I was meeting an old friend I hadn't seen in months. Walking toward her, everything looked right: the hair, the outfit, the bag slung over her shoulder.
But the silhouette was all wrong. She looked like half herself! Who was this doppelganger? And then I blurted it out: “Are you on weight loss drugs?” Her answer: yes.
She excitedly told me the drugs changed her life. If you’re one of the tens of millions taking medications such as Wegovy, and Ozempic, a diabetes drug used off-label for weight – or the newer Zepbound or Mounjaro, another diabetes one, your life may already be changing. And if you’re considering joining the throngs, yours may also change – in ways you may not expect.
What is striking is how well these drugs work. Patients taking Wegovy, or Ozempic at weight loss doses, see the pounds drop by 15%. For Zepbound and Mounjaro, a whopping 20%.
No other medication has ever resulted in such vast weight loss. They work by mimicking hormones released after eating that slow how quickly the stomach empties, and signal to the brain that you feel full.
But, let’s look deeper. Weight loss medications are not like antibiotics, where you take a short course, and you’re done. I call them lifer drugs. In all but a few cases, you will need to take them – for life. Stop, and your body’s old appetite-signals surge back, and within a year or so, most people regain much of what they lost. The drumbeat of ads - they are among the most heavily marketed drugs in the US - barely mention any of this.
Nor do they - or most doctors - explain that we are still learning. Like all new drugs, they were tested on only a few thousand people. Drug trials can’t possibly capture every demographic - only a few hundred people over 65 were included in the weight loss trials - nor every genetic predisposition or lifestyle. Those gaps emerge only after drugs move out of the lab and are unleashed onto the entire population.
For this reason, it’s sometimes better to go with older, tried and true medications. But here, older versions don’t exist. And the side effects of these newbies — nausea, vomiting, fatigue — are difficult to manage, so up to 20% of patients quit within the first year. Other patients stop because, with injections costing up to $1,300 a month, people without insurance can’t afford them, though drugmakers are beginning to roll out less costly pill forms.
The paradox here is stark: weight loss drugs need to be taken for life, yet, they’re new, so no long-term studies exist. Researchers already know of relatively uncommon cases of pancreatitis, kidney injury, and eye complications — but when drugs scale from a few thousand subjects to millions in real life, what’s uncommon can prove widespread.
My friend lost weight; she looks great. But she also signed up for a lifelong prescription, a hefty monthly bill, and questions science hasn’t yet answered. For her, it's worth it – every pound. Whether it's worth it for you is not a decision to take lightly.
The views expressed by commentators are solely those of the authors. They do not necessarily reflect the views of this station or its management.
