In the world of weight loss and diet trends, GLP-1s are all the buzz. While the majority are only FDA approved for Type 2 diabetes, they’ve become the go-to drug for many frustrated calorie-counters and individuals battling the bulge. But are they safe and worth the high cost and potential risks? That depends…
There are lots of these drugs in the pipeline, and those available include tirzepatide and semaglutide. According to a 2024 poll, about 1 in 8 American adults have used them. As demand increases, so do the number of pop-up clinics and online suppliers peddling their compounded versions. But are they safe and worth the high cost and potential risks? That depends…
A lot of evidence suggests GLP-1s are good medications, but outside of the diabetic realm, there’s a big black box unknown. As for their long-term safety, we simply don’t have enough data to know the effects of using them for weight loss alone.
The ABCs of GLP-1s
GLP-1s work by accelerating and enhancing the production of incretin, a hormone your body releases naturally. They help insulin work more effectively, increase metabolic activity, and activate areas in the brain that signal fullness. We call this early satiety. In some cases, I’ve seen patients achieve significant weight loss, but some people tolerate them better than others. Then there are those who lose weight and gain it all back once they come off the drug. However, the hope is that those who use the medicine appropriately will have the opportunity to kickstart some healthy habits. Because obesity is a chronic condition, short-term fixes aren’t long-term solutions. Therefore, to enjoy meaningful, sustained changes, patients must change their behavior.
Who Are Good Candidates for These Drugs?
If weight is a major morbidity, and it affects a person’s quality of life, movement, sleep, blood pressure, cholesterol levels, disease risks, and more, GLP-1s might be a good fit. But for patients whose body mass index puts them just overweight, these drugs probably aren’t the right approach.
Cost Can Be a Significant Barrier
For some patients, compounded GLP-1s are the only accessible option, as the cost of the brand name, doctor prescribed drugs can exceed $1,000 per month. In contrast, compounded versions are a fraction of the price, which is often the appeal for patients. Some compounding pharmacies dispense their drugs safely, but others are unlicensed, selling substandard products and offering little to no patient support—and that’s where the danger lies.
Clinical oversight is crucial when using GLP-1s, and some patients should absolutely avoid these drugs. For example, if they have a condition called multiple endocrine neoplasia, a family history of thyroid cancer, pancreatic problems, or severe gastrointestinal conditions. If a pharmacy does not properly vet their patients, they could be putting them at risk. I suggest patients first consult their health care providers before pursuing these medications. If the patient is a good candidate, their doctor can guide them to a reputable pharmacy that is monitored by a licensed practitioner.
When GLP-1 treatment begins, it can take some time to find a patient’s sweet spot, which is the dosage that yields the benefits with minimal side effects. It takes time for the body to adjust, so the dosages should escalate slowly, and they may vary from patient to patient. A health care professional should be managing this process, and monitoring the patient’s side effects, which often include gastrointestinal issues, such as nausea, vomiting, abdominal pain, and changes in bowel habits. When a patient is ready to discontinue the drug, clinical oversight may also help ensure a smooth transition and reduce the risk of weight regain.
For certain patients seeking weight loss support, GLP-1s may be the way forward. As for shortcuts and quick fixes, false promises are all that exist.
Dr Reilly is the Medical Director for Risk-Based Care at The Villages Health’s Creekside Care Center.
A version of this article appeared in the Daily Sun.