08/05/2023
Semaglutide (Ozempic), Mounjaro (Tirzepatide) for Fatty Liver disease. Era of GLP-1.
The main aim for writing this blog is to bring awareness to the public about fatty liver disease and the new treatment options available to treat the condition.
This article is especially aimed to reach individuals who suffer from fatty liver disease. This is our newest hope to defeat fatty liver disease which affects about 30% of the US population
What is Fatty Liver disease ? How does this affect a healthy liver ?
As the name suggests, it is a condition in which the liver has more fat cells than the normal healthy liver. Imagine a liver being made of red small marbles (liver cells), and tennis balls (fat cells). In fatty liver these fat cells start to get bigger and their number increases. The fat cells then start pressing on the liver cells and start taking their place. This leads to destruction of the healthy liver cells. The space is taken over by unhealthy large fat cells and fibrous tissues. Over years and decades this process continues to cause damage to the liver. The fat cells in the liver are unhealthy and do not perform the function of liver cells. Liver cells have multiple functions like detoxification, making protein, clear blood and many others. When the fat cells take over the liver, all these functions are affected. Hence the liver becomes fatty and fibrous, and does not function.
Does everyone with Fatty Liver develop liver damage ? What is the difference between NAFLD and NASH ?
Not all the people with fatty liver develop liver damage. In most people even when the liver has excessive fat the damage is not significant. The liver and fat cells live in harmony. In these patients, the liver enzymes are normal and no inflammation is noted on liver biopsy. This is called Non Alcoholic Fatty Liver Disease. In a small percentage of people when the fat cells lead to irritation and destruction it is called NASH. The more severe form of NAFLD is called nonalcoholic steatohepatitis (NASH). Over a period of 20 or more years these people are prone to develop cirrhosis.
How to treat Fatty liver disease (NAFLD or NASH) ?
The mainstay of therapy has been to lose weight, which decreases total fat in the body, and in the liver. Studies have shown people who underwent weight loss surgery with underlying fatty liver can lead to reversible liver damage. It prevents progression and worsening of liver disease. It also leads to healing of the liver. This has been confirmed with multiple studies and with liver biopsy. Various ongoing studies are undergoing to halt progression of liver disease in fatty liver. However no specific medications are yet available. Some studies have shown benefit with Vitamin E therapy. There is no doubt that limiting calorie intake is the easiest and the best way.
Personally, I starve every day. My average calorie intake is usually less than 1500. I have had 2 meals a day for the last 3 years. This is only helping me to keep my weight stable. I have not lost weight with this strategy. Hence if I were to lose, I would have to do vigorous exercise. Before I started medical college, I had gained about 40 lbs and it was a struggle to lose weight. So I can relate with individuals who carry those extra pounds. As most of you know, it is not easy to curb appetite and desire to eat.
If I cannot starve or diet every day, what other options do I have to lose weight ?
Proven, but expensive and drastic option is to go for weight loss surgery. It works most of the time. It is best suited for people with BMI above 35. Two best surgical options are vertical band gastroplasty (VBG) or Roux-en Y gastric bypass (RYGB).
I have a # BMI above 27, and want to lose weight. What is the best option for me ?
Recently available, and life changing for a lot of people is the launch of GLP-1 medications. These medications are revolutionizing weight loss. The recent GLP-1 medications - Semaglutide (Ozempic) and Mounzaro (Tirzepatide) lead to 10-15% weight loss in people. They were initially launched to treat diabetes, but now are being extensively prescribed for weight loss.
How do GLP-1 (Semagltuide, Tirzepatide) work ?
GLP-1 (glucagon-like peptide-1) medications are a class of drugs used in the treatment of type 2 diabetes mellitus. They work by mimicking the action of the GLP-1 hormone, which is naturally produced in the body in response to food intake. GLP-1 helps regulate blood sugar levels by increasing insulin secretion and reducing glucagon production, which leads to decreased glucose production in the liver and increased glucose uptake in the muscles. These medications also work by reducing gastric motility, hence people feel full with less calorie intake which assists in controlling blood sugar and aid weight loss.
How can I get GLP-1 medications ?
The easiest and cost effective way is to have your P*P write a prescription so that the insurance will cover the cost. However, in reality this might be not the easiest way, since insurance coverage is not always good. As a weight loss clinic, we prescribe our patients the medications through compounding pharmacies, The medication can be shipped to your home. Currently we are prescribing Semaglutide, and soon Tirzepatide would be available. As a license prescriber in Texas I can prescribe the medication to any individual in the State of Texas. You can visit the website www.myzoomclinic.com to start the process.
How does a weight loss clinic work ? .com
After visiting the site, you chose between various treatments available for weight loss. You can choose between phentermine or semaglutide. Based on your choice of treatment, you will answer questions to qualify and sign your consent for the treatment. The next step is finalizing payment, and an Online visit on Zoom with our team.
All the steps are Online, and virtual.
Dr. Adi .Malhotra
We are looking forward to being part of your Weight Loss Journey.
www.myzoomclinic.com
