July 8, 2025 • 18 mins
The weight loss world is shifting fast—and the battle between prescription medications like semaglutide (Ozempic/Wegovy) and nutrition-based strategies like the ketogenic diet is front and center. Which one delivers the best results? And more importantly, which is right for you?
In this episode of The Health Pulse, we compare these powerful approaches head-to-head, exploring five key areas: weight loss outcomes, metabolic health benefits, side effects, sustainability, and cost/accessibility. You’ll learn how semaglutide’s triple-action mechanism influences appetite and insulin, and why the ketogenic diet remains a leading tool for those with insulin resistance and metabolic inflexibility.
We also explore the emerging idea of combining both approaches to enhance results and minimize downsides—leveraging semaglutide’s hormonal benefits alongside the metabolic power of a high-protein, low-carb lifestyle.
Before beginning any weight loss journey, we emphasize the importance of testing key metabolic markers like fasting insulin to guide personalized care.
Tune in for science-backed insights that cut through the noise and help you take control of your health—on your terms.
📞 Need lab work done from the comfort of home? QLM offers fast, reliable mobile phlebotomy services—no clinic visit required.
📅 Book your appointment or learn more at:
👉 Quick Lab Mobile
📧 Contact us: info@quicklabmobile.com
💬 Enjoyed the episode? Leave us a review and let us know what topics you'd like us to cover next! Your feedback helps us bring you the content that matters most.
Disclaimer: The information provided in this podcast is for informational purposes only and should not be considered medical advice. The content discussed is based on research, expert insights, and reputable sources, but it does not replace professional medical consultation, diagnosis, or treatment. We strive to present accurate and up-to-date information, medical research is constantly evolving. Listeners should always verify details with trusted health organizations, before making any health-related decisions. If you are experiencing a medical emergency, such as severe pain, difficulty breathing, or other urgent symptoms, call your local emergency services immediately. By listening to this podcast, you acknowledge that The Health Pulse and its creators are not responsible for any actions taken based on the content of this episode. Your health and well-being should always be guided by the advice of qualified medical professionals.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Nicolette (00:01):
Welcome to the Health Pulse, your go-to source for
quick, actionable insights onhealth, wellness and diagnostics
.
Whether you're looking tooptimize your well-being or stay
informed about the latest inmedical testing, we've got you
covered.
Join us as we break down keyhealth topics in just minutes.
Let's dive in.
Mark (00:27):
Okay, so the whole landscape of weight loss, it
feels like it's justdramatically shifted lately,
hasn't it?
It really has For ages it feltlike the conversation was
dominated by dietary changes.
Nicolette (00:37):
Yeah.
Mark (00:37):
You know, like keto, which is still incredibly popular, it
fundamentally changes how yourbody uses fuel.
Rachel (00:43):
Absolutely A metabolic shift.
Mark (00:45):
But now Wow, we're seeing these really powerful new
medical options stepping up,specifically the GLP-1 receptor
agonists.
Rachel (00:56):
Like semaglutide.
Mark (00:57):
Exactly Semaglutide.
You probably know it as Ozempicor Wegovi.
Yeah, and the results peopleare seeing in trials, they're
genuinely transformative.
Rachel (01:04):
Yeah, quite remarkable numbers.
Mark (01:06):
So that's what we're tackling in this deep dive.
It's the big questionSema-glutide versus the
ketogenic diet for weight loss.
Rachel (01:12):
Head to head.
Mark (01:13):
Yeah, we're going to break down the science.
Look at the outcomes side byside, weigh the pros, the cons,
all of that, and this is where Ithink it gets really
fascinating.
Can they actually work together?
Rachel (01:25):
The combination approach .
It's a hot topic.
Mark (01:27):
Definitely, our goal here isn't to just drown you in data.
It's really about guiding you,helping you make an informed
choice, whether you're thinkingmedical nutrition first or maybe
maybe both.
Rachel (01:39):
And that's exactly our mission today.
We want to pull out the reallycrucial bits of knowledge from
the sources, give you thatshortcut to being well-informed.
Mark (01:47):
Yeah.
Rachel (01:47):
We'll flag the surprising stuff, connect the
dots and focus on what reallycounts for your health journey.
Mark (01:53):
Perfect.
Okay, let's start withsemaglutide.
Ozempic, wegovi People know thenames Right.
So what is it fundamentally?
It's a prescription medication.
It's a GLP-1 receptor agonist.
Rachel (02:06):
And that word agonist is key, isn't it?
Mark (02:08):
It is.
It means it basically mimics oractivates the same pathways as
a natural hormone your own gutmakes GLP-1.
Rachel (02:16):
Which your body releases after you eat.
Mark (02:18):
Exactly.
It was first developed for type2 diabetes management, but its
FDA approval specifically forweight management really pushed
it into the mainstream spotlight.
Rachel (02:26):
And the way it works is actually quite elegant.
Biologically speaking, it actslike that natural GLP-1.
Mark (02:31):
So how does that translate into weight loss?
Rachel (02:33):
Well, it hits multiple targets.
Three main things.
First, it really increasessatiety, that feeling of
fullness, and it slows down howquickly your stomach empties.
Mark (02:43):
So you feel fuller, faster and for longer.
Rachel (02:45):
Precisely.
Second, it helps your body useblood sugar better by enhancing
insulin secretion and at thesame time, it suppresses
glucagon, which is the hormonethat raises blood sugar.
Mark (02:57):
Ah, so it stabilizes blood sugar from both sides.
Rachel (02:59):
Exactly Really powerful effect there.
And third, it seems to directlyinfluence the hunger centers in
the brain.
Mark (03:07):
Reducing overall desire to eat.
Rachel (03:08):
Leading to a significant reduction in overall food
intake.
