Weight-Loss Drugs Explained
Video 1

Hi there. My name is Dr. Susan Peirce Thompson. It's nice to meet you, and I want to tell you a quick story. About 20 years ago, I lost all my excess weight. At the time I was living with Class 1 Obesity ,and I lost about 60 pounds. That was 34% of my baseline weight at that time, and I lost it without drugs and without surgery. I've been maintaining that weight loss now for 20 years. But more significantly in that time, I have helped thousands and thousands of people from over a hundred countries on planet Earth to lose their excess weight. Published research studies show that as a group, they're maintaining a weight loss that is equivalent to what people maintain on these new weight-loss drugs, but they're doing it without weight-loss drugs. I'm a professor of brain and cognitive sciences, and what I've done is I've spent the last year unpacking this weight-loss drug phenomenon, and I've created here for you a four-part video series where I'm going to explain the nature of these drugs and how you can get weight-loss drug results without the drugs. We're going to be talking about the pathways, the mechanisms involved, why they work, how they work, and how exactly you can create those same effects naturally.

Who is this for? Well, it's for a few different types of people. It could be for you if you want to lose weight, but you don't want to be on one of these weight-loss drugs, and that could be because you just don't prefer a pharmacological solution. It could be because you've heard about the side effects and those don't sound good to you. It could be because you've heard about the cost, and that doesn't sound good to you. It could just be as simple as you don't prefer shots, or this could be for you if you're on one of these weight-loss drugs right now and you want to get off them maybe because of side effects, maybe because of the cost. And you've heard, and this is true, that you'll gain the weight back once you stop taking the drugs and you're thinking, “I just invested all this, and I've lost this much weight. How can I maintain this weight loss and not just gain it right back?” Finally, it could be for you if you're on one of these weight-loss drugs and you plan to stay on them, but you're investing a lot and you just want the best outcomes, you want the most health and the most weight loss, and you want to learn how to use your biology to work with these drugs naturally.

We're going to start off in this first video explaining all about the new weight-loss drugs, what they are, how they work, the pros and cons, just so we're all on the same page. But first, I want to backtrack for a second and remind us all where we were at before these weight-loss drugs took over our consciousness when it comes to weight loss. Not that long ago, we were living in a state where there was a lot of dismay because really when it came to weight loss, nothing was working. I mean, here's a graph showing a lot of commercial weight-loss programs and the published scientific studies that show their results. Short-term results at two months, then one year and oh, at two years almost nobody's publishing results. Only Weight Watchers has published results. Why? Because most of the weight’s regained at two years. But even then, all of these results are so meager. Look, here at the y-axis we're talking about 5% weight loss. What does that mean? 5% weight loss if you're 200 pounds means losing 10 pounds. It's just not enough weight to get excited about.

Meanwhile, in light of the fact that research shows that diets just don't work pretty much, there was a lot of emphasis growing on health at every size, and the body positivity movement was really gaining traction and people were feeling like maybe we should all just accept ourselves, love ourselves more, work on anti-fat bias, which is still a huge problem, and really reconsider whether it's a problem that our weight continues to go up. Now, on that front, I have to say I am a huge proponent of us all looking at our anti-fat bias. It's the only bias that continues to go up over time, and it's a huge problem. Everybody needs to receive access to services, love and acceptance to be able to live and let live and just be in the world without being the target of anyone's prejudice or discrimination. Point blank. I also know that living with a lot of excess weight, it's just not healthy. It's strongly associated with almost all of our current top causes of premature death. We're talking heart disease and stroke and diabetes and cancer. And, while we're living, it's associated with poor quality of life from mobility issues and joint pain and also poor mood and depression and anxiety and mental health. It also releases inflammatory cytokines. It's not inactive excess adipose tissue. It's releasing inflammatory cytokines that lead to then, for example, hospitalization and early death from COVID, if you catch it, and other diseases. It's active. It carries a lot of toxins. It's not healthy. For a lot of us who are carrying excess weight, like I'm speaking for myself now, when I was living with obesity, I knew I just knew I could try to wish it away by loving myself more. But it wasn't that I didn't love myself, I did love myself. I just knew that that excess weight I was carrying, it wasn't supposed to be on my body. It shouldn't have been there. It was because of my unhealthy relationship with food, and the way I was eating needed to be addressed, and that excess weight needed to be shed. I just knew it.

