By now, weight loss injections with brand names including Ozempic®, Wegovy®, Mounjaro® and others, have become a part of standard drawing room conversation. These include a particular class of medications that were formulated originally to treat Type II Diabetes, and are called glucagon-like peptide 1 (GLP1) agonists. With FDA indication to treat obesity, some of these medications are being prescribed even more widely.

GLP1 agonists work on several levels to regulate blood sugar. These medications promote insulin release from the pancreas as well as block glucagon (a hormone that raises blood sugar) release, decreasing the amount of glucose in the bloodstream. Another effect is to slow how quickly food empties from the stomach, slowing digestion. Not only is the stomach fuller for a longer period of time, but GLP-1 is also present in parts of the brain that process feelings of hunger and fullness.

Researchers are learning more about the contribution of these medications to overall health, including lowering blood pressure and improving cardiovascular health. However, they do come with serious side effects and therefore should be prescribed only by physician teams that are familiar with these medications, especially when used for weight loss.  Severe side effects can include kidney failure, inflammation of the pancreas, gallbladder disease, delayed gastric emptying and others. 

When people experience significant weight loss, they may also notice concerning cosmetic changes including hair loss, loose skin, and changes in the appearance of the face (popularly termed Ozempic® Face). Some of these changes related to rapid weight loss, such as hair loss, may be mitigated by careful attention to nutrition and obtaining proper micronutrients. Others, such as skin excess or change in body contours, may require weight to stabilize before addressing with fillers or cosmetic surgery.

While it's true that semaglutide (the active ingredient in Wegovy®, assists with losing as much as 20% of body weight with the addition of regular exercise and diet program, those taking the medication who do not incorporate significant lifestyle change may see as little as 2% or even zero weight loss while using the medication. Weight loss injections are not a panacea for obesity, as obesity is a multifaceted problem that requires careful diagnosis and treatment. Obesity is a long-term condition, and requires suitably long-term treatment. These medications are not meant to be short term ‘fixes’ or ‘jump-starts.’ Because of potential serious side effects, these medications should be avoided in certain populations. A team of nutritionists, physicians, pharmacists and possibly endocrinologists should be in place to guide prescriptions and treatment.

For more information, please speak with your primary care physician.