Written by Sam Coleman | Co-founder
Fact checked by Andrew Lenau, ISSA CPT & Sports Nutritionist
FACT CHECKED
Setting the Record Straight on Ozempic...
In today's fast-paced world of information dissemination, it's essential to differentiate fact from fiction.
Recently, a statement by Bill Maher on Joe Rogan’s podcast (episode #2029), suggesting that nobody, not even doctors or scientists, knows how Ozempic works, has captured attention.
Such a bold claim inevitably begs scrutiny. As champions of evidence-based information, we aim to dissect this assertion and illuminate the extensive scientific understanding behind Ozempic's mechanism of action.
Join us as we delve into the details, separating misconceptions from the robust scientific truths.
What Did Bill Maher and Joe Rogan Say About Ozempic?
To start, we are going to share a clip from the podcast. The conversation touches on various topics related to body positivity, weight loss, and the medication Ozempic (known generically as semaglutide).
We've transcribed the key statements from the clip of the recent podcast above:
Bill Maher (00:02):
But fat is fat. And it's just not healthy. Even if you find it beautiful or sexy or whatever you want, it's just science. It's bad for literally every part of your health, from how you poop to your eyesight. There's nothing that obesity doesn't affect negatively.
Joe Rogan (00:20):
You know who doesn't get any of that body positivity sh*t, though? Is men. Nobody gives a f*ck about men. If men are fat, you're just fat. Right. That's like when James Corden tried that sh*t with you. Yes. It was such an obvious ploy. Oh, you're hurting my feeling bill. Fat shaming.
Joe Rogan (00:38):
First of all, that guy's fat from food. He's not like, Oh, my God. He's got a genetic disorder. He's just, that's how that guy is obviously not working out and living. Living a good life, eating some nice food. Little plump. Fixable.
Bill Maher (00:53):
Yeah, and interesting a year or so after he made his big crusade against me, he signed a big contract, I think, with Weight Watchers. He turned right around. But even Weight Watchers is out of style because now we've given up on the idea that obesity is something that can be contained by exercise and diet. It's now a disease. I mean, these new drugs they have?
Joe Rogan (01:32):
Ozempic.
Bill Maher (01:33):
Ozempic. Yeah. I was reading about Ozempic. I didn't know this until recently. They have zero clue why it works. They know that it works, just not why. This would bother me.
Joe Rogan (01:51):
They should.
Bill Maher (01:53):
That if they're giving me something and they're like, Hey, this new miracle pill, just take it. We're working on the reason why it might do this to you. But until then, just f*ck it.
Joe Rogan (02:06):
There's no biological free lunch either. I have friends that are on that stuff. And one friend who just got off of it because he was having some serious gastrointestinal issues that are apparently one of the side effects. There's no free lunch. If you're taking an injection that makes you less hungry, something's going on. That's probably not good. Yes. And you're also losing a lot of connective tissue, bone mass, and muscle mass. My good friend Peter Attia did a study on his patients. He's a doctor, did a study on patients that took Ozempic. And one of the things they found is they lost weight, but they gained fat. They were actually had a higher percentage of body fat because they were primarily losing muscle tissue and connective tissue. They were losing so much of that that even though they lost like 20 pounds, they actually went from 15 % body fat to maybe 20 % body fat or whatever the number was.
Is it true that nobody knows how Ozempic works?
No, it's not true that doctors and scientists don't know how Ozempic (semaglutide) works. The mechanism of action of Ozempic is relatively well-understood.
How Does Ozempic Work?
Ozempic is a glucagon-like peptide-1 (GLP-1) receptor agonist. Here's a brief overview of how it works and its mechanisms:
1. Blood Sugar Regulation:
- Insulin Release: Ozempic increases the release of insulin from the pancreas when blood sugar levels are high. Insulin is a hormone that allows cells to use sugar from the bloodstream for energy.
- Glucagon Suppression: It reduces the release of glucagon, a hormone opposing insulin. While insulin decreases blood sugar, glucagon increases it. By suppressing glucagon, Ozempic helps to keep blood sugar levels in check.
- Hepatic Glucose Production: Ozempic can also reduce the amount of sugar produced by the liver, further helping to maintain stable blood sugar levels.
2. Appetite and Weight Loss:
- Central Appetite Regulation: Ozempic can affect the central nervous system to reduce appetite. This effect can contribute to the observed weight loss in patients.
- Gastric Emptying: The drug slows down the process by which the stomach empties its contents into the small intestine. This delay can lead to prolonged feelings of fullness and can help reduce overall food intake.
- Cardiovascular Benefits: Some studies have indicated that GLP-1 receptor agonists might offer cardiovascular benefits, such as reduced risk of major cardiovascular events in certain populations. It's crucial to note that while these benefits have been observed, the mechanisms behind them are still an active area of research.