Then in the winter of 2023, suddenly everyone was talking about weight-loss drugs. The main one, the first one to hit the airwaves was Ozempic. In the years since then, headlines have been saying that these drugs don't just help with weight loss, they help with cardiovascular health, liver health, sleep apnea, kidney function, addiction, and more. What are these drugs? What are they called? What are the side effects? What are the costs? Let's talk about that.

How do they work? Ozempic and Wegovy are a drug called semaglutide, and Ozempic is prescribed for diabetes and Wegovy at a slightly higher dose is prescribed for weight loss. Semaglutide is a drug that's a GLP-1 agonist. Agonist just means it mimics it in the body, which is basically an appetite suppressant. It slows down the digestive system. It moderates blood sugar by increasing insulin from the pancreas, decreasing glucagon from the liver, balancing out blood sugar. That's why it's good for diabetes, and because it's an appetite suppressant, it works for weight loss too.

Now, if we take a look at this graph, no wonder people were excited. So, at two months, the results are not that spectacular. But then at one year, oh my goodness, a lot of weight loss, 15%, we'd never seen results like this before. And even more exciting, it was maintained at two years. People started asking for these drugs, demanding them, doctors started prescribing them hand over fists. Suddenly there were shortages. The manufacturer, Novo Nordisk, which is a Danish company, suddenly was worth $425 billion. That's more than the entire economy of their home country of Denmark. Now, there are other weight-loss drugs as well. There's the tirzepatide, which include Mounjaro, which is for diabetes and Zepbound, which is for weight loss. These are manufactured by Eli Lilly, and they work by combining two hormones together, GLP-1 and GIP. And there's even newer drugs now that are combining three hormones together. This topic of combining hormones together is really important. We're going to be talking about that in due course.

How are these drugs working? Because if we're going to figure out how to get weight-loss drug results without the drugs, we're going to have to really understand the different pathways involved. There are indeed multiple different effects that these drugs have. Now, we don't know everything about the mechanics of each pathway, but we know quite a bit. First of all, first and foremost, these drugs are appetite suppressants. And this GLP-1 hormone works to slow down digestion. It thickens the bowel wall lining. It slows digestion down to the point where someone who used to have a bowel movement every day might start to have a bowel movement every other day, every third day like that. It makes the esophagus feel stuffed, like you just couldn't even imagine wanting to swallow food. It just makes the whole idea of eating unappealing. Now, what that does is it handles the hunger problem, this runaway hunger that a lot of people have where they eat a full dinner and then they go eat more food sitting down in front of the tv. They keep eating and eating. It solves that problem. We're going to have to find a natural way to handle the hunger problem and to create a natural appetite suppressant.

The second pathway is all about cravings. These drugs work in the addictive centers of the brain to modulate dopamine and shut off cravings. People have noticed when they're on these drugs, not only are they not eating as much, but they're not gambling as much. They're not smoking as many cigarettes, they're not drinking as much. They just feel less interested in these rewarding, sort of, drive-oriented activities. That's because of these drugs. That solves the cravings problem. People aren't plagued by food cravings anymore. If we're going to create that effect naturally, we're going to have to find a way to find the same result.

The third thing is that these drugs solve is what I call the Willpower Gap™, which is where you know what you should be eating. You've got a plan of eating. It's very sensible. You've been following it, but then you just cave, right? It's Friday night, you're exhausted, and you just decide to order a pizza. That's the Willpower Gap. These drugs solve that problem by almost entirely taking away people's drive to eat. It's a highly unnatural state. Nobody lives in that state naturally, but these drugs create it pharmacologically. And if you're not going to take one of these drugs, then you have to find a way to handle execution over the long term because it's one thing to know what you should be eating and not eating. Actually, a lot of people are in that state now. They know what they should be eating and not eating. It's another thing to actually behave that way day in and day out, even when your willpower is depleted. So, we're going to have to find a way to handle that situation naturally as well. These drugs do produce some strong weight-loss results, and they do it by taking away your appetite and solving the hunger problem, reducing or eliminating food cravings, and by solving the Willpower Gap, because when you just never really feel like eating, you just don't have to worry about your willpower when it comes to food anymore at all.