Yeah, it's a triple whammyreally.
Mark (03:13):
And the results reflect that, don't they?
The clinical trials like theSTEP series?
Yeah, the numbers are juststriking.
Nicolette (03:19):
They really are.
Mark (03:20):
You're talking average weight loss of what?
12 to 15 percent of body weightover about 68 weeks.
Rachel (03:25):
Yeah, which is substantial.
Mark (03:27):
And it's not just the number on the scale right, it's
the consistency.
People who've struggled foryears were seeing real results.
Rachel (03:33):
But beyond weight, the metabolic benefits were clear
too.
Mark (03:36):
Right.
Better blood pressure, improvedlipids, lower inflammation
markers.
Rachel (03:40):
Reductions in waist circumference, that dangerous
visceral fat.
Mark (03:44):
Yeah, it genuinely outperformed just lifestyle
changes alone in those trials.
Yeah, and often better thanolder obesity meds too.
Rachel (03:52):
But with effects that powerful, you always have to ask
about the other side, thetradeoffs the side effects and
considerations.
Mark (03:59):
Yeah, absolutely crucial.
Rachel (04:00):
Yeah, People need to know what they might be signing
up for the common stuff firstNausea, sometimes vomiting,
constipation is a big one.
Fatigue, dizziness, especiallywhen you're first starting out.
Mark (04:12):
Kind of flu-like symptoms for some.
Rachel (04:14):
Sort of yeah.
And then there are potentialrisks, less common but more
serious, like pancreatitis orgallbladder issues.
Those need monitoring.
And here's something reallyimportant, often missed muscle
loss.
Mark (04:26):
Ah, yes, you lose fat, but you might lose muscle too.
Rachel (04:30):
Exactly If you're not careful.
You absolutely need adequateprotein intake and, ideally,
resistance training to combatthat.
Mark (04:38):
That's a critical point, and it's not a short-term fix,
is it?
Rachel (04:41):
Generally not.
It's typically a long-termmedication.
Most people find the weightcomes back if they stop taking
it, unless they've also madereally solid, sustainable
lifestyle changes alongside it.
Mark (04:52):
Okay, so that's the pharmaceutical side.
Powerful, but withconsiderations.
Now let's shift gears to thenutrition.
First approach the keto dietStill a major player.
Rachel (05:03):
Absolutely A longstanding strategy.
Mark (05:05):
So defining it simply Very low carb, high fat, usually
under 50 grams of carbs a dayRight, and the whole goal is to
push your body into ketosis,which means Switching your
primary fuel source.
Instead of burning carbs, yourbody starts efficiently burning
fat, both dietary fat and storedbody fat, and produces these
(05:25):
things called ketones for energy.
Rachel (05:27):
It's a fundamental shift in metabolism.
Mark (05:29):
Totally, and the thinking behind it, the way it works.
Rachel (05:31):
Well, that metabolic shift itself encourages your
body to tap into its fat storesmuch more readily.
That's the core mechanism forfat loss.
Mark (05:39):
Makes sense.
Rachel (05:39):
But it's praised for more than just weight loss,
right?
It often improves insulinsensitivity quite dramatically.
Mark (05:44):
Which is huge for metabolic health.
Rachel (05:46):
Huge, and it can lower inflammation markers too.
Remember it originally hadclinical uses for epilepsy.
Mark (05:52):
Right Decades ago.
Rachel (05:53):
But now it's widely used for broader metabolic health
issues, think insulin resistance, prediabetes, even PCOS,
polycystic ovary syndrome.
It can be particularlybeneficial there.
Even PCOS, polycystic ovarysyndrome, it can be particularly
beneficial there.
Mark (06:05):
OK, so strong potential metabolic benefits.
How does that translate to thescale?
What kind of weight lossresults do people typically see
with keto?
Rachel (06:13):
The results can be really significant.
Lots of studies showsubstantial weight loss, often
quite rapid in the first, say 6to 12 months.
Mark (06:22):
Interesting.
Is it consistent across theboard or does it work better for
certain people?
Rachel (06:25):
That's a great question.
What's really interesting isthat the most dramatic results
are often seen in people whostart with high baseline insulin
levels.
Mark (06:33):
So people who are already struggling with insulin
resistance or carb metabolism.
Rachel (06:37):
Exactly.
It suggests it's particularlypotent for folks with that
underlying metabolic dysfunction.
It's like it directly addressestheir specific problem.
Mark (06:45):
And what about that muscle loss issue we discussed with
semaglutide?
How does keto fare there?
Rachel (06:51):
That's potentially a key advantage for keto.
A well-formulated keto diet,one with enough protein,
combined with resistancetraining, seems pretty good at
preserving lean muscle massduring weight loss.
Mark (07:02):
So potential for fat loss without sacrificing as much
muscle.
Rachel (07:07):
It appears that way.
Yes, the protein intake and themetabolic state of ketosis
itself seem to have musclesparing effect.
Mark (07:14):
That's a really important distinction.
Yeah, but it sounds like itrequires serious effort, yeah.
What are the practicalchallenges, the downsides?
Rachel (07:22):
Oh, absolutely, you hit the nail on the head.
Success with keto demands real,consistent dietary commitment.
It's not a casual diet.
Mark (07:29):
Lately planning discipline .
Rachel (07:30):
Definitely it might not suppress appetite quite as
strongly for everyone as saysemaglutide does, and many
people go through that initialadaptation phase, the keto flu.
Mark (07:39):
Right, feeling rough for a bit.
Rachel (07:40):
Yeah, headaches, fatigue , irritability usually passes,
but it's a hurdle.
Then there can be digestivechanges, constipation or
diarrhea sometimes, and in someindividuals we do see an
increase in LDL cholesterol, thebad cholesterol.
