Fasting + diet pills, Musk lost 18 pounds a month, what is the scientific principle behind it?

Recently, a Twitter user posted a recent photo of Elon Musk and asked what is the secret to Musk's fitness and proportionality now
.

In July this year, photos of Musk's seaside vacation went viral on the Internet, and he was ridiculed by netizens as the fattest and richest
man in history.
Later, Musk said in an interview that he wanted to make his body better
.

On August 29, Musk posted on Twitter that he had successfully lost weight and lost 20 pounds (about 9 kilograms)
in just one month.

In response to the netizen's question about the secret of rapid weight loss, Musk said that the secret is Fasting and Wegovy

Fasting, or fasting, and Wegovy is the trade name
for Semaglutide, a drug developed by Novo Nordisk.
The drug, originally intended to treat type 2 diabetes, was approved by the FDA as a weight loss drug in June last year
due to its excellent weight loss effect.

How fasting and Wegovy quickly helped Musk achieve weight loss goals, and what is the principle behind it?

fasting

Fasting, which refers to not eating or eating less food for a certain period of time, is an effective way to
treat obesity.
Today, obesity has become a global epidemic, and obesity rates are on the rise worldwide, including in China
.
To combat metabolic function problems such as obesity, many dietary interventions have been tested, the most popular of which is Intermittent Fasting (IF), which alternates fasting and eating
.

In October 2021, Krista Varady et al.
of the University of Illinois at Chicago published a review paper titled: Cardiometabolic Benefits of Intermittent Fasting in the journal Annual Review of Nutrition [1].

This review systematically summarizes and analyses the effects and precautions
of various intermittent fasting methods.
Intermittent fasting has been shown to significantly reduce body weight clinically and improve metabolic health
in obese individuals.

In February 2022, Professor Mao Yilei's team from the Department of Liver Surgery of Peking Union Medical College Hospital published a research paper
titled: Randomized controlled trial for time-restricted eating in healthy volunteers without obesity in Nature Communications.

In the first randomized controlled trial of time-restricted feeding (a form of intermittent fasting) in a healthy non-obese population, the team compared the effects of time-restricted eating at different times in healthy adults and found that eating in the morning (eTRE, or skipping dinner) was more effective
at improving insulin sensitivity than eating at noon (mTRE, skipping breakfast).

Eating in the morning (eTRE, or skipping dinner) improves fasting blood sugar, weight loss and obesity, improves inflammation, and increases gut microbial diversity
.

In October 2022, a research team from the Feinberg School of Medicine at Northwestern University published a research paper
in Science titled: Time-restricted feeding mitigates obesity through adipocyte thermogenesis.

Once again, the study sheds light on the role
of time-restricted eating in weight control and improved metabolic health.
The study found that eating during the active phase of the circadian clock, adipose tissue burns more calories by enhancing thermogenesis, thereby slowing the development of
obesity.

In addition, many studies have shown that fasting can extend the lifespan of a variety of laboratory animals, and some prospective clinical trials have also shown that fasting can reduce risk factors for aging-related diseases, including cardiovascular disease, diabetes and cancer, and enhance cancer treatment
.

Wegovy

In June 2021, the U.
S.
Food and Drug Administration (FDA) approved the marketing of Semaglutide action weight loss drugs developed by Novo Nordisk, with the trade name Wegovy
.
The slimming effect of sopraglutide is outstanding, and it is evaluated as the first time that humans have achieved weight loss through drugs that can only be achieved by surgery
.

Originally intended to treat diabetes, the drug is a glucagon-like peptide 1 (GLP-1) receptor agonist that mimics its action, reduces hunger, reduces diet, and reduces caloric intake, so it is effective
in weight loss.

In February 2021, the New England Journal of Medicine (NEJM), a top international medical journal, published a global large-scale clinical trial [4], involving 1961 people in 16 countries around the world, and the clinical trial results showed that the new weight loss drug Semaglutide was outstanding, and the experimental group with weekly subcutaneous injection of 2.
4 mg of semaglutide lost an average of 15.
3 kg
compared to the placebo group.

Specifically, three-quarters of people lost more than 10% of their weight, and more than one-third lost more than 20% of their weight, a "game-changer" that was the first time that humans had achieved weight loss through drugs that could only be achieved by surgery
.

What's more, people who lost weight after using Semaglutide experienced a reduction in heart disease and diabetes risk factors such as waist circumference, blood lipids, blood sugar and blood pressure, and an improvement
in their overall quality of life.

The clinical trial showed nausea and diarrhoea to be the most common adverse events of semaglutide, but they were usually short-lived, mild to moderate in severity, and resolved
over time.

It is worth mentioning that in July 2022, the New England Journal of Medicine (NEJM), a top international medical journal, published the results
of a randomized controlled double-blind phase 3 clinical trial of Tirzepatide, a weight loss drug developed by Eli Lilly.

Clinical trial results showed that after 72 weeks of treatment, participants lost up to 22.
5% (24 kg)
of weight on average.
This is also the best effect of weight loss by drug to date, surpassing the phase 3 clinical weight loss effect
of semaglutide.

Lilly said Tirzepatide is the first investigational drug to achieve an average weight loss of more than 20% in a Phase 3 clinical trial, and this clinical data has strengthened the drug's confidence
in the treatment of obesity.

Semaglutide is a glucagon-like peptide 1 (GLP-1) receptor agonist, while Tirzepatide is a dual-acting agonist of glucose-dependent insulin-stimulating polypeptide (GIP) receptors and glucagon-like peptide-1 (GLP-1)
receptors.
Activation of the GLP-1 receptor reduces hunger and thus diet and calorie intake, while activation of the GIP receptor reduces diet and caloric intake and increases energy expenditure
.
Together, they can have a greater impact
on markers of metabolic dysregulation such as body weight, glucose, and lipids.

If approved by the FDA, Tirzepatide will be the most effective weight loss drug
.

It should be pointed out that neither semaglutide nor Tirzepatide has been approved for weight loss
in China.
Participants in phase III clinical trials of sopraglutide and Tirzepatide were both obese (BMI ≥30, or BMI≥27 but had at least one obesity-related disease, except diabetes).

Therefore, there is no data
on the weight loss effect of these two drugs in people whose weight does not meet this standard.
In addition, both drugs are prone to gastrointestinal-related side effects, such as nausea, vomiting, diarrhea, and more
.

References:

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