There has been a recent boom in people using the prescription medicine Ozempic
Wegovy, and Zepbound — brands containing the active ingredient semaglutide. It is actually a medication used to treat diabetes. Some use it for sudden, fast weight loss. Its appeal lies in the easy, no effort, yet significant weight loss that can be achieved while misusing the medication.
But what happens inside the body if you lose weight rapidly? What are the side effects?
Endocrinologist and obesity specialist Marcio Griebeler, MD, explains why slow and steady wins the weight-loss race over fast and furious.
A phenomenon known colloquially as “Ozempic face” offers some clues. Basically, people who use Ozempic and other semaglutide medications for weight loss tend to suffer from the following;
- increased signs of aging, such as more lines and wrinkles.
- loss of fat, which can lead the skin to become loose and sag.
- a hollowed-out appearance.
- lipodystrophy, which affects how the body accumulates and stores fat.
A phenomenon dubbed “Ozempic Personality” is gaining attention as users of these misused medication as weight loss drugs — they may cause mood deterioration, anxiety, depression, anhedonia (loss of interest in pleasurable activities), and decreased libido.
The trouble with any drug treatment is the potential to cause side effects, both short term and long term.
Do not believe the flashy ads that promise amazing weight loss within a few short weeks or less. Most of the time, those fad diets are not only difficult to maintain, they have bad news for your health too.
“When you lose weight too quickly, your body slows down its calorie-burning process,” explains Dr. Griebeler. “That is your body’s way of trying to ensure you don’t starve. You might lose a good amount of weight right away, but your metabolism quickly goes into survival mode.”
The change in your metabolism is a key reason why people regain weight after trying rapid weight loss. When you go back to eating a regular diet, your metabolism isn’t used to that many calories — and the weight come back, plus a bit extra. It is as of the body is saying ‘don’t do that again, or I will punish you for it.’
When you cut way back on calorie intake, you might see that number on the scale drop like a stone. But it’s not only the excess fat you’re losing. You’re also losing muscle. The body is cannibalising itself.
“Sudden and severe calorie restriction will make you lose muscle mass as well as fat,” warns Dr. Griebeler. “It’s harder to lose weight when you don’t have enough muscle mass because muscles burn lots of calories.” So fast and furious weight loss is actually self-defeating.
On the other hand, slower weight loss combined with exercise, gives your body time to lose fat while keeping your muscle mass. And bonus: You keep your muscles’ calorie-burning power intact. So slow and steady wins the day.
Remember the rabbit and turtle race? Same applies to successful weight loss.
Your body needs a certain amount of fat, protein and carbs to function. It also needs a whole range of vitamins and minerals. When you slash calories or cut out entire food groups such as carbs or dairy, you risk:
- Digestive problems, including constipation.
- Fatigue and loss of energy.
- Loss of bone density and strength.
- Low immunity to infections.
- Hair loss.
“There’s nothing wrong with cutting calories if you’re eating a variety of nutrient-rich foods,” says Dr. Griebeler. “Your diet should contain a wide variety of healthy, whole foods. Don’t try to cut more than 500 calories a day.”
When you go for fast weight loss, you may find that it gets harder — not easier — to keep losing weight. A couple of weeks in, you’ll likely feel tired and exhausted all the time. You certainly won’t feel like exercising. The temptation to crawl into bed.
Do not blame a lack of willpower. It’s your hormones, and they’re doing exactly what they were designed to do.
“Cutting too many calories too quickly triggers hormonal changes that make you want to eat,” says Dr. Griebeler. The constant food cravings are a cry for help. “Even a very determined person will find it difficult to overpower those hunger hormones. These fast hormonal changes make you so hungry that they set you up for diet failure.”
Steady and consistent weight loss is the key to success.
These general guidelines can help you lose weight, and importantly keep it off..
Healthy weight loss isn’t just about what you eat and do not eat. You need physical activity if you want the best results.
Cardiovascular exercise such as brisk walking burns calories, but strength training is just as important. When you lift weights or do resistance training, you increase muscle mass. And when you have more muscle mass, you:
- Burn more calories, even at rest.
- Improve your balance and reduce your risk of falls.
- Reduce joint pain and symptoms of arthritis so you can keep moving and losing weight.
- Strengthen your bones and reduce your risk of fractures and osteoporosis.
- Make good quality sleep, not just quantity sleep a priority.
Personally, I have joined a local gym 3 days a week, with a personal trainer. I briskly walk 40 minutes to the gym as a warmup. Then in conclusion I walk 40 minutes home again. Thats 80 minutes extra cardiovascular exercise daily, because I do a similar walk on the other 3 days of the week, with one day rest and recovery.
Ever notice that when you’re exhausted you want to eat more? When you’re tired, your hunger hormones flood in and ruin your chances of bypassing temptations. They put sugary temptations in front of us wherever we go.
If you’re regularly missing out on quality sleep, even the best weight loss plan is going to suffer. Go to
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“Aim for at least seven or eight hours of quality sleep each night,” says Dr. Griebeler. If you consistently have trouble sleeping, go to
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Can your diet plan become your new lifestyle. Could you do it for the rest of your life? Can you cut out a couple of hundred calories a day?
