The new generation of GLP-1 drugs like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) has become a focal point in weight loss, offering significant results where traditional methods often fall short. However, these medications aren’t a simple solution, and understanding their benefits, risks, and suitability is crucial.
How These Drugs Work
These drugs function by mimicking natural hormones that regulate hunger and fullness. Unlike older weight loss medications that focused on fat absorption, semaglutide and tirzepatide impact the body’s hormonal signals, reducing appetite and slowing digestion. Studies show that these drugs can lead to substantial weight loss: some trials report over 20% weight reduction in participants over a year.
These mechanisms also have metabolic effects: lowering blood sugar and improving insulin control, which is why these drugs are initially designed for diabetes treatment. However, this has led to off-label use for weight loss, even among individuals without diabetes.
Who Should Consider These Medications?
The primary candidates for these drugs are those with a body mass index (BMI) of 30 or higher, or those with a BMI of at least 27 who also have weight-related health conditions like high blood pressure. But the lines are blurring, with some using them despite not meeting these criteria. Experts warn against this inappropriate use, emphasizing that no medication can replace a healthy lifestyle.
Key Point: These drugs aren’t meant to be a shortcut. They work best when combined with a balanced diet, regular exercise, and sufficient sleep.
Cost, Access, and Long-Term Use
A major barrier is cost: a single injection can run close to $1,000 without insurance coverage. While some plans help offset this, accessibility remains an issue. The FDA has approved oral versions (like Rybelsus), but these may not be as effective as injectables.
Crucially, these medications often require long-term use to maintain results. Stopping them usually leads to weight regain. This means patients must be prepared for a sustained commitment, not a temporary fix.
Side Effects and Risks
While effective, these drugs aren’t without downsides. Common side effects include nausea, diarrhea, bloating, and stomach pain. More serious risks include potential issues with the kidneys, pancreas, and thyroid (especially for those with pre-existing conditions).
Important Note: Individuals with a history of thyroid cancer or pancreatitis should avoid these drugs altogether. Those with disordered eating patterns should proceed with extreme caution under medical and psychological supervision.
The Unknowns and the Future
Semaglutide and tirzepatide are relatively new, meaning long-term effects remain largely unknown. There’s limited research on decades of continuous use, and even less on how they impact individuals without obesity. The current hype, fueled in part by celebrity endorsements, doesn’t change the fact that these drugs are powerful medications with potential consequences.
Ultimately, GLP-1 drugs can be a valuable tool for weight loss when used responsibly under medical guidance. However, they’re not a miracle cure and shouldn’t be viewed as a substitute for sustainable lifestyle changes.