It's always important to recognize that the landscape of medical knowledge is continuously evolving. New studies, trials, and reviews can lead to a deeper understanding or refinement of what we know about any given medication, including Ozempic.
The primary misconception or simplification of Bill Maher might arise elsewhere because while the general mechanism of action is known, the intricate details of how any medication interacts with the human body on a molecular, cellular, and systemic level can be incredibly complex.
But to state that there is "zero clue" regarding its mechanism is not accurate.
If you or someone you know is considering this medication, it's crucial to consult with a healthcare professional who can provide the most up-to-date information and personalized advice.
Scientific Literature on Ozempic's Mechanisms & Effectiveness:
It's always essential for such claims to be verified with established scientific literature and expert opinions in the field.
Many studies delve into the mechanism of action of Ozempic (semaglutide) and how it affects the body, particularly in terms of glycemic control and weight loss.
When researchers conduct clinical trials on medications, understanding the drug's mechanism of action is essential not only for ensuring its efficacy but also for monitoring potential side effects and predicting its interactions with other drugs.
There are some notable studies and trials related to Ozempic (semaglutide):
- SUSTAIN Trials and PIONEER Trials: These trials, while focused on clinical outcomes and safety, typically include background sections or discussions about the drug's mechanism of action. The details might not be as extensive as a comprehensive review article on the subject, but they often provide a succinct summary of how the drug works1,2,3
- Review Articles: Beyond clinical trials, there are review articles written by experts in the field that summarize the current understanding of a drug or class of drugs. These reviews will delve deeper into the mechanisms, providing details on the biochemical interactions and physiological effects. Searching for review articles specifically about GLP-1 receptor agonists, including semaglutide, could yield in-depth explanations of the drug's workings4,5.
- Pharmacology and Mechanistic Studies: Apart from large clinical trials, there are studies dedicated exclusively to understanding the pharmacological properties and mechanisms of the drug. These types of studies might employ a variety of methods, from cellular assays to animal models, to tease apart the intricate details of how a drug functions6.
FAQS:
- How Long Does Semaglutide (Ozempic) Take To Work?
- How Much Weight Can You Lose With Semaglutide?
- Why Am I Not Losing Weight On Ozempic?
Why Did Bill Maher Say They Have Zero Clue How Ozempic Works?
Bill Maher is a comedian, political commentator, and television host, not a medical expert or scientist. The same goes for Joe Rogan, so it’s no wonder he was unable to correct Bill (although I’m sure Joe looked into after and realizes his mistake).
When public figures make statements, especially on complex topics like medicine, their reasons can vary and may be influenced by multiple factors.
Without speculating too much, a few general considerations can be highlighted:
- Entertainment and Provocation: As a television personality and comedian, Maher often takes provocative or controversial stances to generate discussion, capture viewers' attention, or emphasize his viewpoint, even if it means oversimplifying complex topics.
- Personal Beliefs and Opinions: Maher has his beliefs and opinions on a range of issues, including health, medicine, and politics. It's possible he genuinely believes or has been led to believe certain notions based on his understanding, personal experiences, or the sources he relies on.
- Secondary Sources and Misinformation: Maher, like many public figures, might rely on producers, researchers, or secondary sources for some of the information he discusses. These sources can sometimes introduce biases, misunderstandings, or oversimplifications.
- Rhetorical Effect: Making a bold claim, like stating nobody knows how a drug works, can be a rhetorical device to emphasize a larger point or critique about the medical industry, pharmaceuticals, or broader societal issues. The claim may not be meant to be taken literally but to prompt reflection or discussion on a broader topic. This is highly doubtful.
- Feedback Loop: Public figures often get feedback from their audience. If a stance or viewpoint resonates with their viewers, they might lean into it more, even if it's not fully aligned with mainstream scientific understanding.
It's always essential for consumers of media to approach such claims with a critical mindset, cross-referencing with trusted and reliable sources, especially when it concerns health and medicine.
WHAT ABOUT JOE ROGAN’S CLAIMS ON OZEMPIC SIDE EFFECTS?
Ozempic (semaglutide) is known to have several side effects, with gastrointestinal side effects being the most common. Here are some known side effects of Ozempic:
Common side effects of Ozempic:
1) Gastrointestinal Issues:
- Nausea
- Vomiting
- Diarrhea
- Abdominal pain or discomfort
- Constipation
- Bloating
- Reduced appetite
2) Injection site reactions:
Redness, pain, or swelling at the site of injection.
Less common side effects:
- Gallbladder problems: Like gallstones.
- Pancreatitis: Inflammation of the pancreas.
- Kidney issues: Changes in kidney function or kidney failure.
- Vision changes or loss: Due to diabetic retinopathy or swelling in the back of the eye.
- Low blood sugar (hypoglycemia): Especially when taken with other glucose-lowering medications.
- Increased heart rate.