“The best diet is one you will stick to (as a new lifestyle),” says Dr. Griebeler. “Changing our habits can be done (when you know how). Choose a diet plan that allows you to have an occasional piece of chocolate or slice of pizza. It’s much easier to keep doing these types of plans for months and even years.”
Personally, I take one day off per week when I can break all my rules and eat anything want. The next day I pay for it by eating nothing. I only drink water. That shocks the metabolism and starts the process of weight loss.
For the next 5 days I eat normally – for me. That is eggs, fish, fruit and vegetables. A small amount of dairy. And plenty of nuts, seeds and natural cold grape seed and olive oil. It is what they call a ‘Mediterranean diet”.
I have cut sugar from everything. I avoid starch and processed foods like the plague. I rarely eat red meat.
How many calories is the right number per day?
Many factors go into determining calorie needs. Age, weight, gender, height, race and activity level all play a role. According to dietary guidelines in the United States, adults 21 years old and older should consume somewhere between 1,600 and 3,000 calories per day. That’s a ballpark figure which takes into consideration all the factors I just mentioned.
Registered dietitian Julia Zumpano, RD, LD, helps us do the math to more accurately find what is better for you.
A calorie is a measure of the energy in food. To maintain your weight, energy in must equal energy out (average calories consumed per day vs. average calories burned per day).
So, the answer is simple. Eating fewer calories than you burn, and you will lose weight. But if you consume more calories than you need, your body stores the energy for later as fat.
That was fine hundreds of thousands of years ago when humanity was evolving into who we are today. They hunted and gathered food while it was plentiful, ate it and stored the energy as fat. Then when they almost hibernated in their caves during the cold winters they survived. The extra fat layer they created during Spring and Summer gave them an extra insulation lay during Winter.
Those skinny people who were less efficient fat storers died and failed to reproduce. So, through a process of natural selection, we have a highly developed ability to gain weight.
However, we do not live in caves anymore to shelter from the snow outside. We have central heating and supermarkets. And so, we efficiently get fat as a process of survival. Unfortunately, we were designed to gain weight and then lose it every year – not maintain it. The fat around our vital organs can and does eventually kill us. That is not survival.
How many calories should you be eating a day today?
Everybody’s daily calorie needs is different, which can make it hard to figure out the oerfect number. In general, men and people assigned the male gender at birth (AMAB) need more calories than women and people assigned the female gender at birth (AFAB).
Physically active people need more than those who have desk jobs. And younger people need more than older people, whose metabolisms slow down as they age.
As a farmer I ate twice as much as my wife. I had a slim yet wry, muscled physic because I was working outside (often in the cold) all day., while she was inside in the warmth. These factors can impact your caloric intake:
- Gender.
- Height.
- Weight.
- Age.
- Activity level.
- Hormones.
- Medications.
Your basal metabolic rate (BMR) is the minimum calories per day your body needs to function while resting. Your BMR contains around 70 per cent of the energy used by your body. That number changes depending if you lose, gain or maintain your body weight.
So, how do you calculate your BMR? If you wear a smartwatch to track your fitness, BMR is used to come up with your daily goals. You can also find BMR calculators online.
“BMR is an essential starting point for calculating calories, although is it an estimate and is not 100% accurate,” clarifies Zumpano. “The most accurate means of measuring your BMR is direct calorimetry or indirect calorimetry, although those methods are not commonly used or available, therefore the Mifflin St-Joer equation is best to use and is only about 10% off. Most health professionals, apps and online calorie calculators use this equation.”
And while it’s a good idea to know how many calories you need each day, it also matters what kind of calories you’re consuming. “Empty calories” can be found in junk foods, sugar-sweetened beverages and processed foods — items that typically contain added sugar, trans fat and an unnecessary amount of fat and calories.
While you might get a boost of energy from consuming those foods, they tend to be void of nutrition — specifically fiber, minerals and vitamins. Those empty calories are designed by food scientists to make you want more, leading to food cravings and overconsumption. You may even feel tired or fatigued. These foods also promote inflammation and gut dysbiosis, which can both inhibit weight loss and eventually lead to disease.
Instead, make sure you focus on eating a well-balanced diet full of fruits and vegetables, lean meats, whole grains, nuts, seeds and vegetables oils (rather than animal fats).
This is the U.S. Department of Agriculture (USDA) recommended calories per day:
Calories per day for women and people AFAB
Age 21 to 25
Calories: sedentary 2,000
Calories: moderately active 2,200
Calories: active 2,400
Age 26 to 30
Calories: sedentary 1,800
Calories: moderately active 2,000
Calories: active 2,400
Ahe 31 to 50
Calories: sedentary 1,800
Calories: moderately active 2,000
Calories: active 2,200
Ages 51 to 60
Calories: sedentary 1,600
Calories: moderately active 1,800
Calories: active 2,200
Aged 61 plus
Calories: sedentary 1,600
Calories: moderately active 1,800
Calories: active 2,000
Source: Dietary Guidelines for Americans 2020-2025, Office of Disease Prevention and Health Promotion).
