The Science Behind Saving Dessert for Last

By Koby Taylor, PharmD

Probably one of the hottest topics of our time is weight loss. I spend a great deal of time consulting and coaching my patients on this very subject. Whether it be a few pounds brought on by age-related decrease of metabolism, unhealthy lifestyles, or genetic predispositions to obesity, weight loss and weight management are topics I discuss with patients daily.

As a culture, we’re exposed to “revolutionary” fad diets, exercise routines, surgical procedures, products, supplements, and pharmaceuticals, to name a few. And in recent months, thanks to advertising, our exposure to the aforementioned has proven to be no different.

Hot Weight Loss Medications/Products That Have Recently Hit the Market

Semaglutide, the active ingredient in brand-name drugs such as Ozempic, Wegovy, and Rybelsus, which were designed for the management of type 2 diabetes, have also been shown to be effective for weight loss. Semaglutide works by targeting GLP-1, which is a thirty or thirty-one amino acid long peptide hormone that lives in the gut. Triggered when you eat, this GLP-1 mechanism tells your brain when you’re full. In some people, this mechanism doesn’t work properly, so semaglutide will affect the GLP-1 and in a sense, turn on the “I’m full” mechanism.

I am often asked the following leading questions:
How long can I use semaglutide?
If I discontinue use, will the fat come back?

The length of time you can use semaglutide will vary from person to person. If you tolerate it well and are monitored, you may be able to stay on it indefinitely. I’d like to add that if you view this medication as a “tool,” rather than a fail-safe, to help you jump-start better eating habits with food and exercise and to help you get you to a healthier place mentally and physically, you won’t need to be on it indefinitely.

Once you’ve discontinued use, you may regain your weight. Keep in mind that for the length of time you have been taking it, this drug has been telling your body that you don’t need as much food or as many calories for survival. Once it has left your system, your body may start to feel as though it’s starving, which may cause you to eat more than you did while on it. Keypoint: this is also true with any fad diet or exercise routine. Anytime you stop, there is always that risk that your weight will come back. Please also recall what I wrote above about using this medication as a “tool.” If you are able to retrain your habits and your relationship with food, you’ll be able to overcome any weight gain brought on by stopping the use of semaglutide.

Semaglutide products, whether name-brand or compounded, will require a prescription, and you should be monitored by your healthcare provider.

Quick note about compounding:
Patients are able to get semaglutide in compounded form. In particular, my pharmacy can create semaglutide lozenges in an oral form instead of an injectable form. There have been reports that compounded forms could be suspected of not being genuine. It is important to know your compounding pharmacy and its accreditations. Legitimate compounding pharmacies work extremely hard to gain and maintain accreditations and are under radical ethical guidelines. So rest assured, legitimate compounding pharmacies will not jeopardize their standing by creating substandard medications.

Over-the-counter supplements, such as CM Core and HiPhenolic by Ortho Molecular Products, are showing a lot of promise for weight management. These supplements are something I have many of my patients try frequently, and they are showing promising signs of efficacy for weight loss.

CM Core contains berberine, a plant- derived ingredient shown to boost metabolism and help regulate blood sugar as well as serve as a potent antioxidant.

HiPhenolic contains a high concentration of polyphenols (plant-derived) and helps to support normal blood pressure levels, manage weight, and control appetite.

What I love about these supplements is that they are over-the-counter, and many of my patients are reporting that while weight loss/management is one component, they have more energy and generally feel better throughout the day.

These supplements aren’t designed to work as fast as semaglutide, but if you’re someone who wants to shed a few extra pounds, they may be a good alternative to explore.

The Meat and Potatoes of Food

I have spoken with people who comment that they mainly eat salads and fruit, and yet they still have unwanted pounds. I have spoken to people who are very active, eat balanced meals, and either can’t lose weight or have gained weight. If either of these scenarios sounds familiar, here’s what we know about how our body processes food.

For the purpose of this article, I’m going to bypass naming all the hormones in our body’s complex system and the roles they play with weight and instead, jump to one hormone in particular, and that is insulin.

In brevity, insulin is created by the pancreas, and its sole function is to carry sugars we’ve consumed to blood cells for energy. If our body is insulin resistant, glucose can’t enter the cells as easily, which leads it to build up in the blood and may cause type 2 diabetes and/or obesity. In other words, when insulin levels are high, your body switches to a state of “fat storage,” and the fat that is stored is sugar that can’t be utilized.

Interestingly, just thinking of sweet treats can cause the body to create insulin and start its biological process. Isn’t that crazy? The same holds true for imagining your favorite meal; your mouth may start to salivate, and your body may literally get ready to ingest and digest this imaginary meal.

Can you counteract the insulin resistance response?

Yes. Enjoy your dessert after your meal. While we’ve been brought up to think of dessert as saving the best for last, let’s now think of it this way: when you eat your meal consisting of proteins, fats, and fibers first, any sugars you consume afterward (even carbohydrates) now have a cushion that helps your body process sugar more slowly and efficiently. You may not even desire that sweet treat after all.

If you’re curious about your blood sugar, there are wearable glucose monitors on the market. I highly recommend them to anyone who is on a weight loss journey. Your biggest asset will be how your support yourself and increase your knowledge.