The Health series is presented by AdventHealth
A Conversation with Christine Khong, MD, board-certified obesity medicine
and family medicine physician with AdventHealth Medical Group
Over the past year or so, you can’t watch television or read a magazine without seeing ads for semaglutide medications for weight loss. You might even know people who have used them with great success.
But what are they? And how do they work?
Christine Khong, MD, board-certified obesity medicine and family medicine physician, explains.
How do weight-loss medications such as Ozempic, Wegovy, Mounjaro, and Zepbound work?
A semaglutide, such as Ozempic or Wegovy, is a weekly injection medication that mimics a hormone that the body makes called GLP-1. A tirzepatide, such as Mounjaro or Zepbound, targets two receptors: GLP-1 and also GIP. (Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) are both hormones that are released in the small intestine within minutes of eating.)
These medications help with weight loss by slowing down gastric emptying and quieting the food noise in your brain. It can help you feel less hungry, slow digestion, and decrease appetite. It can also help break down stored fat. It’s important to note that all weight-loss medications are only meant to supplement a healthy diet and exercise.
What do these medications cost?
These name-brand medications can cost from $1,000 to $1,500 per month, without insurance. That cost is brought down significantly if your insurance covers them. The manufacturer websites also offer coupons online, which can reduce the cost for self-pay patients.
Who can use them?
When speaking about the name-brand medications, Ozempic and Mounjaro are FDA-approved for patients who have diabetes. Wegovy and Zepbound are FDA-approved for weight loss. If your health insurance covers these weight-loss medications, and if you meet the criteria—BMI greater than 30 or BMI greater than 27 and also have other related health conditions, such as high blood pressure, high cholesterol, obstructive sleep apnea—you likely would be able to get the medication. Patients may not be good candidates for these medications and need to further discuss with their doctor if they have had a personal history of pancreatitis, a family history of medullary thyroid cancer, are currently pregnant or are breastfeeding.
Some people have been able to get compound semaglutide and compound tirzepatide, which are custom-made formulations of the commercially available medications. While this would be a less expensive option, these compound medications are not FDA regulated and patients should talk with their doctor about these options.
What are the potential side effects?
Nausea, vomiting, constipation, diarrhea, fatigue, headaches, and rash at the injection site are the most common side effects. Most side effects do improve as the patient continues to use the medication, as their body adjusts to the medication. Also, eating small portions and more bland foods helps. I also encourage my patients to increase their intake of protein, fiber, and water!
Are these medications a short- or long-term answer to weight control and the many health risks associated with obesity?
We should recognize obesity as a long-term health concern. So, these medications are meant to be long-term. Studies have shown that most people who stop taking the medication do end up slowly gaining the weight back over time, so these injection weight-loss medications are here to stay. It will be exciting to see more weight-loss medication options in the future. Treating obesity can decrease a patient’s risks of developing diabetes, heart disease, and strokes.