileus to the warning label of this specific brand of GLP-1 RA. 

Makers Novo Nordisk – Drug Pushers 

The makers of GLP-1 RA are using Social Media to push their new obesity drug targeting vulnerable population groups by sponsored advertising with the call to action by sending you to a website truthaboutweight.global.  The website sponsored by Novo Nordisk having affiliations with Australian Diabetes Society which in turn has affiliations with Diabetes Australia and Endocrinology Associations in Australia.  It points to obesity being a disease – their definition and I quote 

“Obesity is a chronic disease that can seriously impact your quality of life and wellbeing. Here’s everything you need to know about obesity – including signs and symptoms of obesity, diagnosis, and an accurate obesity definition”. 

It then helps you find a medical doctor, GP to help you with your disease of obesity and as most doctors do not have any training in lifestyle and nutrition. You can imagine that their knowledge of diagnosis and management with medications will mean that you will be prescribed Ozempic/Wegovy. 

When Obesity is considered a disease it is a triumph for the pharmaceutical industry.  In my way of thinking it is impossible to solve a pandemic of obesity caused by a very unhealthy, ultra-processed food environment by treating it with drugs.  And Novo Nordisk is no different to the rest of the weight loss industry, it’s selling a body beautiful, be thin illusion with a one pill wonder. 

My Thoughts 

Losing weight should be a health pursuit, not something where you lose the weight but, in the meantime, continue bad habits, may get cancer, gastroparesis and feel unhealthy.  It is beyond my comprehension why a drug is even being considered especially by a lead dietitian for the new clinical guidelines?  

People who are overweight because of poor choices need education and training and support to change their habits and form new habits that are conducive to lifelong health and wellbeing without dramatic and life-threatening side effects.  This is what we do at The Nutrition Academy.  We are here to help these people, some come to us because of education others come for our programs and protocols.  It takes hard work and consistency, it’s not as easy as a drug and not as hazardous as medication, but the rewards are far greater in the long run in many ways both physically and mentally both for you, your family, your community and the planet, in more ways than people every realise. 

People who have no control of their eating habits (as the woman depicted in The Australian magazine February 2023), whether they have binge eating disorder, food addiction, anorexia nervosa or bulimia and or food addiction are just that – addicts and have mental health issues and should be treated as addicts with mental health issues long before they are treated for obesity.  An obesity drug is not going to fix the problem but merely mask the symptom (weight issues).  Addiction comes in many forms and the total lack of control of whatever substance is being abused should be addressed firstly. 

The Root Cause 

I believe that mental health issues and addiction may be due to the health of the individual due to diet, emotional stress, childhood trauma, lifestyle — it is multi-factorial.  These have all been compounded by the ultra-processed food environment found in every grocery store, that adorn the supermarket shelves that create illness both physically and mentally.  Giving the body the right foods, the right lifestyle, changes things almost instantaneously, but it is the consistency for the rest of your life that turns things around.   

I’m one person, I’ve lived the lifestyle and eaten the foods to be the best version of myself.  I’ve helped others achieve this, either family and or friends and I have an incredible team that supports me to do this.  On top of that I have all the graduates from The Nutrition Academy that have changed their own health habits and that of their family, friends and clients.  We are not going to change policies (I’ll leave that to Dr James Mueke – he is my hero in that space) but we can start a grass roots movement that will in turn change what is happening at the top which for me is pure incompetence. 

Cyndi O’Meara 

 References 

Front page Weekend Australian 4-5^th February 2023 

Weekend Australian Magazine Disease or Lifestyle 4-5^th February 2023 

The Australian February 6^th 2023 – The Nations Weight Divide page 7 

The Australian February 15^th 2023 – Shining spotlight on shadow drug campaign page 8 

Ozempic Side Effects: Common, Severe, Long Term (drugs.com)