Zepbound and Wegovy: What women need to know about weight loss with Dr. Persondek
Today, let's delve into Zepbound and Wegovy, specifically what women should understand about these medications and weight loss in general. This includes insights for women with PCOS, those aiming to conceive, undergoing pregnancy, and experiencing the perimenopausal and menopausal stages.
Joining me is Dr. Stephanie Persondek, a double board-certified expert in obstetrics and gynecology and obesity medicine. With over 15 years of experience in OBGYN and a certification in obesity medicine obtained in 2021, Dr. Persondek leads Inclusa Health and Wellness. She is dedicated to women's health across all life stages and actively educates future healthcare professionals through university teaching positions and by authoring materials for McGraw Hill and ABC Board Review.
Weight Loss and Hormonal Changes
The dynamic nature of hormones means that women experience constant fluctuations throughout their reproductive years. From their twenties to their fifties, hormonal levels undergo significant shifts, profoundly impacting metabolism and weight.
The stability of male & female hormones are fundamentally different. While male hormones are relatively constant through their lifespan, female hormones fluctuate cyclically, creating a variable landscape for regulating weight.
While concerns about estrogen, progesterone, and other female hormones are valid, attention should also be given to the hormone insulin, which plays a crucial role in appetite regulation, metabolism, and even how well those female hormones function.
Insulin resistance is frequently implicated in weight gain, but resolving it isn't a one-size-fits-all solution. Instead, it mirrors the complexity of hormonal interaction and necessitates a nuanced approach of those behind the scenes dynamics.
Acknowledging the role that hormones play on weight allows women to approach their weight loss endeavors with informed perspectives. Rather than focusing solely on individual hormonal imbalances or a single approach, embracing the holistic interplay between hormones, metabolism, and weight regulation offers much more success and sanity long-term.
Understanding PCOS and its Treatment Landscape
Polycystic Ovarian Syndrome (PCOS) is one tricky hormonal puzzle, and it's getting a lot of attention these days thanks to some cool new treatment options.
Basically, in PCOS, the hormone levels go haywire, with estrogen and testosterone hanging out at higher levels than usual. Unlike the regular ups and downs of hormones during the menstrual cycle, in this syndrome, they stay elevated, causing all sorts of metabolic chaos. One big problem is insulin resistance, where insulin doesn't do its job correctly, making it tough for the body to deal with carbs and sugars.
Treating PCOS means tackling both the hormonal imbalances and the messed-up metabolism. Weight management is a biggie because carrying extra pounds makes insulin resistance worse and throws the metabolism even further out of whack. So, the focus is on shedding those extra pounds to improve how insulin works and how the body reacts.
And it's not just about weight. Insulin resistance often goes hand-in-hand with other conditions like high cholesterol, blood pressure, and wonky blood sugar levels.
Now, here's where it gets interesting. There are these new meds called Wegovy and Zepbound, and they're showing some serious promise in sorting out the hormonal mess that comes with PCOS. They target specific pathways involved in this syndrome, like how hormones are processed and how sensitive the body is to insulin.
Adding these meds to the PCOS treatment toolkit is a game-changer. They're like a precision strike against the hormonal and metabolic chaos, making other treatments even more effective.
So, in a nutshell, dealing with PCOS means taking a comprehensive approach. While old-school methods focus on losing weight and getting metabolism in line, these new meds like Wegovy and Zepbound bring some fresh hope to the table. By combining different treatment strategies, healthcare providers can give PCOS patients the best shot at better health and a higher quality of life.
Preparing for Pregnancy: The Role of Medications in Optimizing Health
When it comes to planning for pregnancy, getting to a healthier weight and managing medical conditions beforehand can make a significant impact.. So how do medications fit into this picture, and when might they not be the best option?
Medications like the ones we've talked about can be real game-changers in helping women reach their health goals before pregnancy. The goal here isn't even about dropping a ton of weight; even a modest 10 percent reduction can work wonders by regulating cycles and hormones. This can make conception more likely without needing fertility treatments like IVF or IUI, which can be costly, uncomfortable, and stressful.
