In recent years, weight loss injections such as Mounjaro (tirzepatide) have become extremely popular worldwide, promising quick and dramatic weight loss. Nevertheless, even though these medications bring much-needed hope to many who have issues with obesity and diabetes, the journey is normally not without difficult side effects. A 27-year-old British woman named Bethany Diana has spoken openly about her life-changing though tough journey when she lost 84 pounds in nine months on Mounjaro, highlighting the usually unspoken negative aspects of this weight loss medication.

Bethany's tale is inspiring. She lost six stone (84 pounds) and transformed from a size 18 to an eight, a change of body that has obviously increased her self-esteem and general well-being. On her TikTok handle (@bethanydianax), where she has gained over 75,000 likes, she gives her journey publicly, hoping to motivate people. Bethany says she is "such a better version" of herself after losing six stone (84 pounds).

Mounjaro's weight loss effects are documented. The drug, initially created to control type 2 diabetes, functions by imitating hormones that control hunger and blood sugar. Patients will usually feel fuller for a longer time, which, understandably, results in eating less and, as a consequence, weight loss. The NHS does caution, however, that Mounjaro is only to be prescribed to diabetes and certain specific medical needs patients, and that off-label usage to aid weight loss is cautioned against.

The Unpleasant Side Effects No One Talks About

Even in success, Bethany did not hold back from sharing the less glitzy details of her weight loss process. In a viral TikTok video that received over 100,000 views, she enumerated the side effects she had:

• Diarrhea, a typical gastrointestinal issue.
• Bad breath, one of the lesser-known but unpleasant symptoms.
• Hair loss, which she suffered but did not elaborate on at length.
• "Sulphur burps" – rotten egg-smelling burps caused by hydrogen sulfide gas within the gut.
• Constipation, nausea, heartburn, wind, and acid reflux.

Bethany's honesty provides a vital insight into the drug's effect other than weight loss figures, acknowledging that the journey to change can be painful and even traumatic.

One of the very noticeable grievances Bethany recounted was that "Mounjaro stole my booty." This expression summarizes a grievance often expressed by users of weight reduction pills — sagging or loss of volume in the buttocks and other places caused by rapid fat loss.

Quick weight loss can cause flabby skin and body reshaping that others will not find attractive or easy to accept. Though Bethany recognizes the transformation, she weighs it against her overall experience and confirms that her side effects were "temporary" but the weight loss was "for life."

Bethany's honesty resonated on social media. Several viewers posted their own side effects, corroborating her experience and generating a community conversation about the drug's impact:

One viewer wrote, "It's the sulphur burps and nausea I find hardest, especially when barely eating." Another confessed, "I had bad breath too, didn't know it was due to the injection." Others described milder effects such as constipation.

Though Bethany's tale comes to a positive end despite the side effects, note must be taken of the safety issues that accompany weight loss and diabetes shots such as Mounjaro and Ozempic. The UK Medicines and Healthcare Products Regulatory Agency (MHRA) has noted more than 80 fatalities attributed to these drugs since they began more extensive use, with 22 deaths that directly involve tirzepatide.

A notably sad example is that of Susan McGowan, a 58-year-old Lanarkshire nurse, who passed away from multiple organ failure and pancreatitis after receiving only two low-dose injections of tirzepatide. Her death was the first to be recorded with this drug as a contributory factor on a death certificate, leading to increased vigilance.

The NHS has since released clear messages cautioning patients never to take anti-obesity drugs without a prescription and under medical guidance, highlighting the risks of unmonitored usage.

Bethany's tale summarizes the promise and the dangers of weight loss injections such as Mounjaro. The medication provides a powerful tool for shedding pounds, especially for individuals with type 2 diabetes or obesity-related complications. But it also comes with a range of side effects — from transient gastrointestinal upset to more serious health threats.

Individuals who contemplate such medications should speak to healthcare providers, carefully consider pros and cons, and be on guard for side effects. Weight loss is a personal, multifaceted experience, and an approach that benefits one may not appeal to another.

The rapid rise of Mounjaro and other drugs signals a shift in how obesity and diabetes are managed with pharmacology paired with lifestyle modification. Further studies are required to learn more about long-term consequences, achieve optimal dosing, and create safer protocols.

The liver and heart are two of the most vital organs of the body, and although they perform very different functions, they are closely connected. When the liver is not functioning properly, it can place significant stress on the heart and circulatory system of the body.

Liver disease not only affects the digestion process, metabolism, and detoxification but can also trigger serious cardiovascular changes that may go unnoticed in the early stages. Understanding this particular connection is significant for timely diagnosis and better overall care.