That needs monitoring.
Mark (07:56):
So the formulation matters .
Rachel (07:58):
Critically.
A well-formulated keto diet iskey.
You need enough fiber.
Electrolytes have to be managedcarefully.
Micronutrients need attention.
It's not just about cuttingcarbs.
It's about smart replacement.
Requires education.
Mark (08:11):
Okay, we've got a good picture of both individually.
Now let's put them head to headSemi-glutide versus keto.
Let's unpack this across, sayfive key areas, starting with
pure weight loss results.
Rachel (08:23):
All right.
So results Samuglutide tends todeliver very consistent, strong
weight loss for most people.
We talked about that 12-15%average over a year in trials,
often with minimal initiallifestyle changes required.
Mark (08:36):
And keto.
Rachel (08:37):
Keto often shows rapid initial fat loss maybe 5-10% on
average in the first six months.
But the results vary more.
They really depend on how wellsomeone sticks to it, the
quality of their keto diet.
So if we're just looking ataverages across the general
population, Simiglutide probablyedges it out for average total
weight loss across a broadpopulation.
But for those specificindividuals with significant
(08:58):
insulin resistance whose bodiesare really struggling with carbs
, a well executed keto diet itcan absolutely match, or maybe
even exceed, the results ofsemi-glutide.
For them it's like a targetedmetabolic intervention
fascinating distinction.
Mark (09:13):
Okay, area two metabolic health benefits.
Both seem to improve thingslike blood sugar and insulin.
Rachel (09:19):
They do Both generally lower blood sugar, improve
insulin sensitivity, reduceinflammation markers.
It's largely a tie on thosebasics.
Mark (09:27):
But anything he wants is.
Rachel (09:28):
I'd say keto often shows broader, sometimes more
profound effects, especiallywhen tackling lifestyle driven
diseases head on, if it'sfollowed consistently.
Mark (09:37):
Like reversing things.
Rachel (09:38):
Yeah, we see studies showing a potential reversal of
insulin resistance fatty liverdisease.
It's particularly noted for itsimpact on prediabetes and PCOS.
Keto also tends to raise thegood HDL cholesterol and lower
triglycerides.
Mark (09:51):
But the LDL caveat remains .
Rachel (09:53):
Yes, that LDL cholesterol can go up in some
people on keto, which needswatching.
So both are good metabolically,but keto might offer a more
fundamental dietary fix formetabolic dysfunction if you
stick with it got it okay.
Mark (10:06):
Area three side effects and risks the downsides right
semaglutide.
Rachel (10:12):
we covered the common gi stuff nausea, constipation,
then the potential forgallbladder issues, maybe
pancreatitis, and that big one,muscle loss, if not managed,
plus the long-term effects ofbeing on it indefinitely are
still being fully understood.
Mark (10:26):
And keto's risks.
Rachel (10:27):
You've got the temporary keto flu, digestive adjustments
, that potential LDL increaseand the risks if it's poorly
formulated low fiber,electrolyte problems,
micronutrient gaps.
Mark (10:37):
So comparing the risk profiles.
Rachel (10:38):
It's tricky.
Maybe maybe a well-executedketo diet has fewer potential
long-term side effects thanbeing on a medication
indefinitely.
But keto absolutely requiresmore upfront education and
personal diligence to do itsafely and effectively.
Mark (10:52):
Right.
The onus is more on theindividual with keto, which
leads perfectly into area four,sustainability Keeping the
weight off.
Rachel (10:58):
This is so individual Semagl, individual with keto,
which leads perfectly into areafour, sustainability keeping the
weight off.
This is so.
Individual Semaglutide is, youknow, a weekly injection,
relatively simple to administerbut often needed long term to
maintain the results.
Mark (11:08):
And it doesn't automatically teach healthy
habits.
Rachel (11:10):
Not necessarily.
It reduces appetite powerfully,but doesn't inherently change
what you choose to eat or otherlifestyle factors.
Keto, on the other hand, Hugeupfront commitment.
Massive daily planningdiscipline.
But for those who master it andstick with it, it builds
incredible self-reliance,metabolic flexibility.
(11:30):
It can genuinely create lastingchanges in how you eat and how
your body works.
Mark (11:35):
So simpler compliance maybe with some of Glutide but
potentially deeper, more lastingchange with keto, if you commit
.
Rachel (11:42):
That's a good way to put it.
Semaglutide is easier day today but might need ongoing use.
Keto is harder initially butcould foster a more permanent
metabolic reset.
Depends on the person.
Mark (11:52):
OK, final comparison point , and it's a big one Cost and
access.
Rachel (11:56):
Yeah, this is where the difference is stark.
Sem, it's a big one.
Cost and access yeah, this iswhere the difference is stark.
Semaglutide can be incrediblyexpensive.
We're talking potentially over$1,000 a month without good
insurance coverage.
Mark (12:05):
And insurance hurdles.
Rachel (12:06):
Often requires prior authorization hoops to jump
through.
It's a major financial barrierfor many and keto.
Keto clearly wins on cost andaccess.
The information is widelyavailable.
Food is accessible.
Yes, maybe your grocery billgoes up slightly for quality
fats and proteins.
Mark (12:23):
But no prescription needed .
Rachel (12:24):
Exactly no prescription, no insurance battles.
It's a much more democratizedapproach, financially speaking.
Mark (12:30):
Okay, that head-to-head is really helpful, but now the
plot twist can you do both?
Is combining semaglutide withketo.
This is where it gets reallyinteresting for me.
Rachel (12:43):
It absolutely is, and the answer is yes, you can.
In fact, for many people,combining semaglutide with a
ketogenic or at least awell-formulated low-carb diet
might actually give betterresults and make the medication
easier to tolerate.
