Attaining and maintaining a healthy weight is important to feeling good and staying healthy. A healthy weight can help lower your blood pressure and cholesterol, reduce your risk for chronic diseases like diabetes and heart disease and prevent worsening of some conditions such as arthritis.

Approaches to preventing or managing overweight and obesity include a healthy diet and regular exercise. Unfortunately, healthy lifestyle behaviors and choices do not always lead to successful results, and other interventions may be necessary. This may include the use of weight-loss medications.

The weight-loss drug surge

Fueled by television ads, celebrity endorsements and an obesity epidemic, there is a weight-loss drug boom sweeping the United States. At the center of this boom is a class of injectable drugs called GLP-1 receptor agonists.

Semaglutide (Ozempic and Wegovy), liraglutide (Saxenda), and tirzepatide (Mounjaro and Zepound) are among the drugs that are considered GLP-1s. These medications were originally designed to help manage blood sugar (glucose) levels in people with type 2 diabetes. However, in recent years, some GLP-1s have also been studied and approved for chronic weight management because of their ability to reduce hunger, constant cravings and food intake.

“While studies have shown that certain GLP-1 agonists can help suppress appetite and lead to weight loss, they are not intended as the first step in weight management and not everyone should use them,” said Dr. Deirdre Wheat, Medical Director, Quality & Population Health Management, Independent Health.

According to Dr. Wheat, weight-loss medications are most appropriate for patients who are considered overweight or obese, have tried other evidence-based approaches for weight loss (e.g., healthy diet and exercise) without success and have at least one weight-related health condition, such as type 2 diabetes, high blood pressure or heart disease.

Concerns over proper usage and costs of GLP-1s

Although not all GLP-1s are approved by the U.S. Food and Drug Administration for chronic weight management, this hasn’t prevented millions of Americans from using them for the sole purpose of weight loss. The off-label use of certain GLP-1s for weight loss – particularly Ozempic – has not only led to significant supply shortages but is also a big reason why overall prescription drug costs continue to skyrocket. A month’s supply of GLP-1s can cost upward of $1,300 per month.

With more than 1 in 3 U.S. adults currently struggling with obesity, some analysts predict the weight-loss medication market could surpass $150 billion a year within a decade, which would likely drive up both health care spending and health insurance premiums.

“When it comes to a chronic disease like obesity, finding a balance between effective and affordable solutions can sometimes be difficult. The fact that GLP-1s specifically made and approved for weight loss, like Wegovy, Saxenda and Zepound, are often effective when used properly and appropriately is very encouraging,” said Dr. Wheat. “At the same time, these medication are not meant to be a quick fix. While most weight loss occurs within the first few months of starting a GLP-1, it may take longer to achieve and maintain sustainable weight loss. Plus, they are intended to be used alongside other lifestyle modifications, including changes to your diet and regular physical activity.”

GLP-1 side effects are on the rise

Like any medication, there are various side effects associated with GLP-1s. According to the manufacturers’ warnings, the most common symptoms associated with the use of GLP-1s are nausea, vomiting, diarrhea, abdominal pain and slowed or paralyzed digestion. They can also drop your blood sugar too low, leaving you feeling weak. In addition, as the popularity of these drugs has soared, more serious gastrointestinal issues that may require hospitalization have started to appear on the radar, including intestinal blockage, pancreatitis and gastroparesis.

“There are still plenty of unknowns when it comes to GLP-1 agonists being used for weight loss, including the long-term health effects,” said Dr. Wheat. “Patients who use these drugs for weight loss may be at higher risk for adverse events as compared to those who take it for diabetes. Therefore, it’s imperative that they follow up with their doctor about side effects. As with any medication, patients should not stop taking their GLP-1 without speaking with their doctor first.”

Lifestyle changes are still key to lasting health

Despite the dramatic increase in the use of GLP-1s for weight loss, experts agree that there are safer, more cost-effective strategies to shed some weight and keep the pounds off that should be considered well before medication therapy. If you are considered obese or overweight, incorporating healthier habits into your everyday life can still help lead to sustained weight loss over the long term.

Ways to lose weight without needing expensive medications

  • Increase your physical activity: Moving your body helps you burn more calories and can improve other aspects of your physical and mental well-being. Adults should aim for 150 minutes of moderate-intensity physical activity and two days of muscle strengthening activity each week, according to the current Physical Activity Guidelines for Americans
  • Eat healthy foods. On most days, eat a variety of whole grains, vegetables, fruits, dairy products, and lean meats. All foods, if eaten in moderation, can be part of healthy eating. Even sweets can be okay.
  • Make more homemade meals: Cutting back on ultra-processed foods and takeout can reduce your calorie consumption and intake of added sugar.
  • Add more fiber and protein to your diet: Fiber and protein can help decrease blood sugar levels and increase fullness, as foods high in these substances take longer to digest.
  • Limit added sugars: Consuming high amounts of added sugar — especially from sugary beverages — can increase blood sugar levels and contribute to weight gain. You may want to opt for water or low-calorie beverages more often.
  • Get enough sleep: Sleep helps you recover and feel your best, both physically and emotionally, whereas lack of sleep can contribute to less nutritious food choices and a decrease in physical activity.
  • Work with a registered dietitian: Registered dietitians are nutrition specialists and can work with you to identify positive, health-promoting food choices to support weight loss and manage blood sugar levels. Independent Health members can search for participating registered dietitians by using our online “Find A Doctor” tool.

Again, there are many options for weight loss these days. If you are considering taking action to lose weight, talk to your doctor to establish a plan that is right for you. Your doctor can also help determine whether a GLP-1 may be right for you, depending on your health concerns and goals.