Rare side effects:
- Thyroid tumors or cancer: Semaglutide, like other GLP-1 receptor agonists, has a warning regarding the risk of thyroid C-cell tumors, including medullary thyroid carcinoma, but the absolute risk remains a topic of debate.
It's important to understand that not everyone will experience these side effects, and their severity can vary between individuals. It's also essential for patients to work closely with their healthcare provider to monitor for side effects and decide on the best therapeutic approach.
Analyzing Joe Rogan's Statement About "No Biological Free Lunch":
- Gastrointestinal issues: Joe Rogan's mention of "serious gastrointestinal issues" aligns with the known side effects of Ozempic.
- Weight loss and body composition: The mention of loss of "connective tissue, bone mass, and muscle mass" and the phenomenon of losing weight but gaining a higher percentage of body fat due to a significant loss of muscle tissue is interesting. These are more detailed observations that may not be captured in all clinical trials or summaries of the drug. However, GLP-1 agonists primarily lead to weight loss by reducing appetite and caloric intake. Muscle mass preservation or loss during weight loss depends on various factors, including diet composition and physical activity. If a patient's protein intake is inadequate or they're not engaging in resistance training, they might lose more muscle during weight loss, regardless of the weight loss method.
- No biological free lunch: This implies that medications come with potential downsides or trade-offs, which is generally true. Every medication has potential side effects, and the benefits should always be weighed against the risks.
In summary, while Joe Rogan's comments align with some known aspects about Ozempic, some statements, especially regarding body composition changes, are more nuanced and require more in-depth discussion and understanding.
As always, when it comes to medical treatments and their effects, it's essential to consult directly with medical professionals and rely on peer-reviewed scientific literature.
SUMMARY: WAS BILL MAHER RIGHT ABOUT "THEY HAVE ZERO CLUE HOW OZEMPIC WORKS"?
In essence, Maher expressed concerns about the drug, implying that medical professionals and scientists don't fully understand its mechanism of action, which could be unsettling for potential users. This statement seems to reflect a belief that the drug's efficacy might be accepted without a comprehensive understanding of its workings.
However, the claim made by Bill Maher about the unknown mechanism of Ozempic is not accurate. Ozempic, or semaglutide, is a GLP-1 (glucagon-like peptide-1) receptor agonist. The mechanism of action for GLP-1 agonists is well-understood in the medical community. They mimic the effects of the body's natural GLP-1, leading to:
- Increased insulin release: This happens in response to meals, helping to lower blood glucose levels.
- Decreased glucagon release: Glucagon is a hormone that increases blood glucose levels. By reducing its release, blood glucose levels are further lowered.
- Slowed gastric emptying: This can lead to a feeling of fullness and reduce food intake, assisting with weight management.
- Direct effect on the brain: They might reduce appetite.
Maher's comment, while it might reflect a broader public perception or skepticism about new drugs, is not in line with the current scientific understanding of semaglutide.
This highlights the importance of clear communication between the scientific community and the public, ensuring that individuals have accurate information about medical treatments and their mechanisms.
Comparisons of Weight Loss Drugs:
References:
- Information NC for B, Pike USNL of M 8600 R, MD B, Usa 20894. Results. Canadian Agency for Drugs and Technologies in Health; 2019. https://www.ncbi.nlm.nih.gov/books/NBK544016/
- Aroda VR, Aberle J, Lars Bardtrum, et al. Efficacy and safety of once-daily oral semaglutide 25 mg and 50 mg compared with 14 mg in adults with type 2 diabetes (PIONEER PLUS): a multicentre, randomised, phase 3b trial. Published online June 1, 2023. doi:https://doi.org/10.1016/s0140-6736(23)01127-3
- Singh G, Krauthamer M, Bjalme-Evans M. Wegovy (semaglutide): a new weight loss drug for chronic weight management. Journal of Investigative Medicine. 2021;70(1):jim-2021-001952. doi:https://doi.org/10.1136/jim-2021-001952
- Cornell S. A review of GLP‐1 receptor agonists in type 2 diabetes: A focus on the mechanism of action of once‐weekly agents. Journal of Clinical Pharmacy and Therapeutics. 2020;45(S1):17-27. doi:https://doi.org/10.1111/jcpt.13230
- Knerr PJ, Mowery SA, Douros JD, et al. Next generation GLP-1/GIP/glucagon triple agonists normalize body weight in obese mice. 2022;63:101533-101533. doi:https://doi.org/10.1016/j.molmet.2022.101533
- O’Neil PM, Birkenfeld AL, McGowan B, et al. Efficacy and safety of semaglutide compared with liraglutide and placebo for weight loss in patients with obesity: a randomised, double-blind, placebo and active controlled, dose-ranging, phase 2 trial. The Lancet. 2018;392(10148):637-649. doi:https://doi.org/10.1016/s0140-6736(18)31773-2
Sam Coleman
Author