Tanmay Bhat Says He Had No Hunger Suppression While On Weight Loss Drugs; Here's Why

Due to the massive popularity and high effectiveness of GLP-1 drugs, it seems like the world is now losing weight with medication. Celebrities across the world continue to attribute their weight loss journeys to GLP-1 medications. However, comedian Tanmay Bhat didn't have the same experience. In a post shared on X, he revealed that he experienced no appetite suppression despite being on the medication. Bhat, who previously lost 75 kg without medication, decided to try these popular weight loss drugs, only to find himself among the minority for whom GLP-1s do not work. "I have experienced zero appetite suppression - upon further investigation, my gene report suggested a BDNF gene variant that is prone to weakened satiety signalling," he wrote in the post.

In simple words, Brain-Derived Neurotrophic Factor (BDNF) is a key protein in the brain that acts as a powerful suppressor of appetite and a regulator of energy expenditure. Specific genetic variants of the BDNF gene can lead to weakened satiety signalling, which means the brain does not receive strong signals of fullness even when the body has consumed enough calories.

"GLP-1 drugs mainly reduce hunger and appetite signals. They may not work well if a person's weight gain is driven by other factors such as genetics, slow metabolism, hormonal problems, emotional eating, medication effects, or metabolic adaptation. In some people, the brain's response to GLP-1 is weaker, so appetite suppression and weight loss are limited," says Dr. Abhay Inderjit Ahluwalia, Director of Endocrinology at Fortis Gurgaon.

For the unversed, GLP-1 drugs, such as Ozempic (semaglutide) and Wegovy (also semaglutide at a higher dose), are medications originally developed to treat type 2 diabetes. They work by mimicking the action of the glucagon-like peptide-1, a hormone that helps regulate blood sugar levels, insulin secretion, and suppress appetite.

How do they help with weight loss?

These medications assist with weight loss primarily through three mechanisms:

1. Appetite suppression: GLP-1 medications can help you feel full faster and reduce hunger, which significantly reduces overall calorie intake. They also interact with the brain's reward system to diminish the pleasure associated with eating, particularly fatty or sugary foods.

2. Slowed gastric emptying: They slow down the rate at which food leaves your stomach, which can prolong feelings of fullness after eating.

3. Improved blood sugar control: By enhancing insulin secretion and reducing glucagon levels, these drugs help stabilise blood sugar levels. High and low blood sugar levels can influence hunger and cravings.

In what cases GLP-1s may not work?

While GLP-1 medications are highly effective for many, an estimated 13% to 25% of users may be considered non-responders who do not experience desired appetite suppression or weight loss.

Dr. Ahluwalia says GLP-1 medicines may be less effective when:

• Eating is stress or emotion-driven rather than hunger-driven
• Severe insulin resistance is present
• Poor sleep or sleep apnea exists
• Thyroid or hormonal disorders are untreated
• Muscle mass is low, or protein intake is inadequate
• Weight regain after repeated dieting has slowed metabolism
• Weight-gain medications are being used

Here's a complete breakdown of factors that may restrict GLP-1 effectiveness:

1. Biological and genetic factors

Responses to these medications can vary widely among individuals due to genetics.

• Receptor resistance: Individuals with GLP-1 resistance have a reduced physiological response. Over time, cells become less sensitive to the drug's signals.
• Genetic variation: Specific variations in the GLP1R gene can change the structure of receptors, preventing the medication from binding effectively or triggering the correct fullness signal in the brain.

2. Underlying health conditions

Certain medical conditions may also interfere with the drug's effectiveness, such as diabetics often experience less appetite suppression and slower weight loss compared to those without it. Additionally, hormonal and inflammatory conditions like hypothyroidism, PCOS, and insulin resistance can create a hormonal environment that actively resists the drug's signals. Chronic inflammation, often driven by high-fat diets, can also disrupt the brain's ability to receive satiety signals.

3. Other medication

Conflicting medications can affect the effectiveness of GLP-1s. Drugs that promote weight gain, such as certain antidepressants, antipsychotics, beta-blockers, and others, can counteract the appetite-suppressing effects of GLP-1s.

4. Diet and lifestyle habits

If a person continues to consume a high-calorie diet or leads a sedentary lifestyle, the effectiveness of GLP-1 drugs may be diminished. Additionally, factors like emotional eating, poor sleep, and chronic stress, which affect one's appetite, can influence weight loss results.

What should individuals do when GLP-1 fails for weight loss?

Dr. Ahluwalia recommends the following:

• Confirm adequate dose and treatment duration with a doctor
• Check for underlying medical or hormonal issues.
• Improve nutrition (especially higher protein intake)
• Add resistance/strength training
• Address sleep, stress, and emotional eating habits
• Consider combination medical therapy or alternative treatments under medical supervision
• Approaching weight loss Sustainably

While GLP-1 medications can aid in weight loss, they work best in combination with a healthy lifestyle and should be tailored to individual needs. For sustainable weight loss, it's essential to adopt a multifaceted approach that focuses on consuming a balanced diet combined with regular physical activity. Additionally, behavioural changes, mindful eating, and setting realistic goals can help achieve sustainable results.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.