Mark (12:56):
Okay, unpack that synergy.
How do they work together?
Rachel (12:58):
Well, think about it.
Semaglutide is powerfullysuppressing appetite and
reducing overall calorie drive.
That's its main weight losslever.
Nicolette (13:05):
Right.
Rachel (13:05):
Meanwhile, keto is stabilizing blood sugar,
dramatically improving metabolicflexibility and often crushing
carbohydrate cravings.
Mark (13:13):
Ah, so keto makes it easier to stick to the lower
calorie intake that semaglutideencourages.
Rachel (13:17):
Precisely.
It tackles the problem from twocomplementary angles hormonal
appetite control from the drugand metabolic stability, plus
craving control from the diet.
It can be a really potentcombination.
Mark (13:30):
And you mentioned evidence .
I think I saw a study.
Was it in the journal Obesity?
Rachel (13:34):
Yes, that 2021 study was interesting.
It showed people on GLP-1agonists like semaglutide, who
also followed a low-carb diet,had even greater improvements in
things like insulin levels andtriglycerides compared to those
on the drug alone.
Mark (13:47):
So added metabolic benefits potentially.
What about the muscle lossconcern with semaglutide?
Does keto help there?
Rachel (13:54):
That's another potential major synergy.
We know semaglutide alone canlead to muscle loss, especially
if protein is low.
A well-formulated keto dietusually emphasizes adequate,
sometimes even higher, proteinPlus.
Ketosis itself seems to havemuscle-sparing properties.
Mark (14:10):
There was research highlighted in Nutrition and
Metabolism back in 2020 aboutthis, so combining them could
help you lose fat while betterpreserving that vital lean mass.
Rachel (14:20):
That's the theory and often the clinical observation.
Yes, and anecdotally, manyclinicians report something else
.
What's that?
Fewer side effects.
Patients combining semaglutidewith a solid nutritional plan
like keto often seem to reportless nausea, less GI upset,
especially if they're reallyavoiding processed carbs and
sugars.
Mark (14:40):
Interesting.
So the clean diet might buffersome of the drug's side effects.
Rachel (14:43):
It seems plausible.
Cleaner inputs, less digestivedistress, maybe.
Mark (14:47):
But there must be a catch right, Starting both at once.
Rachel (14:50):
Definitely needs caution , a crucial word of warning here
.
Starting both simultaneouslyrequires careful thought and,
ideally, supervision.
Mark (14:58):
Why Too much change at once?
Rachel (15:00):
Potentially.
Think about it.
Your body is adapting toketosis and it's adapting to the
effects of a powerful GLP-1medication.
Both can independently messwith your energy levels, your
hydration, your electrolytes.
Mark (15:13):
Right Could be overwhelming.
Rachel (15:14):
It could.
So the recommendation isusually to phase things in,
maybe get keto adapted first,then introduce the semaglutide
or vice versa, but do itgradually, ideally with guidance
from a healthcare professionalwho understands both approaches.
Mark (15:28):
Okay, that makes sense.
So bringing it all together,what does this mean for you, the
listener?
It's clearly not a simplechoice.
Semiglutide, keto, maybe thecombo.
Rachel (15:37):
Yeah.
Mark (15:38):
It really boils down to the individual.
Rachel (15:39):
Absolutely.
It depends entirely on yourpersonal health picture what
your specific goals are justweight loss or broader metabolic
health and, critically, whatkind of change you're
realistically able and willingto commit to.
Mark (15:52):
So who might lean towards semaglutide?
Rachel (15:55):
Well, if you've really battled with intense appetite or
significant insulin resistance,and maybe other methods just
haven't worked for you,semaglutide offers that powerful
, medically supervised boost.
It can provide rapid,significant fat loss when you
need that kind of clinicalimpact.
Mark (16:10):
And who is keto potentially better suited for?
Rachel (16:12):
Keto might be the right path if you're highly motivated
for a lifestyle first approach,if you really want to improve
your metabolic health from theground up, naturally through
diet, and if you're truly readyand open to making that
significant, consistent dietaryshift.
Mark (16:27):
Especially if dealing with specific conditions.
Rachel (16:30):
Exactly Particularly powerful if you're dealing with
prediabetes, PCOS, fatty liverdisease and you're prepared for
the required consistency.
Remember that clinical insightFor people starting with high
insulin levels, a well-done ketodiet can match or beat
semaglutide results, but theeffort is a key.
Mark (16:48):
Effort education consistency Got it Okay.
Before anyone makes a decision,you mentioned a pro tip.
What's that?
Rachel (16:55):
Know your starting point Before you jump into any plan.
Get baseline lab work done.
Understand your own metabolichealth.
Mark (17:01):
Which tests are most important?
Rachel (17:02):
Key markers would be things like fasting insulin, not
just fasting glucose, butinsulin.
Important Key markers would bethings like fasting insulin, not
just fasting glucose butinsulin, Also hemoglobin A1c,
triglycerides and maybe ALT,which is a liver enzyme.
And why are they so crucial?
Because these markers tell astory.
They reveal if your body isalready insulin resistant.
Knowing that gives you a hugeclue about which strategy, or
maybe which combination, islikely to be most effective for
(17:25):
your specific biology.
Don't guess Test.
Mark (17:29):
Excellent advice.
So let's wrap this up.
The big takeaway seems to bethere's no single magic bullet,
no one-size-fits-all answer forweight loss and metabolic health
.
Nicolette (17:37):
Definitely not.
Mark (17:38):
Semaglutide offers potent medical intervention with
impressive results, but comeswith side effects, cost and
sustainability questions.