They create these phenomenal results at a cost. There are many types of costs to these drugs. The first one we're going to talk about is financial. Now, the financial costs are significant. In the United States where I live, they're beyond significant. They're outrageous. The costs of these drugs are right about $1,300 a month, so we're talking like $16,000 a year. Maybe you can afford that, and that's not a problem. Write the check and move along if cost is not an issue. Can your insurance cover it? Maybe. If you've got diabetes, it's more likely. For weight loss alone, most insurance companies are trying not to cover these drugs because if everyone who qualified for them was on them, it would bankrupt them. It would be a $6 trillion annual payout if everybody in the United States alone who qualified for these drugs was on them. So, maybe your insurance will cover it. There's a zillion insurances, I don't know. Go call your provider and see if they'll cover it for weight loss, but less and less of them are willing to do so.

Now, if your insurance won't cover it, there are workarounds on the cost. You can go directly to Novo Care Pharmacy and get over half off, which brings it down to $499 per month, but that's still nearly $6,000 each year. Or you can try a compounding pharmacy and get it even cheaper. But here's the thing, doctors really don't recommend this because you'll have to calculate the dose and mix it at home on your own, and this can be very dangerous. In 2023 alone, poison control centers saw a nearly 1500% increase from people accidentally overdosing on injected weight-loss drugs. So, cost, that's one major effect.

Some of the other side effects are medical in nature, and the main one that is experienced by a lot of people is gastrointestinal in nature. They just don't feel right in their GI tract. They feel stuffed up in the neck and the esophagus, they're not eliminating. They feel these toxins building up. They are vomiting, they feel sick to their stomach, kind of like having the flu. And there are GI symptoms potentially from impacting or messing with your GI system this way, thickening your bowel lining and so forth. We don't have long-term safety data on semaglutide and these other related weight-loss drugs. For some people, the GI symptoms culminate in a total bowel obstruction, and in fact, bowel obstructions are up right now, 450% thanks to these drugs. So, what's a bowel obstruction? It's when you literally can't eliminate any more at all. They have to do surgery to go in and clear out your intestines, and it's not reversible. It's an absolutely devastating condition. Pancreatitis is also up 900%, an extremely painful condition. There's good research showing that these drugs produce thyroid disease, not thyroid cancer, that was in animals, animal models, but in humans, these drugs do produce thyroid disease, and a lot has been made about the muscle loss people are experiencing as they lose weight on these drugs. I think people are having a hard time eating enough protein, and that combined with the weight loss means they're just losing muscle mass. Finally, anhedonia is a problem. This is sort of a lack of pleasure in life, certainly a lack of pleasure in eating, but for some people, the malaise that they're feeling, the lack of dopamine really is what's happening, results in them not feeling very good anymore or very excited about life. This anhedonia may be related to a couple of potential side effects that have just been uncovered more recently, namely the potential for depression and suicidal ideation. These have been found, especially in patients who have genes for low dopamine or under expressed dopamine, and there are many. So, doctors are now recommending genetic tests to screen for these genes before someone starts on weight-loss drugs. And finally, in mid 2024, research came out showing a huge increase in people losing their vision in one eye due to these drugs. This was published in JAMA Ophthalmology, a top journal, and the condition is called neon or non-arthritic anterior ischemic optic neuropathy. What does that mean? It means lack of blood flow to the optic nerve that suddenly creates loss of vision. It's typically not reversible, it's permanent. The study was done in people who were overweight ,and/or had diabetes, in the control group. 1.8% of them developed this condition, and in those taking Ozempic or Wegovy, 8.9% of them developed the condition, and that's a 394% increase in risk. Astronomical.

