As the New Year begins, many set health goals, including weight loss. One treatment gaining significant attention is semaglutide, a medication originally developed for type 2 diabetes. It is now the most widely prescribed treatment for weight loss and is sold under brand names like Ozempic, Wegovy, and Rybelsus.
Semaglutide mimics a natural hormone in the body called GLP-1, largely produced in the intestines. It aids in weight loss through a triple effect: it lowers blood sugar levels; reduces hunger by acting on the brain’s appetite centers; and slows digestion, prolonging feelings of fullness and reducing overeating. These combined effects make it effective for both managing diabetes and promoting weight loss, thus it has gained attention beyond its original purpose.
One study showed people on semaglutide lost 7-8% of their body weight in the first 6.5 months, with weight loss plateauing at around 10-11% after 16 months. It also can lower hemoglobin A1C in people with diabetes and reduces cardiovascular risks.
However, semaglutide comes with challenges. Common side effects include nausea, vomiting, diarrhea, constipation, fatigue, headache, bloating, and stomach pain. These symptoms may be temporary or persist throughout treatment.
Muscle loss has been reported, with one study estimating that approximately 38% of the total weight lost may come from muscle mass. Weight re-gain often occurs after discontinuing the medication, particularly among those who do not maintain lifestyle changes in diet and exercise. Additionally, the cost – exceeding $1,000 a month without insurance – places it out of reach for many.
Semaglutide offers significant benefits, but it is not a universal solution, especially for Native Hawaiians who face unique health challenges influenced by social determinants of health. Issues such as potential side effects, high costs, and reliance on medication instead of sustainable lifestyle changes, highlight the need for a culturally rooted approach to weight loss.
While semaglutide can be a helpful tool for managing obesity, it should never replace healthy habits. Before turning to semaglutide, consider natural alternatives that stimulate the body’s own GLP-1 production. Berberine, a compound found in herbs like goldenseal, Oregon grape, and barberry, has shown potential for activating GLP-1 pathways. You can also enhance GLP-1 activity through dietary choices.
Teas made with ginger, ʻōlena (turmeric), and cinnamon may promote GLP-1 secretion, as well as bitter melon, which can be added to soups or stir-fries. Fermented foods like sour poi, kimchi, natto, and yogurt help support a healthy gut microbiome, essential for healthy GLP-1 function.
Additionally, tailor your weight loss journey to reflect your values and lifestyle. Focus on incorporating traditional Hawaiian and other cultural foods, like fresh fish, fruits, and vegetables. Engage in enjoyable physical activities such as hula, surfing, walking, or even a high-intensity interval (HIIT) workout.
Prioritize spiritual and emotional wellbeing through prayer, hoʻoponopono, and spending time in nature. Make it a collective effort by involving your ʻohana to strengthen support and accountability.
Ultimately, the best approach to weight loss is one that aligns with your needs, values, and culture, blending tradition, sustainability, and modern knowledge for lasting health.
