Oral GLP1

  • Thread starter Thread starter Needtoloseit
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Needtoloseit

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Hello and Happy New Year,

I’m currently a revenue airman who is 31 and considered obese. My doctor desperately wants me to lose some weight as all of my cholesterol panels and triglycerides are extremely high. I was considering GLP-1s to help start the process and saw the FDA approved Wegovy as a once daily pill that I can take. I know the injectables are allowed, but would this also assumed to be allowed as well?
 
What does your doctor recommend?
Have you investigated the side effects of these types of medications?
Have you asked an AME for a consult for these medications?
Have you read the FAA's opinion on these medications and any restrictions?
Do you have a copy of the the FAA's Weight Loss Management Disposition Table?

Let me summarize
  • Medical Documentation: You need an AME (Aviation Medical Examiner) to review the FAA's Weight Loss Management Worksheet, a recent A1C (6.4% or less), and a physician's note confirming no significant side effects or diabetes diagnosis.
  • Observation Period: A 14-day ground period (2 weeks) is required when starting the medication to monitor for side effects, plus 72 hours grounding after any dose increase.
Note: I'm an engineer, not a health professional but all this is on the FAA website.
 
murphey said:
What does your doctor recommend?
Have you investigated the side effects of these types of medications?
Have you asked an AME for a consult for these medications?
Have you read the FAA's opinion on these medications and any restrictions?
Do you have a copy of the the FAA's Weight Loss Management Disposition Table?

Let me summarize
  • Medical Documentation: You need an AME (Aviation Medical Examiner) to review the FAA's Weight Loss Management Worksheet, a recent A1C (6.4% or less), and a physician's note confirming no significant side effects or diabetes diagnosis.
  • Observation Period: A 14-day ground period (2 weeks) is required when starting the medication to monitor for side effects, plus 72 hours grounding after any dose increase.
Note: I'm an engineer, not a health professional but all this is on the FAA website.
Click to expand...
Thank you for that. I realize that it is on the FAA’s website. But the oral Wegovy is new on the market as of tomorrow morning. It was just released within the last 30 days as prior it was injectable only. I am asking if the oral form would still be considered acceptable over the injectable form.
 
Needtoloseit said:
Thank you for that. I realize that it is on the FAA’s website. But the oral Wegovy is new on the market as of tomorrow morning. It was just released within the last 30 days as prior it was injectable only. I am asking if the oral form would still be considered acceptable over the injectable form.
Click to expand...
The issue isn't delivery method, the issue is grounding
Needtoloseit said:
Thank you for that. I realize that it is on the FAA’s website. But the oral Wegovy is new on the market as of tomorrow morning. It was just released within the last 30 days as prior it was injectable only. I am asking if the oral form would still be considered acceptable over the injectable form.
Click to expand...
The news is less than 48 hours. Once again, the answer is talk to an AME. There are 3 here. Not sure if they even know if the FAA has made a decision yet.
 
Needtoloseit said:
Thank you for that. I realize that it is on the FAA’s website. But the oral Wegovy is new on the market as of tomorrow morning. It was just released within the last 30 days as prior it was injectable only. I am asking if the oral form would still be considered acceptable over the injectable form.
Click to expand...
Your AME will be the gatekeeper between issued and deferred. Ask him. If it's the same drug, it may be easy. If it's a different drug, then the FAA's position is you have to wait until it's been on the market for a year.
 
shocked if it’s not allowed. it’s the same medicine. moreover it will bring all your numbers down and is hugely beneficial
 
There are much better alternatives to GLP 1's. The biggest being what lifestyle changes can you make to get you out of the situation you got yourself into. This is the method I used to lose 160 pounds and keep it off for nearly a decade. I understand everyone is in different situations, and GLP1's are the best option for some. Most however are looking for the "get rich quick" of weight loss when some discipline is all thats needed.
You will be surprised how quickly you can lose weight if you are running in a true caloric deficit mixed with some basic movement.
 
Kitch said:
There are much better alternatives to GLP 1's. The biggest being what lifestyle changes can you make to get you out of the situation you got yourself into.
Click to expand...

Agree. The unknowns of GPL 1s would give me pause, but the possible side effects that are known have already done that. I have family and friends that use these and I've watched them deal with the side effects. Nope ... nada, no thanks, forget about it. It's been nearly 30 years ago that I changed diet and lifestyle to shed 40 lbs. Been a great change. If not outside walking/jogging in the morning I get on the treadmill. It really doesn't take much to make the weight come down and the health benefits go up but it needs a commitment to work.

TANSTAAFL
 
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frfly172 said:
After hearing from people who use GPL1s about the side affects I’ll stick with diet and exercise.
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After hearing from friends who had no side effects and were able to stick to their diet and exercise routines that had previously failed, I'm strongly considering trying one.

One of the side effects is a 70% reduction in Alzheimer's risk. I wouldn't mind that either.
 
A podcast I recently started listening to raised the issue of around 40% of weight loss with GPL1 is muscle. It's hard to build/maintain muscle at calorie deficit. Metabolism drops with muscle mass. It will be interesting what long term studies reveal.
 
Mahneuvers said:
A podcast I recently started listening to raised the issue of around 40% of weight loss with GPL1 is muscle. It's hard to build/maintain muscle at calorie deficit. Metabolism drops with muscle mass. It will be interesting what long term studies reveal.
Click to expand...
Semaglutide has been around for 9 years. The long term studies are what revealed the massive reduction in Alzheimer's risk.

In any case, this paper talks about both the positive and negative side effects. It's quite well understood at this point, having been available for almost a decade, related compounds studied since the 70's in animals and semaglutide in it's current form in human clinical trials starting in 2008.
 
I've been on a GLP-1 since October. Saying it is life changing would be a little overdramatic, so I won't say it, but I have zero regrets. Lots of other benefits for me besides weight loss.
 
172andyou said:
After hearing from friends who had no side effects and were able to stick to their diet and exercise routines that had previously failed, I'm strongly considering trying one.

One of the side effects is a 70% reduction in Alzheimer's risk. I wouldn't mind that either.
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Recently, one of the best studies, an RCT (as opposed to a lot of the lesser quality studies), did not show any reduction in clinically meaningful progression of AD symptoms. Medically speaking, we wouldn't prescribe a glp1 for AD treatment or prevention because the evidence isn't really there yet. I wouldn't say it is dead, but lots of folks had high hopes for this study and, preliminarily, it's not looking good... There may be a role for GLP1 and dementia, but it's not at all clear...

O, O, Ozempic doesn't work for AD...
 
Mark K said:
Recently, one of the best studies, an RCT (as opposed to a lot of the lesser quality studies), did not show any reduction in clinically meaningful progression of AD symptoms. Medically speaking, we wouldn't prescribe a glp1 for AD treatment or prevention because the evidence isn't really there yet. I wouldn't say it is dead, but lots of folks had high hopes for this study and, preliminarily, it's not looking good... There may be a role for GLP1 and dementia, but it's not at all clear...

O, O, Ozempic doesn't work for AD...
Click to expand...
Ok, that report is almost a year after the one I cited. Must be part of the follow up the other paper said should be done.

Bummer...
 
@172andyou

I think this podcast was making two points for people heading into their senior years. First, it's better to have a metabolism that burns calories rather than a restricted diet which might lack vital minerals/nutrients.

Second, there are some strength/flexibility tests which are pretty good at predicting longevity, the grip test being a big one. Maintaining muscle as you age greatly reduces falls/broken hips etc. which is often a death sentence.

I believe the study they would like to see is are seniors on these meds falling and dieing at a faster rate.
 
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