The Liver-Heart Connection

The liver helps to regulate the flow of blood, fluid balance, cholesterol metabolism, and inflammation as well. When liver disease develops—whether due to fatty liver, hepatitis, cirrhosis, or alcohol-related damage—all these processes become disturbed.

As a result of the same, the heart may have to work harder to maintain circulation, while blood vessels may also undergo certain changes that impact blood pressure and delivery of oxygen as well.

Changes In Blood Circulation

In well-advanced liver disease, especially cirrhosis, the flow of blood through the liver becomes restricted. This can also increase pressure in the portal vein, a condition known as portal hypertension. At the same point in time, blood vessels in the rest of the body may also widen, causing a drop in effective blood pressure.

To compensate, the heart pumps faster and harder. With the passage of time, this constant strain can weaken cardiac function and even lead to a condition sometimes referred to as cirrhotic cardiomyopathy, where the heart does not respond normally under stress.

Fluid Retention And Heart Stress

Liver disease often causes the body to retain both salt and water. This can also lead to swelling in the legs, abdomen, and surrounding tissues as well. Extra fluid in the body increases the workload on the heart, making it more difficult for it to pump blood in an efficient way. In severe cases, this may also contribute to shortness of breath, fatigue, and worsening cardiovascular strain.

Inflammation And Metabolic Impact

Some of the conditions, such as non-alcoholic fatty liver disease, are also linked with diabetes, obesity, high levels of cholesterol, and high blood pressure – all of which are the major risk factors for heart disease. Chronic inflammation, well-associated with liver damage, may further increase the risk of atherosclerosis and other cardiac complications.

GLP-1 receptor agonist drugs such as Ozempic and Wegovy have shown significant benefits for people with diabetes and obesity. However, not everyone experiences the same results.

Now, a study suggests that this variation may be due to genetic resistance, which means that some people are biologically less responsive to these medications, making these drugs less effective.

Also Read: NAFLD to MASLD: Experts Explain Why This Common Yet Dangerous Liver Condition Got Renamed

The new study by scientists at Stanford University in the US showed that about 10 per cent of the general population carry genetic variants that lead to what the researchers called “GLP-1 resistance”.

The GLP-1- receptor agonist drugs typically work by mimicking the hormone GLP-1 (glucagon-like peptide-1), which naturally helps regulate blood sugar by stimulating insulin release. The process slows the emptying of the stomach and reduces appetite.

However, in individuals with certain genetic variants, the team found that higher levels of GLP-1 did not regulate blood sugar better.

The researchers noted that the findings, published in the journal Genome Medicine, may be key to developing new therapies for people with GLP-1 resistance.

“There are a whole class of medications that are insulin sensitizers, so perhaps we can develop medications that will allow people to be sensitized to GLP-1s or find formulations of GLP-1, like the longer-acting versions, that avoid the GLP-1 resistance,” said Anna Gloyn, professor of pediatrics and of genetics at Stanford Medicine.

The Gene Linked to GLP-1 Resistance

Also read: Foundayo: US FDA Approves Eli Lilly’s GLP-1 Weight Loss Pill

To zero in on the gene resistant to GLP-1 drugs, the team conducted experiments in humans. They traced this resistance to a PAM variant known as p.S539W.

PAM (peptidyl-glycine alpha-amidating monooxygenase) is an enzyme that is uniquely capable of activating many hormones in the body, including GLP-1.

While the researchers suspected that people with the PAM variant would have lower levels of GLP-1 in their blood, it actually increased levels of GLP-1. Although the exact mechanism is still unclear, experiments in both humans and mice confirmed signs of reduced response to GLP-1.

Analyzing diabetes drug trial data, they found that individuals with these variants were less able to lower their blood sugar levels even after six months of treatment. This suggests that despite having more circulating GLP-1, their bodies are less responsive to it.

“When I treat patients in the diabetes clinic, I see a huge variation in response to these GLP-1-based medications and it is difficult to predict this response clinically,” said Mahesh Umapathysivam, an endocrinologist and clinical researcher at Adelaide University in Australia.

“This is the first step in being able to use someone’s genetic make-up to help us improve that decision-making process,” he added.

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Importantly, participants with the PAM variants did not respond differently to other common diabetes treatments, including sulfonylureas, metformin, and DPP-4i.

The finding may help develop precision medicine, the researchers said. Knowing ahead of time who is likely to respond would help patients get on the right drugs faster, Gloyn said.

Reasons Why Ozempic May Not Help All People Lose Weight

Ozempic is primarily indicated for type 2 diabetes management. But some doctors may prescribe it for weight loss in appropriate patients without diabetes.