Beyond the numbers on the scale, these meds do some other cool stuff too. They help with things like improving how our bodies handle insulin, lowering blood pressure, and getting those blood sugar and cholesterol levels in check. All of this not only makes pregnancy safer for mom but can also mean a smoother ride for baby.
It's not just about the here and now. What we do before we get pregnant can have long-lasting effects on our future kiddos. Research suggests that our health and lifestyle choices before pregnancy can actually influence our children's health through something called epigenetics. So, by taking steps to be healthier now, we're ideally setting up our kids for a healthier life down the road.
In a nutshell, these meds can be a trusty sidekick on our journey to parenthood. They can help get health on track before we even start trying, making pregnancy and delivery safer. So, if you're thinking about baby-making down the road, it might be worth having a chat with your doc about whether these meds could be part of your prep plan.
Balancing Medication Use with Pregnancy Planning: A Critical Consideration
When it comes to managing health conditions like type 2 diabetes and obesity, medications such as Zepbound and Wegovy are valuable assets. However, the decision to continue these medications during pregnancy warrants careful consideration. Let's delve into the complexities surrounding medication use before and during pregnancy, and explore the importance of this transition period.
Currently, healthcare recommendations advise against continuing medications like Zepbound or Wegovy during pregnancy. This cautious stance stems from the limited research available in pregnancy (currently, the only studies that exist are on rats or retrospective on patients who didn’t know they were pregnant). With uncertainties surrounding their effects on fetal development, healthcare professionals advocate for discontinuing these medications approximately eight weeks before attempting to conceive.
This recommendation prioritizes the well-being of both the expectant mother and the developing fetus. While ongoing research seeks to explore the possibility of safely managing conditions like type 2 diabetes with these medications during pregnancy, conclusive findings aren’t available yet. Therefore, the conservative approach of discontinuing them remains current standard practice.
The prospect of temporarily halting medication use may understandably raise concerns for individuals reliant on these treatments for managing their health conditions. And indeed, the transition off these medications can pose challenges, potentially leaving patients without their therapeutic benefits for an extended period. Consider the timeline: stopping the medication eight weeks before conceiving, followed by the duration of pregnancy and possibly beyond. In some cases, this could amount to over a year without the medication.
For patients accustomed to the positive effects from Zepbound or Wegovy, this adjustment may seem daunting. However, with our current evidence lacking, we’re hoping to view this transition period as a necessary precaution in the journey toward a safe and healthy pregnancy. Moreover, healthcare providers can offer support and guidance during this process, exploring alternative strategies to maintain optimal health and closely monitoring blood sugar levels and other relevant parameters.
Ultimately, the decision to discontinue medications before and during pregnancy is about prioritizing maternal and fetal well-being. While medications like Zepbound and Wegovy may play pivotal roles in managing health conditions outside of pregnancy, the unique considerations necessitate a cautious approach. By adhering to current recommendations and engaging in open communication with healthcare providers, individuals can navigate this transition with confidence, ensuring the best possible outcomes for themselves and their future children.
Considerations for Women Previously on Medications
For pregnant women seeking alternative options to Wegovy and Zepbound, metformin emerges as a safer choice for managing insulin resistance during this phase.
Metformin, a well-studied medication, offers a less potent but still effective means of regulating insulin levels and supporting metabolic health during pregnancy. Its safety in pregnancy makes it a valuable tool in managing health conditions while minimizing risks.
It’s also important to point out that most traditional weight loss medications are generally not recommended during pregnancy due to potential adverse effects on development. Instead, emphasis shifts towards adopting small lifestyle changes to support overall health and well-being.
Yet! Pregnancy brings its unique set of challenges and considerations. Cravings, aversions, and physical discomforts may necessitate adjustments to dietary habits and exercise routines. Despite these challenges, the overarching goal remains consistent: to support maternal health and ensure a healthy pregnancy outcome.
Most important is keeping communication open with healthcare providers. Regular check-ins provide opportunities to discuss dietary habits, exercise routines, and any concerns or challenges encountered along the way. A supportive healthcare team that understands the importance of holistic maternal health can offer invaluable guidance and support throughout the pregnancy journey.
