- Jillian Michaels is urging people to use diet and exercise for weight loss instead of medication.
- The drug semaglutide has promising results for treating obesity, but is still being researched.
- Michaels’ comments perpetuate dangerous myths about obesity, according to experts.
Celebrity fitness guru Jillian Michaels is speaking out against a promising new obesity medication, saying that lifestyle changes are a better method of weight loss with fewer side effects.
Michaels, who rose to fame as a trainer on the controversial weight loss reality show “The Biggest Loser,” argues that the drug may have unforeseen side effects and the weight loss results aren’t sustainable.
The medication semaglutide was found in a recent to study to help people with obesity lose about 15% of their weight in 68 weeks. “These results are not game-changing,” Michaels said in a video posted to Instagram. “What’s game changing is exercise and proper nutrition.”
A post shared by Jillian Michaels (@jillianmichaels)
Experts told Insider that Michaels is also perpetuating misconceptions about obesity.
Semaglutide has side effects, but it’s no riskier than medications for diseases like hypertension
Semaglutide is a medication originally approved to treat type 2 diabetes in 2017, and usually dosed as a once-weekly injection. It’s since been studied to treat obesity since it can reduce body fat and suppress appetite.
Michaels said in the video she’s wary about potential risks of semaglutide, and the fact that patients regain weight once they stop taking the drug.
That’s made her an unlikely ally to health experts who normally object to Michaels’ emphasis on weight loss at any cost. “This is the first time I will say I agree with Jillian Michaels,” said Rachael Hartley, a registered dietitian who specializes in intuitive eating and the author of the new book “Gentle Nutrition.”
The medication works by boosting insulin production and increasing appetite-suppressing hormones, causing some experts to worry that it may have long-term consequences.
“I get really concerned about a medication in which the method of action is putting the pancreas into overdrive,” Hartley said.
Evidence suggests people regain the weight that lost once they stop receiving the once-weekly injections of the drug.
Dr. Scott Butsch, director of obesity medicine at the Cleveland Clinic, said that the potential of side effects for semaglutide are no riskier than medications used to treat other chronic conditions like hypertension, diabetes, and high cholesterol. That’s true even if people continue the medications to maintain the weight loss.
The difference, he said, is that people are resistant to thinking of obesity as a disease, and treating it as such.
Michaels said weight loss is ‘not hard to do’ with diet and exercise
In the recent study on semaglutide, participants on the drug lost an average of 34 pounds total during the trial, or about half a pound per week. Michaels said in the video that losing a comparable amount of weight with diet and exercise is “not hard to do” by cutting an average of 300 calories a day (roughly equivalent to a Frappuccino from Starbucks).
This assumption is based on a common myth in nutrition, according to Hartley, that cutting 3,500 calories is equivalent to a pound of body weight or fat. While a calorie deficit is necessary for weight loss, a variety of factors influence how an individual person will lose weight, which makes blanket recommendations unhelpful, she said.
Michaels also recommends exercise for creating a calorie deficit. It takes a lot of exercise to instigate weight loss without making dietary changes, however. Exercising solely for weight loss can sometimes even backfire, prompting people to eat back some or all of the calories they burned, research suggests.
Butsch said that while lifestyle changes can lead to weight loss for some people, insisting on diet and exercise can leave people feeling like they’ve failed if they can’t lose weight with these methods. It can also discourage people from seeking out other forms of treatment, such as bariatric surgery or medication.
“That doesn’t replace trying to live a healthier life, eat healthier foods, exercise regularly, but it recognizes that people are different from one another and don’t necessarily respond in a similar fashion to a treatment,” he said.
It’s not always possible to ‘see’ someone’s health
In the video, Michaels talks about people with obesity or overweight “choosing” not to change. She said if diet and exercise aren’t working, it’s because people aren’t doing it enough, or correctly.
Hartley said that while changing diet and exercise habits could be a healthy choice for some people, it’s not one size fits all solution. Promoting lifestyle solutions for obesity can sometimes cause more harm than good, as weight stigma is linked to eating disorders and yo-yo dieting.
“Jillian Michaels and unfortunately the majority of healthcare providers have the assumption that you can visually see someone’s health,” Hartley said. “There’s an assumption that if you’re higher weight, you’re doing something wrong, and frankly that’s not true. Body diversity naturally exists.”