By: Emory Healthcare
Date: Sep 10, 2024
They are being called miracle drugs. New prescription weight loss drugs like Ozempic, Wegovy and Zepbound are currently in the spotlight for their fast, dramatic results.
Indeed, these medications are helping people lose a lot of weight. Plus, they’re enjoying a better quality of life and can do more with greater confidence.
“We see so many success stories and significant life changes in patients that take this type of medication,” says Reema Dbouk, MD, an internal medicine doctor and obesity medicine specialist at Emory Healthcare. “They’ve empowered patients to address their weight, change their lives and embrace a new outlook.”
According to the U.S. Centers for Disease Control and Prevention (CDC), 70% of Americans have obesity or are overweight. This increases the risk of other diseases, including hypertension (high blood pressure), diabetes and high cholesterol.
But it’s hard for many people to lose and keep weight off through diet and exercise alone. Prescription weight loss medication is helping people lose as much as 20 percent of their body weight. These drugs not only provide results but also much-needed hope.
How Prescription Medicine for Weight Loss Works
Ozempic, Wegovy and Rybelsus have the generic name semaglutide. Zepbound and Mounjaro are brand names for a newer medication called tirzepatide. Doctors have used this class of medication to treat Type 2 diabetes for more than 10 years.
The results were dramatic. What’s more, these drugs were found to:
- Control blood sugar in people with diabetes by triggering the release of insulin after eating
- Manage hunger cues in the brain
- Slow stomach emptying so you feel full longer
The result is that you decrease your calorie intake. Over time, you can lose 10-20% of your body weight.
Who Is Eligible for Weight Loss Drugs
The U.S. Food and Drug Administration (FDA) has guidelines for who is eligible for drugs like Wegovy. These include:
- Body mass index (BMI) over 30%
- BMI over 27% and at least one serious medical condition due to weight, such as high blood pressure
“We have guidelines to help us determine who is a good fit for these medications, but doctors should always use their professional judgment,” Dr. Dbouk says. “Insurance companies may use these guidelines or specific criteria to provide coverage.”
Doctors and drug manufacturers do not recommend these medicines for anyone who:
- Has a history of pancreatitis or medullary thyroid cancer
- Has multiple endocrine neoplasia syndrome type 2 (MEN2)
- Is pregnant, attempting to conceive or breastfeeding
There are no restrictions on who can prescribe them. You may get a prescription from your primary care doctor, obesity medicine specialist, endocrinologist or cardiologist.
What To Expect from Ozempic and Other Prescription Weight Loss Medications
Medications like Ozempic often come in a single-use pen. You use it to inject the medicine under the skin, in your belly, once per week. Rybelsus is a tablet you swallow.
Your doctor usually begins with the lowest dose for at least four weeks. They will see how you respond at each dose.
If you aren’t losing weight, they may increase the dose. This can happen as often as every four weeks. By 12 weeks, your doctor is looking for a loss of at least five percent of your body weight.
The two different class of drugs can affect people differently, so it’s essential to work closely with your doctor to check your response.
All medications have side effects. Among the most common for these weight loss drugs:
- Nausea
- Vomiting
- Constipation
- Diarrhea
- Acid reflux
- Fatigue
- Abdominal pain
“By far, nausea is the most common side effect, but it tends to go away within the first couple of weeks,” Dr. Dbouk notes. “A small number of patients have such significant nausea and vomiting that they cannot take this medicine.”
Rarer side effects include allergic reactions, pancreatitis and acute kidney injury.
Lifestyle changes, such as a healthy diet and regular exercise, are important for anyone taking weight loss medication. “These medications are meant to work with healthy eating and physical activity,” Dr. Dbouk says. “We work with patients on this over time as the backbone of our approach to weight management.”
Weight loss of 10-20% of your body weight is common. The exact amount depends on the drug you’re taking and the lifestyle changes you make.
Weight loss can lead to other benefits as well. These include:
- Better mobility
- Less joint pain
- Lower blood pressure and cholesterol
- Reduced inflammation
- Resolution of sleep apnea
Current Challenges
One issue with prescription weight loss drugs is that if you stop taking them, you may regain the weight you lost.
“These must be used long-term, or possibly indefinitely, for best results,” Dr. Dbouk says. “Some patients don’t want to commit to using a medication for that long, so they need to discuss this with their doctor.”
Prescription weight loss medications can also be expensive. Depending on the drug, monthly costs can range from approximately $700 to $1400. Insurance doesn’t always cover them, so they can be out of reach for many people. Some manufacturers offer patient assistance programs or discounts.
Due to the great demand for these drugs, shortages have occurred. This is frustrating for patients and doctors and can disrupt treatment and progress.
Because of the high cost and supply issues, generic or compounded versions have emerged. They cost less and are widely available. However, compounded medications are not regulated. They may not contain the same ingredients or formulations as the FDA-approved name-brand versions.
The FDA is investigating reports of adverse effects from compounded medications and has warned about using them.
“There isn’t enough regulation when it comes to compounding. It’s a risky route,” Dr. Dbouk says. “We have concerns about patient evaluation, monitoring and follow-up when these compounded versions are prescribed through telemedicine companies.”
Dr. Dbouk says there is still much to learn about these medications for weight loss. We need more research in areas such as:
- Brain-gut connection
- Long-term effects
- Sustainability of weight loss
- Weaning or transitioning off medication
- Why some patients don’t respond well
Optimistic Outlook
Prescription weight loss drugs have changed how people look at obesity.
“Traditionally, obesity has been considered a lifestyle choice, which has led to a stigma,” Dr. Dbouk says. “Now it’s beginning to be seen as a chronic and complex disease. That has helped combat the weight bias that’s been so pervasive in our society for so long.”
Studies are ongoing to learn more about prescription weight loss drugs, and companies are developing other medicines. “This could be the tip of the iceberg,” Dr. Dbouk says. “And it likely will become the standard of care for treating obesity. It’s so rewarding to see lives being changed.”
Take Charge of Your Health
Emory Healthcare has helped many patients effectively lose weight and transform their lives. We are here to support your weight loss journey and answer your questions about weight loss prescription drugs. Talk with your primary careprovider first. Or make an appointment online.
