🔒 Weight loss ‘quick fix’ drug Ozempic is dangerous – Tim Noakes, Amanda Kuit

Experts Amanda Kuit and Tim Noakes criticize the off-label use of Ozempic for weight loss, arguing it promotes a quick-fix mentality. They highlight the dangers of processed foods in driving obesity and stress the importance of sustainable dietary changes over medication. Kuit advocates for personalized nutrition, while Noakes emphasizes whole foods.

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By Tim Noakes, Amanda Kuit

___STEADY_PAYWALL___The controversial off-label use of the diabetes drug, Ozempic, as an appetite suppressant for weight loss is an expensive, ‘quick fix’ for exercise-averse patients – and for prescribing doctors who want to get rid of weight-fixated patients easily.

That’s the shared view of a top Cape Town clinical molecular dietician, Amanda Kuit, and Tim Noakes, an emeritus professor in the Division of Exercise Science and Sports Medicine at the University of Cape Town and author of several books on exercise and diet. They agree that processed food addiction is a major driver of all stages of obesity. Nutrient-poor, ultra-processed foods specifically designed by the food industry to produce food cravings and displayed in supermarket and pharmacy check-out corridors are driving increased calorie consumption without satiating hunger, they add. Kuit says that the Covid pandemic-induced move to working from home has worsened population-wide obesity, “with a laden fridge now just a short step away from people’s desks.”

A Human Sciences Research Council, (HSRC), study finds that almost 50% of adult South Africans are overweight or obese, while the country ranks 24^th on the global obesity ranking. Thirty one percent of SA men and sixty eight percent of women are obese.¹

The two experts however differ strongly on Noake’s much-vaunted high fat/low carbohydrate, (HF/LC), diet as being the most effective alternative to Ozempic, with Kuit claiming this can also cause long term harm.

She says, “I don’t think the HF/LC diet is sustainable. I did my Masters’ degree on molecular nutrition, focussing on the topic of fatty acids. If you eat the wrong fat you’re going to end up with problems. Fatty acid levels act differently in different population groups because of the DNA pools, so for example Black people can have more severe problems if they consume the wrong fat.”

Ozempic has well documented harmful side-effects¹, and, says Kuit, does not result in anywhere near the weight loss claimed in studies much cited by its protagonists. When stopped, it results in users picking up double the usual weight, she adds. 

Off-label use of Ozempic for weight loss has dominated headlines globally because it denies the drug to patients with diabetes who’ve stabilized on uninterrupted supplies, forcing them to using other semaglutides, sometimes with disruptive effect. (A semaglutide is an antidiabetic medication used for the treatment of type 2 diabetes and an anti-obesity medication used for long-term weight management. It can be administered by subcutaneous injection or taken orally.)

Says Noakes, “it’s been known for at least two hundred years that that natural (unprocessed) real foods like fish, meat, eggs and dairy are highly satiating and are an extremely effective treatment for obesity. We now know that these foods can also put type 2 diabetes into remission.”

He adds that the popular diet that promotes the exclusive consumption of natural (real, unprocessed) foods is known in South Africa as the Banting diet or in medical terms as the Low-carbohydrate High-fat diet (LCHF). 

“A key advantage of the LCHF diet is that it produces satiety at a lower energy intake than does a diet of ultra-processed foods. One likely mechanism is that these foods stimulate secretion in the intestine of the natural hormone – GLP-1. Ozempic acts in exactly the same way to mimic the effects of this hormone and so produce increased levels of satiety, leading to a reduced caloric intake, resulting in (effortless) weight loss. 

However, he emphasises, this is exactly where the problem lies.

“The use of Ozempic will encourage people with obesity or type 2 diabetes to continue eating the same bad foods – albeit in slightly reduced amounts – that caused their problem in the first place.”

He mourns the time in medical practice when the goal of therapy was to seek out and treat the cause of the problem, not to simply alleviate symptoms with powerful pharmaceutical agents.

Ozempic was a “classic product of this failed medical approach,” contends Noakes.

“Those who choose to treat their obesity or type 2 diabetes with this medication rather than with the LCHF diet will need to use this medication for the rest of their lives. Besides the exorbitant cost – money which could be more profitably spent in purchasing nutrient-dense real foods – this “effortless” approach will expose them to the risk of long-term complications. It will also prevent them from enjoying the other health benefits of eating a diet of nutrient-dense foods that are naturally highly satiating and health promoting,” he adds.
Kuit says doctors are as much to blame as patients for misusing Ozempic.

“If you have a patient nagging about her weight, the easiest way is to prescribe medicine. It’s a case of ‘get out of the consulting room, and good riddance.’”

She says dieticians and nutritionists should rather come into play, emphasising that all dietary recommendations should be tailored to each individual’s body.

“We need to motivate and spend a lot of time with them. I use visualisation, telling them we’re going to run the Comrades together. You’re going to have trouble. Let’s say ten kilometres equals five kilograms. But you go to a social function, and you overeat. The idea is you don’t run back and start again. You just get motivation and continue until you finish the race. Too many people just want to run back and say it’s too difficult and rather have the Ozempic injection. But the thing is to continue, adding the fibre and making a difference in your lifestyle.”

Kuit says we live in a ‘food jungle’ that is constantly working against us.

“Chocolate won’t just disappear because you want to lose weight. You have to work out how you’re going to eat less chocolate or drink less wine and still lose weight.”

She said ketogenic diets where fat created ketones which the body used for energy could be achieved three ways; a low carb/high fat diet, eating high protein foods, or by lowering calories to 4 200 kilojoules – the minimum needed for normally bodily function, (below this one moves into starvation). 

“Ozempic does have a place in the market – but for diabetes. I believe you have to be diagnosed as a diabetic to use it. It does not have a place for weight loss, which is easy to do but takes discipline and a decision that you want to change,” she added.

1. Simelane T: National Food and Security Nutrition Survey, HSRC. March 18^th, 2024.
2. Documented side effects of Ozempic include, inflammation of the pancreas (pancreatitis), changes in vision, low blood sugar (hypoglycemia), kidney problems (kidney failure), serious allergic reactions, and gallbladder problems.

Read also:

• 🔒 Is the price of Ozempic really so outrageous?: Tyler Cowen
• 🔒 How the Ozempic maker Novo Nordisk became the epicentre of the Danish economy
• Novo Nordisk CEO grilled over high prices of obesity drugs: Lisa Jarvis

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