Wegovy, Ozempic and Mounjaro are weight loss and diabetes drugs that have made quite a splash in health news. They target regulatory pathways involved in both obesity and diabetes and are widely considered breakthroughs for weight loss and blood sugar control.
But do these drugs point toward a root cause of metabolic disease? What inspired their development in the first place?
It turns out your body produces natural versions of these drugs – also known as incretin hormones – in your gut. It may not be surprising that nutrients in food help regulate these hormones. But it may intrigue you to know that the trillions of microbes in your gut are key for orchestrating this process.
I am a gastroenterologist at the University of Washington who studies how food and your gut microbiome affect health and disease. Here’s an inside-out perspective on the role natural gut hormones and healthy food play in metabolism and weight loss.
A broken gut
Specialized bacteria in your lower gut take the components of food you can’t digest like fiber and polyphenols – the elements of plants that are removed in many processed foods – and transforms them into molecules that stimulate hormones to control your appetite and metabolism. These include GLP-1, a natural version of Wegovy and Ozempic.
GLP-1 and other hormones like PYY help regulate blood sugar through the pancreas. They also tell your brain that you’ve had enough to eat and your stomach and intestines to slow the movement of food along the digestive tract to allow for digestion. This system even has a name: the colonic brake.
GLP-1 serves many functions in the body.
Lthoms11/Wikimedia Commons, CC BY-SA
Prior to modern processed foods, metabolic regulatory pathways were under the direction of a diverse healthy gut microbiome that used these hormones to naturally regulate your metabolism and appetite. However, food processing, aimed at improving shelf stability and enhancing taste, removes the bioactive molecules like fiber and polyphenols that help regulate this system.
Removal of these key food components and the resulting decrease in gut microbiome diversity may be an important factor contributing to the rise in obesity and diabetes.
A short track to metabolic health
Wegovy and Ozempic reinvigorate the colonic brake downstream of food and microbes with molecules similar to GLP-1. Researchers have demonstrated their effectiveness at weight loss and blood sugar control.
Mounjaro has gone a step further and combined GLP-1 with a second hormone analogue derived from the upper gut called GIP, and studies are showing this combination therapy to be even more effective at promoting weight loss than GLP-1-only therapies like Wegovy and Ozempic.
These drugs complement other measures like gastric bypass surgery that are used in the most extreme cases of metabolic disease. These surgeries may in part work much like Wegovy and Ozempic by bypassing…