Previous research has shown that medical conditions such as sleep apnea, along with certain common medications, such as antidepressants, steroids, and contraceptives, can hamper the process of shedding extra pounds.

Another major reason that can hamper weight loss is the side-effects of these drugs that can prompt a person to halt their prescription mid-way.

Once widely known as non-alcoholic fatty liver disease (NAFLD), the common and dangerous fatty liver condition was rephrased as Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) due to its strong link to metabolic health issues like obesity and diabetes.

MASLD now includes patients with fatty liver disease linked to metabolic risk factors such as obesity, diabetes, and hypertension.

Also Read: GLP-1 Drugs: Why Not Everyone Taking Ozempic May Have Lower Blood Sugar Levels

MASLD: So What Prompted The Change?

Globally, it was observed that all patients who have non-alcoholic fatty liver disease also have some associated form of metabolic dysfunction. The patients reported having either obesity, diabetes, metabolic syndrome, hypertension, or cholesterol problems.

And all these problems eventually lead to significant comorbidities later, like some people developed heart disease, while others developed complications of diabetes.

In view of these, a global consensus process in 2023 involving hundreds of experts from different countries adopted MASLD as it better reflected these underlying causes of the condition.

What Does MASLD Mean?

Also read: Lancet Study Shows Metabolic Liver Disease To Rise Over 38% By 2050: What’s Behind The Surge

MASLD is an umbrella term for liver conditions that develop in the presence of 1 or more cardiometabolic risk factors—including high blood sugar, elevated body mass index (BMI), and hypertension—but in the absence of other causes of liver fat accumulation.

The condition can be defined by excess liver fat accumulation (more than 5 per cent of liver weight) in the presence of metabolic dysfunction, independent of alcohol intake.

It encompasses a spectrum from simple steatosis to steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma.

“Initially, it was thought that having fatty liver disease without alcohol was a benign condition, but now it is recognized that, since it is associated with lots of metabolic comorbidities, it's no longer benign,” Dr. Ashish Kumar, Professor of gastroenterology and hepatology at Sir Ganga Ram Hospital in New Delhi, told HealthandMe.

He stated that whenever a diagnosis of fatty liver is present, "we should actually include other comorbidities, like obesity, dyslipidemia, which means cholesterol problem, diabetes, sugar problem, pre-diabetes, and hypertension. At least 50–70–80 percent of these patients will have one or more of these comorbidities".

Why Alcohol Is Not The Only Culprit For Fatty Liver

Although alcohol has remained the number one risk for liver disease, MASLD seems to be rising globally, including among people who do not drink. Why?

The reasons include:

a sedentary lifestyle,

increased consumption of fast and processed food,

lack of exercise,

lack of sleep,

stressful life.

Also read: Why Regular Scans Are Crucial for Liver Cancer Patients: Doctors Explain

The experts noted that food, especially the increasingly accessible junk food or processed food, is a major culprit.

“So even if the person is not drinking alcohol, people are developing addiction to processed food, and this is causing an epidemic level of obesity and diabetes. Consequently, MASLD is also increasing, and now it is becoming the number one cause of liver disease,” Dr Kumar said.

How To Prevent MASLD?

According to Dr. Sanjay Goja, Director, Liver Transplant & HPB Surgery, Narayana Hospital, Gurugram, prevention must focus on following a healthy lifestyle like maintaining a healthy BMI, engaging in regular physical activity, and eating a balanced diet.

Controlling diabetes, cholesterol, and blood pressure is also important to prevent the risk of MASLD.

Dr Siddharth Badola, Manipal Hospital, Ghaziabad, suggested sustainable lifestyle changes such as:

Maintaining an adequate body weight: Even slight weight loss (5–10 percent) has been shown to significantly reduce liver fat and inflammation.

Follow a balanced and nutrient-rich diet: People should focus on consuming whole grains, fresh fruits and vegetables, lean proteins, and healthy fats, while limiting refined carbohydrates and processed foods.

Avoid foods with added sugar: Excess consumption of fructose, commonly found in packaged foods and sugary beverages, is a key contributor to fat accumulation in the liver.

Engage in regular physical activity: At least 150 minutes of moderate-intensity exercise per week is recommended to improve insulin sensitivity and liver health.

Manage associated metabolic conditions: Effective control of diabetes, hypertension, and dyslipidemia is essential in reducing the risk of MASLD progression.

Ensure adequate sleep and stress management: Poor sleep quality and chronic stress can negatively impact metabolic balance and liver function.

Keep your body hydrated with ample water intake and follow structured meal timings.