In Defense of Ozempic: Harnessing the Detox Potential of GLP-1s

GLP-1s are powerful tools for rapid weight loss and bioelimination of stored toxicants. How can we use the tools of Environmental Medicine to minimize negative effects and optimize outcomes?

Ozempic and other GLP-1s: Should we be prescribing them?

There's an ongoing debate about use of Semaglutide and other GLP-1s in non-diabetics.

It's true that GLP-1s can reduce lean muscle mass as well as fat mass, and sometimes in greater proportion.

Nonetheless, I'm not ready to eliminate them from my practice. I'm seeing excellent outcomes using GLP-1s for short periods in conjunction with high-dose binders in a combined rapid fat-loss and detox protocol.

Sequestration of toxicants in adipose tissue

Our bodies like to hide toxic substances away in our fatty tissue. You know all of those environmental chemicals I talk about all the time? Most of those get banked in fat cells. (BPA, for example, loves adipose tissue).

During periods of rapid fat loss, those chemicals are rapidly liberated, which can make people feel sick, and accounts for what we colloquially call “detox reactions.”

So where do these unwanted compounds go after they’re released from fat cells?

Nerds call it "Enterohepatic Circulation"

After a ride through the machinery of the liver and gallbladder, processed toxins get dumbed into the GI tract. Great, now they can leave the body for good!

They go down, down, down.. but by the time they reach the rectum 95% of them have reabsorbed through the gut lining back into the body. This process is called “enterohepatic circulation” and means that under normal conditions, it’s exceedingly difficult to actually get rid of most of the toxic sludge liberated from fat.

Using binders: a trick from Environmental Medicine

If you take them by mouth, substances like charcoal and clay can stick to the processed toxins in the GI tract, preventing them from resorbing so they have no choice but to exit the body with the stool. For this reason, I give a slurry of high-dose binders several times per day while my patients are rapidly losing fat on a GLP-1.

I also give support for certain liver, gallbladder and drainage processes (especially glucuronidation and GI motility if I suspect a high BPA burden, to continue my example) .

Treatment duration and counseling

I give this combination protocol for a period of about 3 months and give substantial repletion of fat soluble vitamins as far from binder doses as possible.

Counseling your patient well is of critical importance here, and it's probably what differentiates the cases that lose mostly fat from those that lose mostly muscle. Most patients lose both, but loss and rebuild exist in an equilibrium, so poor food choices mean that they will rebuild new tissue with fat, affecting the final tally.

The most important thing

The most important thing to remind your patient is that they are going to lose a lot of their body mass, both fatty and lean, and how they move and what they eat during this period (and just after) will determine what makes up their new body mass, and whether it's fatty or lean

Most most most importantly, let's make sure their new body mass is non-toxic.