Keto offers a powerful naturalmetabolic reset, particularly
for insulin resistance, butdemands significant commitment
and careful formulation.
Rachel (17:56):
Right and the combination potentially
synergistic but needs carefulimplementation.
So the final thought Ultimately, the best, most sustainable
results will likely come fromunderstanding your own unique
body testing, not guessing Thendiligently tracking your
progress, seeing what works foryou and then choosing the method
or the blend of methods thatyou can realistically stick with
(18:17):
for the long haul.
It's about finding yoursustainable path.
Mark (18:20):
Which brings us to our final question for you, the
listener, before you startanything, do you truly know your
baseline?
What are your metabolic markerstelling you right now about
your best path forward?
And, maybe more importantly,what steps will you take next to
get that clarity?
Nicolette (18:40):
Thanks for tuning into the Health Pulse.
If you found this episodehelpful, don't forget to
subscribe and share it withsomeone who might benefit.
For more health insights anddiagnostics, visit us online at
wwwquicklabmobilecom.
Stay informed, stay healthy andwe'll catch you in the next
episode.
Welcome to the Health Pulse, your go-to source for
quick, actionable insights onhealth, wellness and diagnostics
.
Whether you're looking tooptimize your well-being or stay
informed about the latest inmedical testing, we've got you
covered.
Join us as we break down keyhealth topics in just minutes.
Let's dive in.
Mark (00:27):
Okay, so the whole landscape of weight loss, it
feels like it's justdramatically shifted lately,
hasn't it?
It really has For ages it feltlike the conversation was
dominated by dietary changes.
Nicolette (00:37):
Yeah.
Mark (00:37):
You know, like keto, which is still incredibly popular, it
fundamentally changes how yourbody uses fuel.
Rachel (00:43):
Absolutely A metabolic shift.
Mark (00:45):
But now Wow, we're seeing these really powerful new
medical options stepping up,specifically the GLP-1 receptor
agonists.
Rachel (00:56):
Like semaglutide.
Mark (00:57):
Exactly Semaglutide.
You probably know it as Ozempicor Wegovi.
Yeah, and the results peopleare seeing in trials, they're
genuinely transformative.
Rachel (01:04):
Yeah, quite remarkable numbers.
Mark (01:06):
So that's what we're tackling in this deep dive.
It's the big questionSema-glutide versus the
ketogenic diet for weight loss.
Rachel (01:12):
Head to head.
Mark (01:13):
Yeah, we're going to break down the science.
Look at the outcomes side byside, weigh the pros, the cons,
all of that, and this is where Ithink it gets really
fascinating.
Can they actually work together?
Rachel (01:25):
The combination approach .
It's a hot topic.
Mark (01:27):
Definitely, our goal here isn't to just drown you in data.
It's really about guiding you,helping you make an informed
choice, whether you're thinkingmedical nutrition first or maybe
maybe both.
Rachel (01:39):
And that's exactly our mission today.
We want to pull out the reallycrucial bits of knowledge from
the sources, give you thatshortcut to being well-informed.
Mark (01:47):
Yeah.
Rachel (01:47):
We'll flag the surprising stuff, connect the
dots and focus on what reallycounts for your health journey.
Mark (01:53):
Perfect.
Okay, let's start withsemaglutide.
Ozempic, wegovi People know thenames Right.
So what is it fundamentally?
It's a prescription medication.
It's a GLP-1 receptor agonist.
Rachel (02:06):
And that word agonist is key, isn't it?
Mark (02:08):
It is.
It means it basically mimics oractivates the same pathways as
a natural hormone your own gutmakes GLP-1.
Rachel (02:16):
Which your body releases after you eat.
Mark (02:18):
Exactly.
It was first developed for type2 diabetes management, but its
FDA approval specifically forweight management really pushed
it into the mainstream spotlight.
Rachel (02:26):
And the way it works is actually quite elegant.
Biologically speaking, it actslike that natural GLP-1.
Mark (02:31):
So how does that translate into weight loss?
Rachel (02:33):
Well, it hits multiple targets.
Three main things.
First, it really increasessatiety, that feeling of
fullness, and it slows down howquickly your stomach empties.
Mark (02:43):
So you feel fuller, faster and for longer.
Rachel (02:45):
Precisely.
Second, it helps your body useblood sugar better by enhancing
insulin secretion and at thesame time, it suppresses
glucagon, which is the hormonethat raises blood sugar.
Mark (02:57):
Ah, so it stabilizes blood sugar from both sides.
Rachel (02:59):
Exactly Really powerful effect there.
And third, it seems to directlyinfluence the hunger centers in
the brain.
Mark (03:07):
Reducing overall desire to eat.
Rachel (03:08):
Leading to a significant reduction in overall food
intake.
Yeah, it's a triple whammyreally.
Mark (03:13):
And the results reflect that, don't they?
The clinical trials like theSTEP series?
Yeah, the numbers are juststriking.
Nicolette (03:19):
They really are.
Mark (03:20):
You're talking average weight loss of what?
12 to 15 percent of body weightover about 68 weeks.
Rachel (03:25):
Yeah, which is substantial.
Mark (03:27):
And it's not just the number on the scale right, it's
the consistency.
People who've struggled foryears were seeing real results.
Rachel (03:33):
But beyond weight, the metabolic benefits were clear
too.
Mark (03:36):
Right.
Better blood pressure, improvedlipids, lower inflammation
markers.
Rachel (03:40):
Reductions in waist circumference, that dangerous
visceral fat.
Mark (03:44):
Yeah, it genuinely outperformed just lifestyle
changes alone in those trials.
Yeah, and often better thanolder obesity meds too.
Rachel (03:52):
But with effects that powerful, you always have to ask
about the other side, thetradeoffs the side effects and
considerations.
