Trying to lose weight with drugs against obesity and diabetes, GLP-1 analogues, but without diet or physical exercise, “is a total mistake” that can have consequences, such as a rebound effect or even severe loss of muscle mass and strength, warns Jordi Salas-Salvadó, professor of Nutrition and Bromatology at the Rovira y Virgili University of Tarragona.
“I have met many people who want to lose weight without making any effort, without taking care of themselves, without exercising, without having to diet. This is a total mistake,” he says in an interview with EFE Health.
The professor and researcher celebrates the arrival of these drugs against diabetes and obesity (the popularly known Ozempic or Mounjaro) convinced that they will help many people, but considers that “irrational use is being made” of these medications.
“It is not indicated to take the drug without diet and without physical exercise,” insists the director of the Nutrition program at the Obesity Network Biomedical Research Center (CIBERobn).
“First you have to test if you can achieve a normal weight through diet and exercise and then have the drugs authorized, but always on the basis of diet and physical exercise,” he explains.
And he warns: “The problem with GLP-1 analogues is that they make many people feel nauseous, they take away their hunger and that is very good for losing weight, but if you do not take care of your diet, if you follow deficient diets, one of the possible consequences of this type of drugs is that they can cause sarcopenia, loss of muscle mass and strength, in people with obesity and in the elderly.”
But another consequence is the so-called rebound effect: “When a person takes a drug without exercising or dieting, they lose weight and that is when they stop taking it and a yo-yo effect occurs”, they regain the lost kilos.
The Mediterranean diet, the best option
The Mediterranean diet is the eating pattern that demonstrates the most scientific evidence in the control of obesity and may be the most indicated to complement this treatment with anti-obesity drugs.
“Depending on the calorie restriction produced by the drug, it may be the Mediterranean diet supplemented with other proteins, vitamins and minerals” to avoid deficiencies.
Aside from these drugs, although there are different nutritional strategies to combat obesity, the Mediterranean diet is the one that occupies first place, as was confirmed at the recent national meeting of the Spanish Society for the Study of Obesity (SEEDO) held in Toledo in which Jordi Salas-Salvadó participated.
“Adherence to a slightly low-calorie Mediterranean diet, accompanied by physical activity, is the best strategy to lose weight in an overweight or obese person,” he says.
In his opinion, “there are different ways of eating healthy but the one that gathers the most scientific evidence is the Mediterranean diet” and its benefits in weight control and type 2 diabetes and in the reduction of cardiovascular and breast cancer risk factors have been demonstrated.
And this has been proven by two main studies, Predimed 1 and Predimed Plus, which include the largest number of patients and the greatest number of patients over time, and after being compared with other diets, such as Nordic or vegetarian diets.
The basis of our diet
This diet, based on fruits, vegetables, legumes, fish, nuts and olive oil, is not only a tool against obesity and other diseases but should be the eating pattern, as it was in the 60s in Spain.
Adherence to this Mediterranean diet is assessed by a typical 14-point scale and, according to the professor, reflects that people over 55 years of age, especially women, and with a higher cultural and economic level “are more aware that they should eat better and that they should exercise.”
Education in healthy habits in children is essential, but not only in schools, but also at home because, he recognizes, “adults don’t set an example either.”
“We live in a world of hurry, we are abandoning classic cuisine and the consumption of processed foods has tripled in the last two decades. And this is the industry. But the industry does what the consumer demands,” he says.
And he warns that through epigenetics it is known that if parents eat poorly, this is transmitted to their children through changes in the methylation of genes and in studies with rats it has been observed that “it happens with three, four and five litters,” he points out.
“We are responsible – he emphasizes – for what is going to happen in the coming years and, furthermore, with the added problem that we are destroying the planet because of this food system that we have.”
intermittent fasting
More than a year ago, Jordi Salas-Salvadó participated in a bibliographic review, published in the British Journal of Medicine, on studies related to intermittent fasting and its effectiveness for weight loss and cardiovascular risk factors.
Compared intermittent fasting with a traditional hypocaloric diet, “we only found that this diet in alternate days had a small profit” short termbecause in the long term there are no studies on obesity.
“And I have seen many short-term studies that are not reproduced in the long term, for example the very low-calorie diets that were done a few years ago with liquids or food substitutes,” he adds.
Therefore, regarding the effectiveness in long-term weight loss, “the only thing we have evidence for is the slightly hypocaloric Mediterranean diet,” which is effective and safe, concludes the professor at the Rovira y Virgili University.
