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Newer prescription medications that can help people lose a significant amount of weight are receiving a lot of media attention these days—Wegovy, Ozempic and Mounjaro, to name a few. Here at Memorial Regional Health, patients are asking providers about these drugs.

Carol Bolt is a Certified Family Medicine Physician Assistant and Certified Diabetes Care & Education Specialist at MRH. To help educate the MRH community, she answered some common questions about the newer categories of weight-loss drugs and when they can be effective.

Q. I’ve been hearing about medications you can inject to lose weight. What are these drugs?

A. A number of drugs that help patients with diabetes control their blood sugar and lower their A1C have also been shown to cause weight loss in most patients. Weight loss occurs because although the medications increase the body’s production of insulin to help lower blood glucose, they also stimulate areas in the stomach and brain. The result is two-fold: there is a slowing of gastric emptying and a sense of feeling fuller faster.

Q. Are these drugs for diabetes or weight loss?

A. Many of these drugs began as Type 2 diabetes treatments. (None of the drugs are indicated for Type 1 diabetes.)

Wegovy (semaglutide) has been approved by the Food and Drug Administration (FDA) for weight loss independent of Type 2 diabetes. Ozempic is also semaglutide, but it is not FDA-approved for weight loss alone.

Wegovy is intended for people aged 12 and older who have a body mass index of 30 or greater, or those who have a body mass index of 27 or greater plus one or more weight-related medical conditions, such as high blood pressure or high cholesterol.

Patients take Wegovy by injecting themselves in the stomach, thigh or upper arm once a week.

Saxenda (liraglutide) has also been approved by the FDA for weight loss and is indicated for the same populations but is a daily injection.

Mounjaro (tirzepaptide) is only indicated for Type 2 diabetes management but is expected to have FDA approval in the near future for weight loss.

Q. How much weight do people lose taking Wegovy?

A. It may vary with the individual, but some of my patients have lost 25 pounds or more fairly quickly. While the medication may help to control appetite, it is important to make healthy choices, and those who do lose more than others. Trials suggested 5 to 12% weight loss, but in the clinical setting the numbers may end up being much higher, particularly when an individual has more to lose.

Q. Are there side effects?

A. Yes. Most patients struggle with nausea and bloating, especially in the beginning. Vomiting and constipation or diarrhea are not uncommon. A rare but serious complication is pancreatitis. The entire class of GLP-1 inhibitors is contraindicated for people with a personal or family history of medullary thyroid carcinoma or metabolic endocrine neoplasia.

Q. What is the follow-up schedule?

A. If I prescribe one of the newer weight-loss drugs for a patient, I have them come back after the first month to assess their tolerance, weight loss and food diary. After that appointment, I generally have them return every three months.

Q. Are these new weight-loss drugs covered by insurance?

A. They are often not covered, and they are very expensive. Some drug manufacturer programs help pay for the drugs, and coupons are available, but these forms of assistance are typically temporary.

Q. What happens when I stop taking a weight-loss drug?

A. If an individual maintains the healthy changes they made when they were on a weight-loss medication, they can maintain that weight loss. If they go back to old habits, however, it is not unlike other medications we have used in the past, where they gain back the weight—and sometimes more. The goal with using any weight-loss medication should truly be to support a change in lifestyle. The patients I work with who are getting the most out of these medications are those who understand this.

Q. What is the bottom line?

A. Weight-loss treatment must be individualized for each person. No medication takes the place of healthy eating and exercise. Not everyone may be a candidate for certain medications. You may try a medication and not even be able to tolerate it. The current cost of some medications may be prohibitive. It’s still early in the use of this class of medication, so time will tell if they become more mainstream or not, and how they really hold up over time.