Mark (03:59):
Yeah, absolutely crucial.
Rachel (04:00):
Yeah, People need to know what they might be signing
up for the common stuff firstNausea, sometimes vomiting,
constipation is a big one.
Fatigue, dizziness, especiallywhen you're first starting out.
Mark (04:12):
Kind of flu-like symptoms for some.
Rachel (04:14):
Sort of yeah.
And then there are potentialrisks, less common but more
serious, like pancreatitis orgallbladder issues.
Those need monitoring.
And here's something reallyimportant, often missed muscle
loss.
Mark (04:26):
Ah, yes, you lose fat, but you might lose muscle too.
Rachel (04:30):
Exactly If you're not careful.
You absolutely need adequateprotein intake and, ideally,
resistance training to combatthat.
Mark (04:38):
That's a critical point, and it's not a short-term fix,
is it?
Rachel (04:41):
Generally not.
It's typically a long-termmedication.
Most people find the weightcomes back if they stop taking
it, unless they've also madereally solid, sustainable
lifestyle changes alongside it.
Mark (04:52):
Okay, so that's the pharmaceutical side.
Powerful, but withconsiderations.
Now let's shift gears to thenutrition.
First approach the keto dietStill a major player.
Rachel (05:03):
Absolutely A longstanding strategy.
Mark (05:05):
So defining it simply Very low carb, high fat, usually
under 50 grams of carbs a dayRight, and the whole goal is to
push your body into ketosis,which means Switching your
primary fuel source.
Instead of burning carbs, yourbody starts efficiently burning
fat, both dietary fat and storedbody fat, and produces these
(05:25):
things called ketones for energy.
Rachel (05:27):
It's a fundamental shift in metabolism.
Mark (05:29):
Totally, and the thinking behind it, the way it works.
Rachel (05:31):
Well, that metabolic shift itself encourages your
body to tap into its fat storesmuch more readily.
That's the core mechanism forfat loss.
Mark (05:39):
Makes sense.
Rachel (05:39):
But it's praised for more than just weight loss,
right?
It often improves insulinsensitivity quite dramatically.
Mark (05:44):
Which is huge for metabolic health.
Rachel (05:46):
Huge, and it can lower inflammation markers too.
Remember it originally hadclinical uses for epilepsy.
Mark (05:52):
Right Decades ago.
Rachel (05:53):
But now it's widely used for broader metabolic health
issues, think insulin resistance, prediabetes, even PCOS,
polycystic ovary syndrome.
It can be particularlybeneficial there.
Even PCOS, polycystic ovarysyndrome, it can be particularly
beneficial there.
Mark (06:05):
OK, so strong potential metabolic benefits.
How does that translate to thescale?
What kind of weight lossresults do people typically see
with keto?
Rachel (06:13):
The results can be really significant.
Lots of studies showsubstantial weight loss, often
quite rapid in the first, say 6to 12 months.
Mark (06:22):
Interesting.
Is it consistent across theboard or does it work better for
certain people?
Rachel (06:25):
That's a great question.
What's really interesting isthat the most dramatic results
are often seen in people whostart with high baseline insulin
levels.
Mark (06:33):
So people who are already struggling with insulin
resistance or carb metabolism.
Rachel (06:37):
Exactly.
It suggests it's particularlypotent for folks with that
underlying metabolic dysfunction.
It's like it directly addressestheir specific problem.
Mark (06:45):
And what about that muscle loss issue we discussed with
semaglutide?
How does keto fare there?
Rachel (06:51):
That's potentially a key advantage for keto.
A well-formulated keto diet,one with enough protein,
combined with resistancetraining, seems pretty good at
preserving lean muscle massduring weight loss.
Mark (07:02):
So potential for fat loss without sacrificing as much
muscle.
Rachel (07:07):
It appears that way.
Yes, the protein intake and themetabolic state of ketosis
itself seem to have musclesparing effect.
Mark (07:14):
That's a really important distinction.
Yeah, but it sounds like itrequires serious effort, yeah.
What are the practicalchallenges, the downsides?
Rachel (07:22):
Oh, absolutely, you hit the nail on the head.
Success with keto demands real,consistent dietary commitment.
It's not a casual diet.
Mark (07:29):
Lately planning discipline .
Rachel (07:30):
Definitely it might not suppress appetite quite as
strongly for everyone as saysemaglutide does, and many
people go through that initialadaptation phase, the keto flu.
Mark (07:39):
Right, feeling rough for a bit.
Rachel (07:40):
Yeah, headaches, fatigue , irritability usually passes,
but it's a hurdle.
Then there can be digestivechanges, constipation or
diarrhea sometimes, and in someindividuals we do see an
increase in LDL cholesterol, thebad cholesterol.
That needs monitoring.
Mark (07:56):
So the formulation matters .
Rachel (07:58):
Critically.
A well-formulated keto diet iskey.
You need enough fiber.
Electrolytes have to be managedcarefully.
Micronutrients need attention.
It's not just about cuttingcarbs.
It's about smart replacement.
Requires education.
Mark (08:11):
Okay, we've got a good picture of both individually.
Now let's put them head to headSemi-glutide versus keto.
Let's unpack this across, sayfive key areas, starting with
pure weight loss results.
Rachel (08:23):
All right.
So results Samuglutide tends todeliver very consistent, strong
weight loss for most people.
We talked about that 12-15%average over a year in trials,
often with minimal initiallifestyle changes required.
Mark (08:36):
And keto.
Rachel (08:37):
Keto often shows rapid initial fat loss maybe 5-10% on
average in the first six months.
But the results vary more.
They really depend on how wellsomeone sticks to it, the
quality of their keto diet.