Exploring the Role of Medications in Perimenopausal and Menopausal Women's Health
Often heralding the transition to menopause, perimenopause marks the onset of hormonal shifts and irregular menstrual cycles. During this stage, estrogen levels gradually decline, which can trigger metabolic changes like insulin resistance. The delicate interplay between estrogen and insulin becomes pivotal, as diminishing estrogen can often lead to increased abdominal fat and muscle loss.
Menopause, characterized by the cessation of periods, further exacerbates these metabolic shifts. With estrogen levels hitting a low point, women encounter fresh hurdles in maintaining their mental and physical equilibrium. With increased life expectancy, women in menopause are rightfully demanding proactive measures to safeguard their health and vitality.
In this context, medications such as Zepbound and Wegovy emerge as promising allies in managing weight and metabolic health. By targeting insulin resistance and facilitating weight control, these medications offer avenues to mitigate age-related risks like osteoporosis, muscle loss, and cardiovascular complications. Just like in any life stage, their role in perimenopausal and menopausal populations necessitates nuanced consideration and careful evaluation.
While these medications offer potential benefits, special attention must be paid, particularly for women with pre-existing health conditions. Healthcare providers need to weigh the potential benefits against risks to devise personalized treatment strategies.
Zepbound and Wegovy present promising prospects for managing weight and metabolic health in perimenopausal and menopausal women. By striking a balance between effectiveness and safety, healthcare providers can provide options that were previously nonexistent.
Preserving Muscle Health in Postmenopausal Women: Strategies and Considerations
When addressing the health concerns of postmenopausal women or older individuals, we need to address the impact of muscle mass. Many women often experience weight gain around their midsection coupled with muscle loss from declining estrogen. Prioritizing muscle building is essential (really!) and especially for those losing weight through medication.
Loss of muscle can cause drastic metabolic consequences. For this group of women, we emphasize strength training and enough protein to preserve muscle mass. Protein plays a vital role in muscle maintenance and influences our resting metabolic rate. Preserving muscle is imperative for sustaining calorie breakdown and metabolic health. Additionally, maintaining muscle mass reduces fall and fracture risk, particularly in older individuals. Strength training and weight-bearing exercises are pivotal for enhancing strength and balance. Have I told you enough how important your muscles are?
Addressing muscle mass changes in postmenopausal and older women requires a multifaceted approach. By prioritizing muscle maintenance through strength training, protein intake, and balance exercises, we aim to reduce metabolic changes, enhance overall health, and reduce the risk of falls and fractures. Through targeted interventions and lifestyle modifications, we empower individuals to age with resilience and vitality.
Exploring Birth Control Considerations with Zepbound and Wegovy
For women on oral birth control pills, understanding the interaction between these pills and Zepbound and Wegovy is crucial. The delay in stomach emptying caused by these medications can affect the absorption of oral contraceptives, potentially reducing their effectiveness!
With each dosage increase of Zepbound and Wegovy (over four weeks), there's a corresponding decrease in the effectiveness of oral birth control pills. This poses a challenge for women seeking pregnancy prevention while using these medications. Note - once on a stable dose of these meds, the risk of birth control pills being ineffective is no longer a concern.
What are the solutions? Exploring alternative birth control methods that aren't affected by Zepbound or Wegovy is one option. Traditional oral contraceptives may not be the best choice. Instead, options like the combination patch, NuvaRing, or long-acting reversible contraception (LARC) methods such as Nexplanon or IUDs offer effective alternatives.
The key is proactive contraceptive management. Healthcare providers should have informed discussions with patients about the potential impact of these medications on birth control efficacy. Offering alternative contraceptive options and comprehensive patient education empowers women to make informed decisions aligning with their reproductive health goals.
Discovering the impacts of Zepbound and Wegovy on women's health throughout different life stages is exciting! We've delved into topics ranging from hormonal shifts during weight loss to managing medication use during pregnancy and perimenopause. If you're eager to explore these topics further, make sure to tune in to the full podcast episode for a comprehensive insight into today's discussion.
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