Now, I want to be clear that experts are not in total agreement about the extent of these side effects and how worried people should be about them. Some experts say, “Oh, the side effects are really overblown, especially the GI side effects. We start people on a very low dose and increase them gradually, and almost everyone can tolerate these drugs.” Other experts are reporting that they find that a lot of the people that they prescribe these drugs to can't tolerate them, that they're vomiting, they feel sick, they have to get off them right away, and they're very, very worried about these bowel obstructions, and they feel like people should be very concerned about the side effects. I just want to create a balanced picture here and say that there isn't complete agreement about how severe the side effect profile really is. I personally think about it like this. Do I think that I would recommend as an expert that's someone who's got 10, 20, 50, even 60, or 70 pounds to lose and is otherwise healthy and pretty happy, should try one of these drugs for weight loss? I don't, but I know someone who's 300, maybe 350 pounds. He's pushing 60, he's got runaway type two diabetes. He knows me. He knows all the things that I'm going to teach you here. He's not going to do it. I don't know if he can't do it, he won't do it. It's just not in his constitution to be able to make sustained choices. He can't get up the oomph to do it, and I really do think that he might die in the next few years from his diabetes and his doctor prescribed him one of these drugs for diabetes, and I think he should be on it. Absolutely. It depends on the profile of the person, and it also depends on the person's risk tolerance. Because with any drug comes risks.

Here's where there is widespread agreement. It is generally accepted and understood that once you go off these drugs, the weight comes back. So, unless you've paired them with a very powerful behavioral program, once you go on them, you really should be prepared to stay on them for life. This brings us to the real issue. The main reason why I'm now convinced that these new weight-loss drugs are not going to be solving our obesity pandemic anytime soon, and that is that people are not staying on them. That's right. Two significant studies have just come out showing that within two years of getting on these drugs, 85% of people are deciding on their own to go off of them. 85%. That's a whopping number, but why would that be? I think I have an answer for you, and it comes from a big study that was published in Nature, the Top Scientific journal in the world, in May of 2024. Here's what they found. Remember that weight-loss drug results were looking great out to about two years while these researchers looked longer term and found that the weight loss itself was only lasting about 15 months, which is one year and three months, and then it stopped. It just stopped. That's on average for the average person. And then after a long plateau on average, people started to gain weight back so that by four years, they had regained about a third of what they had lost. People are paying a lot of money, they think it's not working anymore, and they go off the drugs. It makes sense.

Right now, the behavioral program we're talking about in this video series, it just published a study in May of 2025 in a top journal, Frontiers in Psychiatry, and it showed that six years out, people who kept doing the program were not regaining the weight. In other words, long term they're getting even better results than weight-loss drugs without the drugs. But how are they achieving that? How does it work? Well, that's exactly what we're going to cover in the rest of this video series. We're going to tackle these three main benefits that these weight-loss drugs give you, and we're going to talk about how to get those same effects without taking the drug. Video 2, the next video is going to talk about hunger, that appetite suppression effect and how you can get that same effect by just changing what you eat and don't eat, and the video after that. Video 3 is all about cravings, food cravings, sugar cravings, and how to get them to go down without taking a drug to suppress them. I've published a peer-reviewed scientific journal article showing that it's possible to get people's hunger and cravings going down, down to little or no hunger or cravings anymore ever in just eight weeks. Once you know exactly what you should be eating and not eating and how and why.

I'm not just going to leave you there and say, “Okay, go forth and prosper. You know what to eat and not eat now. You're good.” Because we've all been in that situation before, having a really good plan, knowing what to eat and not eat and not being able to stick with it over the long term. That's the issue with the brain. It doesn't actually show up to help us execute what we know we need to be doing with our food long-term. So, video 4 is going to be all about the Willpower Gap and how exactly you can create a state where you are following through over the long term. Now, drugs solve the Willpower Gap by making you not want to eat pretty much at all ever. If you're not going to take a drug, how do you solve the Willpower Gap problem? That's what we're going to cover in video 4.

Thank you for tuning into this series so far. In the next video, we're going to dive into hunger and how to get that appetite suppression effect without taking a drug. We're done for now, but I just have one ask for you. Could you please just scroll down and leave me a comment because I'm going to be reading the comments and my team's going to be reading the comments, and we're just curious how you're doing with this information. Did you learn something new? Loved it, hated it. Where are you at? Leave a comment down below. We will read them. Thank you so much for tuning in, and I'll see you in the next video.