So if we're just looking ataverages across the general
population, Simiglutide probablyedges it out for average total
weight loss across a broadpopulation.
But for those specificindividuals with significant
(08:58):
insulin resistance whose bodiesare really struggling with carbs
, a well executed keto diet itcan absolutely match, or maybe
even exceed, the results ofsemi-glutide.
For them it's like a targetedmetabolic intervention
fascinating distinction.
Mark (09:13):
Okay, area two metabolic health benefits.
Both seem to improve thingslike blood sugar and insulin.
Rachel (09:19):
They do Both generally lower blood sugar, improve
insulin sensitivity, reduceinflammation markers.
It's largely a tie on thosebasics.
Mark (09:27):
But anything he wants is.
Rachel (09:28):
I'd say keto often shows broader, sometimes more
profound effects, especiallywhen tackling lifestyle driven
diseases head on, if it'sfollowed consistently.
Mark (09:37):
Like reversing things.
Rachel (09:38):
Yeah, we see studies showing a potential reversal of
insulin resistance fatty liverdisease.
It's particularly noted for itsimpact on prediabetes and PCOS.
Keto also tends to raise thegood HDL cholesterol and lower
triglycerides.
Mark (09:51):
But the LDL caveat remains .
Rachel (09:53):
Yes, that LDL cholesterol can go up in some
people on keto, which needswatching.
So both are good metabolically,but keto might offer a more
fundamental dietary fix formetabolic dysfunction if you
stick with it got it okay.
Mark (10:06):
Area three side effects and risks the downsides right
semaglutide.
Rachel (10:12):
we covered the common gi stuff nausea, constipation,
then the potential forgallbladder issues, maybe
pancreatitis, and that big one,muscle loss, if not managed,
plus the long-term effects ofbeing on it indefinitely are
still being fully understood.
Mark (10:26):
And keto's risks.
Rachel (10:27):
You've got the temporary keto flu, digestive adjustments
, that potential LDL increaseand the risks if it's poorly
formulated low fiber,electrolyte problems,
micronutrient gaps.
Mark (10:37):
So comparing the risk profiles.
Rachel (10:38):
It's tricky.
Maybe maybe a well-executedketo diet has fewer potential
long-term side effects thanbeing on a medication
indefinitely.
But keto absolutely requiresmore upfront education and
personal diligence to do itsafely and effectively.
Mark (10:52):
Right.
The onus is more on theindividual with keto, which
leads perfectly into area four,sustainability Keeping the
weight off.
Rachel (10:58):
This is so individual Semagl, individual with keto,
which leads perfectly into areafour, sustainability keeping the
weight off.
This is so.
Individual Semaglutide is, youknow, a weekly injection,
relatively simple to administerbut often needed long term to
maintain the results.
Mark (11:08):
And it doesn't automatically teach healthy
habits.
Rachel (11:10):
Not necessarily.
It reduces appetite powerfully,but doesn't inherently change
what you choose to eat or otherlifestyle factors.
Keto, on the other hand, Hugeupfront commitment.
Massive daily planningdiscipline.
But for those who master it andstick with it, it builds
incredible self-reliance,metabolic flexibility.
(11:30):
It can genuinely create lastingchanges in how you eat and how
your body works.
Mark (11:35):
So simpler compliance maybe with some of Glutide but
potentially deeper, more lastingchange with keto, if you commit
.
Rachel (11:42):
That's a good way to put it.
Semaglutide is easier day today but might need ongoing use.
Keto is harder initially butcould foster a more permanent
metabolic reset.
Depends on the person.
Mark (11:52):
OK, final comparison point , and it's a big one Cost and
access.
Rachel (11:56):
Yeah, this is where the difference is stark.
Sem, it's a big one.
Cost and access yeah, this iswhere the difference is stark.
Semaglutide can be incrediblyexpensive.
We're talking potentially over$1,000 a month without good
insurance coverage.
Mark (12:05):
And insurance hurdles.
Rachel (12:06):
Often requires prior authorization hoops to jump
through.
It's a major financial barrierfor many and keto.
Keto clearly wins on cost andaccess.
The information is widelyavailable.
Food is accessible.
Yes, maybe your grocery billgoes up slightly for quality
fats and proteins.
Mark (12:23):
But no prescription needed .
Rachel (12:24):
Exactly no prescription, no insurance battles.
It's a much more democratizedapproach, financially speaking.
Mark (12:30):
Okay, that head-to-head is really helpful, but now the
plot twist can you do both?
Is combining semaglutide withketo.
This is where it gets reallyinteresting for me.
Rachel (12:43):
It absolutely is, and the answer is yes, you can.
In fact, for many people,combining semaglutide with a
ketogenic or at least awell-formulated low-carb diet
might actually give betterresults and make the medication
easier to tolerate.
Mark (12:56):
Okay, unpack that synergy.
How do they work together?
Rachel (12:58):
Well, think about it.
Semaglutide is powerfullysuppressing appetite and
reducing overall calorie drive.
That's its main weight losslever.
Nicolette (13:05):
Right.
Rachel (13:05):
Meanwhile, keto is stabilizing blood sugar,
dramatically improving metabolicflexibility and often crushing
carbohydrate cravings.
Mark (13:13):
Ah, so keto makes it easier to stick to the lower
calorie intake that semaglutideencourages.
Rachel (13:17):
Precisely.
It tackles the problem from twocomplementary angles hormonal
appetite control from the drugand metabolic stability, plus
craving control from the diet.
It can be a really potentcombination.
Mark (13:30):
And you mentioned evidence .
I think I saw a study.
Was it in the journal Obesity?
Rachel (13:34):
Yes, that 2021 study was interesting.
