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GLP-1 medications, including Ozempic, Mounjaro, Wegovy and others, have grown exponentially since the drugs received FDA approval back in 2005.
Today, millions of people are using or have used the drugs to combat diabetes and obesity.
People can lose up to 20 percent of their body weight.
Dr. Prathyusha Pagadala, an Endocrinologist at the K.U. Medical Center, tells NewsTalk KZRG the drugs work primarily on digestion.
When patients eat, they feel full very easily,” she says, “but those people may have some bloating, nausea, and in severe cases, even vomiting and constipation. We typically start patients on the lowest dose and titrate up based on their tolerance.”
Dr. Pagadala says weight loss from GLP1s can include unintended muscle and bone loss risks, especially in older adults
“Patients can lose 20% of total body weight over the course of their treatment,” she states.
But, she says, unfortunately, that amount is more than just fat.
“It can also be muscle loss and bone loss to some degree,” she explains. “So that is an important conversation to have, especially in older patients with diabetes over the age of 65.
“But at this point when we’re looking at risks versus benefits, the benefits of improving diabetes, improving heart disease, and even some other indications far outweigh those risks at this time.”
Dr. Pagadala says newly identified risks include potential eye complications and surgery-related concerns.
Patients with diabetic retinopathy eye disease may experience worsening eye conditions, so regular eye exams are critical. Because of the GLP1s’ slow digestion, there is an aspiration risk during general anesthesia, requiring coordination between surgeons and prescribing doctors to pause the medication appropriately.
Doctors are learning now that GLP1 drugs help with more than just weight loss.
“There may be a role for patients who have issues with alcohol addiction, tobacco use, even things like impulse control disorders, gambling and such,” the physician answers.
“Of course it’s not FDA approved for this indication, but studies are ongoing in terms of other chronic illnesses,” she says. “There may be a role for these medicines in various autoimmune and inflammatory diseases. And they’re also being studied for type 1 diabetes separate from Type 2 that develops later in life.”
What happens when a patient stops taking a GLP1 drug?
“Stopping doesn’t itself cause any harm, but the benefits we described, the lower blood sugar, the weight control, heart and kidney protection, can fade over time,” Dr. Pagadala states.
“Patients mostly do unfortunately regain the weight that they’ve lost in these studies, where more than half of them do have a higher weight than pre treatment. So there may be alternative strategies that are needed to control their weight and keep their diabetes in check.”
Health plan leaders predict continued steep growth in the use of the drugs. In 2024, there was 100% growth in usage for weight loss, marking them as a top-three drug class for cost.