Despite the buzz about injectable weight-loss medications, it’s important to know the advantages and disadvantages of these powerful drugs. If you have type 2 diabetes or struggle with obesity and related health issues, this candid discussion with Muhammad Feteiha, MD, will help you weigh your options.
Who is interested in injectable weight-loss medications?
As a bariatric surgeon, I see two types of patients. The first group has made the decision to have weight loss surgery. The second group comes in to discuss treatments for weight regain, such as revision surgery and now, injectable weight loss medications. I talk to people quite a bit about the benefits and drawbacks of these drugs so that they can make informed decisions about their health.
How do the medications work?
This new class of drugs — known as glucagon-like peptide-1 agonists or GLP-1 agonists — consists of three common brands that are proven to help people successfully lose weight. Ozempic® and Mounjaro®, are FDA-approved for people with type 2 diabetes. Wegovy® (made by the same company as Ozempic), is FDA-approved for weight loss. All three help you manage your blood sugar (glucose) levels with a once-a-week shot in the abdomen, upper arm, or leg. All three use GLP-1 agonists to stimulate gut hormone secretions, such as insulin. They also slow the emptying of the stomach and intestines, allowing the user to feel full longer.
Who is a candidate?
Anyone with an A1C over seven is a potential candidate for Ozempic and Mounjaro. Adults with weight-related health issues should already know their A1C number and be testing it every three months. People who are significantly overweight, have type 2 diabetes, or have a BMI over 30 would all qualify. Those who are prediabetic may qualify for Wegovy, if they are overweight.
What are the pros and cons?
These medications are some the most effective weight-loss drugs that have ever been on the market. They’re a great way to jumpstart weight loss and something new we can offer to patients. These drugs are not just appetite suppressants, they literally change your gut hormones and help improve one’s metabolism. When we’re able to alter metabolism, we can help you:
- Gain control of your diabetes and weight loss
- Control your appetite
- Reduce related health problems
- Boost your motivation
- Spur honest weight-related conversations between doctor and patient
The physical drawbacks can include nausea, bloating and diarrhea. Some people may also develop gallstones or pancreatitis. Although research on long-term safety and effectiveness is still quite limited, we do know that these drugs can create a physical and psychological dependence. So, think long and hard about whether to start and what happens if you want to stop.
If I decide to go off the medication, what happens?
Studies show that you can regain your weight back because you have lost the ability to manipulate your gut hormones and metabolism. To keep weight from rebounding, you must continue maintenance doses — unless you’ve become so self-motivated that you’ve made huge diet, exercise and lifestyle changes. In fact, any medication or surgery should always be paired with medical support for dietary changes, fitness and lifestyle changes.
Will my insurance cover it?
If your doctor prescribes Ozempic or Mounjaro for type 2 diabetes, it will likely be covered by most major insurance plans. The same is true for Wegovy for weight loss. However, if you get started with these therapies, there is always a chance that insurance will decide to stop covering the medication. Unfortunately, this happens all the time. These are expensive drugs, and with more and more adults seeking them out, insurance companies will always be reevaluating coverage.
How much weight could I lose?
Since I’m a bariatric surgeon, I’ll start by saying you won’t lose as much on Ozempic as you would from weight loss surgery. However, you can lose up to 15% of your body weight. So, for example, if you’re 240 pounds and you lose 15% of your body weight, or 36 pounds, you’ll weigh in at about 200 pounds and that could be enough to eliminate your diabetes.
The weight loss from these drugs can be life changing. They can reduce your risk for cardiovascular disease, lower your blood pressure, eliminate type 2 diabetes, and eliminate the need for many chronic medications that are associated with these diseases. That’s a huge win.
Be Proactive About Your Health
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