It showed people on GLP-1agonists like semaglutide, who
also followed a low-carb diet,had even greater improvements in
things like insulin levels andtriglycerides compared to those
on the drug alone.
Mark (13:47):
So added metabolic benefits potentially.
What about the muscle lossconcern with semaglutide?
Does keto help there?
Rachel (13:54):
That's another potential major synergy.
We know semaglutide alone canlead to muscle loss, especially
if protein is low.
A well-formulated keto dietusually emphasizes adequate,
sometimes even higher, proteinPlus.
Ketosis itself seems to havemuscle-sparing properties.
Mark (14:10):
There was research highlighted in Nutrition and
Metabolism back in 2020 aboutthis, so combining them could
help you lose fat while betterpreserving that vital lean mass.
Rachel (14:20):
That's the theory and often the clinical observation.
Yes, and anecdotally, manyclinicians report something else
.
What's that?
Fewer side effects.
Patients combining semaglutidewith a solid nutritional plan
like keto often seem to reportless nausea, less GI upset,
especially if they're reallyavoiding processed carbs and
sugars.
Mark (14:40):
Interesting.
So the clean diet might buffersome of the drug's side effects.
Rachel (14:43):
It seems plausible.
Cleaner inputs, less digestivedistress, maybe.
Mark (14:47):
But there must be a catch right, Starting both at once.
Rachel (14:50):
Definitely needs caution , a crucial word of warning here
.
Starting both simultaneouslyrequires careful thought and,
ideally, supervision.
Mark (14:58):
Why Too much change at once?
Rachel (15:00):
Potentially.
Think about it.
Your body is adapting toketosis and it's adapting to the
effects of a powerful GLP-1medication.
Both can independently messwith your energy levels, your
hydration, your electrolytes.
Mark (15:13):
Right Could be overwhelming.
Rachel (15:14):
It could.
So the recommendation isusually to phase things in,
maybe get keto adapted first,then introduce the semaglutide
or vice versa, but do itgradually, ideally with guidance
from a healthcare professionalwho understands both approaches.
Mark (15:28):
Okay, that makes sense.
So bringing it all together,what does this mean for you, the
listener?
It's clearly not a simplechoice.
Semiglutide, keto, maybe thecombo.
Rachel (15:37):
Yeah.
Mark (15:38):
It really boils down to the individual.
Rachel (15:39):
Absolutely.
It depends entirely on yourpersonal health picture what
your specific goals are justweight loss or broader metabolic
health and, critically, whatkind of change you're
realistically able and willingto commit to.
Mark (15:52):
So who might lean towards semaglutide?
Rachel (15:55):
Well, if you've really battled with intense appetite or
significant insulin resistance,and maybe other methods just
haven't worked for you,semaglutide offers that powerful
, medically supervised boost.
It can provide rapid,significant fat loss when you
need that kind of clinicalimpact.
Mark (16:10):
And who is keto potentially better suited for?
Rachel (16:12):
Keto might be the right path if you're highly motivated
for a lifestyle first approach,if you really want to improve
your metabolic health from theground up, naturally through
diet, and if you're truly readyand open to making that
significant, consistent dietaryshift.
Mark (16:27):
Especially if dealing with specific conditions.
Rachel (16:30):
Exactly Particularly powerful if you're dealing with
prediabetes, PCOS, fatty liverdisease and you're prepared for
the required consistency.
Remember that clinical insightFor people starting with high
insulin levels, a well-done ketodiet can match or beat
semaglutide results, but theeffort is a key.
Mark (16:48):
Effort education consistency Got it Okay.
Before anyone makes a decision,you mentioned a pro tip.
What's that?
Rachel (16:55):
Know your starting point Before you jump into any plan.
Get baseline lab work done.
Understand your own metabolichealth.
Mark (17:01):
Which tests are most important?
Rachel (17:02):
Key markers would be things like fasting insulin, not
just fasting glucose, butinsulin.
Important Key markers would bethings like fasting insulin, not
just fasting glucose butinsulin, Also hemoglobin A1c,
triglycerides and maybe ALT,which is a liver enzyme.
And why are they so crucial?
Because these markers tell astory.
They reveal if your body isalready insulin resistant.
Knowing that gives you a hugeclue about which strategy, or
maybe which combination, islikely to be most effective for
(17:25):
your specific biology.
Don't guess Test.
Mark (17:29):
Excellent advice.
So let's wrap this up.
The big takeaway seems to bethere's no single magic bullet,
no one-size-fits-all answer forweight loss and metabolic health
.
Nicolette (17:37):
Definitely not.
Mark (17:38):
Semaglutide offers potent medical intervention with
impressive results, but comeswith side effects, cost and
sustainability questions.
Keto offers a powerful naturalmetabolic reset, particularly
for insulin resistance, butdemands significant commitment
and careful formulation.
Rachel (17:56):
Right and the combination potentially
synergistic but needs carefulimplementation.
So the final thought Ultimately, the best, most sustainable
results will likely come fromunderstanding your own unique
body testing, not guessing Thendiligently tracking your
progress, seeing what works foryou and then choosing the method
or the blend of methods thatyou can realistically stick with
(18:17):
for the long haul.
It's about finding yoursustainable path.
Mark (18:20):
Which brings us to our final question for you, the
listener, before you startanything, do you truly know your
baseline?
What are your metabolic markerstelling you right now about
your best path forward?
And, maybe more importantly,what steps will you take next to
get that clarity?
Nicolette (18:40):
Thanks for tuning into the Health Pulse.
If you found this episodehelpful, don't forget to
subscribe and share it withsomeone who might benefit.
For more health insights anddiagnostics, visit us online at
wwwquicklabmobilecom.
Stay informed, stay healthy andwe'll catch you in the next
episode.
Popular Podcasts
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.