In recent years, drugs like Ozempic and Wegovy have skyrocketed in popularity, quickly transforming from diabetes treatments into the latest trend in weight loss. Both medications belong to a class of drugs based on a molecule called semaglutide, which is designed to mimic a gut hormone known as GLP-1. Originally developed to help manage type 2 diabetes, these drugs are now also marketed for obesity and have sparked a massive demand, turning the company behind them into one of the most valuable in Denmark—worth more than the country’s economy itself.
What Exactly Are These Drugs?
GLP-1, short for glucagon-like peptide-1, is a hormone that’s naturally produced in the gut after we eat. This hormone plays several roles: it helps regulate blood sugar by signaling the body to release more insulin, it slows down how quickly the stomach empties, and it tells our brain that we’re full. Semaglutide, the active ingredient in both Ozempic and Wegovy, essentially gives users an extra dose of this “fullness” hormone, which can help reduce food intake and help you lose weight.
These drugs aren’t entirely new—scientists have been studying semaglutide since the mid-2000s, with over 300 clinical trials conducted. The U.S. Food and Drug Administration (FDA) first approved semaglutide under the brand name Ozempic in 2017, specifically for diabetes treatment. Then, in 2021, a higher-dose version called Wegovy was approved for weight management. Both drugs are self-administered via weekly injections.
Semaglutide is not alone. Other drugs in the GLP-1 family are either available now or on the way. Mounjaro (tirzepatide) is a newer option that works on both GLP-1 and another hormone, GIP, potentially offering greater effects on weight and blood sugar management. Additionally, Retatrutide, which is still in clinical trials, mimics GLP-1, GIP, and a third hormone, glucagon, adding even more potential for managing diabetes and obesity.
How Do GLP-1 Drugs Work?
By mimicking GLP-1, these drugs trick the body into feeling fuller, reducing hunger, and curbing appetite. The hormone acts on receptors throughout the body—not just in the gut, but also in areas like the liver, blood vessels, stomach, and even the brain. Although semaglutide’s exact workings are still not entirely understood, the main effect is a reduction in food intake, leading many users to experience significant weight reduction.
In clinical studies, people with obesity using Wegovy lost around 12% of their body weight. The drug has also shown potential benefits beyond weight loss; early research suggests that it may reduce the risk of heart attacks and strokes in patients with obesity, and even have anti-inflammatory effects that might benefit brain health, sparking interest in using GLP-1 drugs to explore conditions like Alzheimer’s and Parkinson’s.
Risks and Side Effects
GLP-1 drugs stand out because they are proving more effective than previous weight-loss medications, with fewer severe side effects than historical drugs like fen-phen, which was pulled from the market in the ’90s due to heart risks. By focusing on natural hunger and satiety signals, GLP-1 drugs are generally safer, though their side effects can still be numerous and potentially serious in some cases.
However, the popularity of these drugs comes with challenges. Common side effects include nausea, vomiting, fatigue, diarrhea, constipation, and most commonly muscle loss, which emphasizes the need for concurrent strength-building exercises and nutritional support to preserve muscle mass. Some users, especially those influenced by social media trends, may mistakenly accept extreme nausea as part of the experience, though such symptoms are not typical and should prompt consultation with a healthcare provider. Serious risks, although rare, include conditions like stomach paralysis and bowel obstruction, leading some patients to pursue legal action against manufacturers. The safety of these drugs during pregnancy also remains understudied, a concern given their use by women of childbearing age.
Thus, it is crucial that these drugs are prescribed and monitored by medical professionals; they should not be purchased over the counter or treated as a simple, risk-free solution.
Who Should—and Shouldn’t—Use These Drugs?
The FDA and other regulators has approved GLP-1 drugs like Wegovy for obesity, which is defined as a body mass index (BMI) of 30 or greater. For those who don’t quite meet this threshold but have a related health condition, such as high blood pressure, the regulators may allow exceptions. However, many people use these drugs off-label, especially if they’re willing to pay out of pocket since health insurance generally follows regulators guidelines for coverage. Once again, these medications should be prescribed by a healthcare professional due to their potential side effects and risks.
Ironically, the groups who might benefit the most from GLP-1 drugs—such as those from low-income backgrounds who have higher obesity rates—are often unable to afford them due to high prices and insurance limitations. Adding to the issue, rising demand has caused supply shortages, forcing patients to search for doses at distant pharmacies and making it even harder for those in need to access the drugs.
Weight Regain: The Challenge of Going Off the Medication
One drawback of GLP-1 drugs is that they generally need to be taken long-term to keep off the weight lost. Studies show that patients who stop using these medications often regain the weight they lost. Some patients, who miss the pleasure of indulging in food for social or celebratory reasons, might try to go off the drugs temporarily. Although short breaks are possible, the underlying appetite returns quickly, often making it hard to maintain the lower weight without medication.
Therefore, even while taking GLP-1 drugs, it’s essential to incorporate regular exercise to help preserve muscle mass, as these medications can lead to muscle loss alongside fat reduction. When coming off the drug, maintaining a routine of exercise and healthy eating habits becomes even more crucial. Without the medication, appetite often returns to pre-treatment levels, making it easy to revert to previous eating patterns if new habits aren’t firmly in place. Sustainable weight management relies on these lifestyle shifts supported by lifestyle coaching or programs focused on nutrition, exercise, and mental well-being, rather than relying solely on the drug.
Final Thoughts
As healthcare continues to advance, one could envision a combined approach where people initially use GLP-1 drugs to jump-start weight loss, then transition to support programs for sustainable weight maintenance without medication. Health experts stress that weight reduction drugs should always be part of a broader lifestyle shift that includes better eating habits and regular physical activity, essential not only for maintaining weight but also for promoting heart, bone, and brain health. These drugs, while transformative, are not a magical solution. They come with risks that require medical supervision, as underscored by reports like the tragic case of a UK nurse whose death was linked to tirzepatide.
Prescribing GLP-1 drugs should always be handled with professional guidance and an understanding that successful, lasting weight management relies on a well-rounded approach.
About the author
Meet Aïda, health & food enthusiast, part of MyAuthentikSpoon team, an online platform dedicated to helping people make better food choices for stronger wellbeing. If you’re ready to tackle wellness with a fresh perspective, schedule a complimentary private consultation with our expert naturopathic coach to receive personalised dietary insights and weight management strategies. This is your opportunity to have your questions answered and to learn how to incorporate the food choices into your lifestyle and achieve a better wellbeing.