Calories per day for men and people AMAB
Aged 21 to 25
Calories: sedentary 2,400
Calories: moderately active 2,800
Calories: active 3,000
Aged 26 to 35
Calories: sedentary 2,400
Calories: moderately active 2,600
Calories: active 3,000
Aged 36 to 40
Calories: sedentary 2,400
Calories: moderately active 2,600
Calories: active 2,800
Aged 41 to 45
Calories: sedentary 2,200
Calories: moderately active 2,600
Calories: active 2,800
Aged 46 to 55
Calories: sedentary 2,200
Calories: moderately active 2,400
Calories: active 2,800
Aged 56 to 60
Calories: sedentary 2,200
Calories: moderately active 2,400
Calories: active 2,600
Aged 61 to 65
Calories: sedentary 2,000
Calories: moderately active 2,400
Calories: active 2,600
Aged 66 to 75
Calories: sedentary 2,000
Calories: moderately active 2,200
Calories: active 2,600
Aged 76 and above
Calories: sedentary 2,000
Calories: moderately active 2,200
Calories: active 2,400
Source: Dietary Guidelines for Americans 2020-2025, Office of Disease Prevention and Health Promotion).
“Keep in mind, these calorie recommendations are for people who are at a normal weight,” states Zumpano. “If your weight is above the normal range for your height and your goal is weight loss, you need to consume less. A deficit of 500 calories can provide a weight loss of 1 pound per week.”
Depending on what your goals are, here are some healthy ways you can maintain, add or lose weight.
To gain weight
If your goal is to gain weight, don’t just focus on eating more. You want to make sure you add weight in a healthy way.
Opt for high-calorie nutrient-dense foods such as meat, fatty fish, eggs, full-fat yogurt, whole grains, nuts and oils. You should also consider eating more often (6 times a day) and looking for ways to add extra calories to each meal. For example, adding nuts or seeds to your yogurt, oatmeal or cereal.
“Don’t forget to include more liquid calories that won’t leave you feeling too full by the next meal,” advises Zumpano. “Opt for high-calorie beverages like whole milk, cream, 100% fruit and vegetable juices, smoothies and high-calorie nutrition shakes.”
For weight loss
If you’re trying to lose weight, you might be tempted to radically slash your calorie count to reach your goals.
Proceed with caution, Zumpano says. If you eat fewer than 1,200 calories per day to lose weight, it’s tough to get all of the nutrients you need to stay healthy. And eating too little can work against you — it can halt weight loss and even lead to weight gain due to being in starvation mode leading to fat storage.
Extreme calorie restriction might backfire.
On an average day, you may burn anywhere from 1,300 to 2,000 calories without any physical activity. You can add some extra exercise to burn more calories.
“Regular exercise not only burns calories, which means you don’t need to cut back as much, but it also builds muscle which uses up more calories, therefore increasing your BMR,” explains Zumpano. “This allows for a more balanced diet and the ability to get all the nutrients you need.”
To maintain weight
If your goal is to maintain your current weight, Zumpano says you need to balance how many calories you eat or drink with the same number of calories you burn through physical activity and exercise.
“Weight maintenance can be tricky because your caloric needs change all the time,” she says. “Factors such as age, increased or decreased muscle mass, change in activity, health conditions and medications can influence your weight without you even realizing it.”
Should I monitor or track my daily caloric intake?
How many calories should I eat in a day? If you’ve pondered this question, it’s a good idea to have a sense of your daily calorie needs and to be aware of how the calories in your favourite foods add up. Those numbers can help guide your decisions about what to eat and what to save for another day.
But if numbers aren’t your thing, never fear. You don’t have to obsess over calories to stay healthy.
“Plenty of people lose weight not by counting calories, but by focusing on the quality of the foods they consume and on portion control,” says Zumpano.
Bottom line?
If you’re a person who likes to track and measure things, you could benefit from determining exactly how many calories you need.
Digital apps and online calorie calculators can help, Zumpano says. But because it can be complicated (are you really active, pretty active or just kind of active?), she recommends seeing a dietitian to get an expert’s opinion.
They can take factors such as your age, gender, medications, lifestyle, weight history, family history and activity level into account and provide you with information on how to tailor your meals and exercise.
Whether you’re trying to lose, gain or maintain your weight, figuring out how many calories will help you achieve your goal is key.
It’s important to understand how many calories you’re consuming compared to how many calories your body needs. And the source of where those calories are coming from is important, too.
“For example, consuming 200 calories from 16 ounces of soda is metabolized differently than 200 calories from 1 ounce of nuts,” says Zumpano.
“You’re gaining vitamins, minerals, fiber, protein and healthy fats from the nuts and no nutritional benefits from the soda. Not to mention that the refined sugars and artificial ingredients in the soda can lead to inflammation and increased blood sugars, which will eventually lead to health problems.”
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Scroll down the front page to the ‘Weight Control’ category. Click and enjoy.