Celebrities have been slimming down for years now, with many openly talking about taking GLP-1 drugs, including Serena Williams, Meghan Trainor and Kelly Clarkson. You may have noticed people in your life have started shrinking too.
From Hollywood to your hometown, weight loss drugs such as such as Ozempic and Wegovy seem to be everywhere these days. According to a KFF Health Tracking Poll published in November, about one in eight adults are currently taking a GLP-1 drug. Nearly one in five people surveyed said they had taken a GLP-1 drug at some point.
Is that a good thing? It depends on who you talk to.
What are GLP-1s?
Cecilia Low Wang is a professor at the University of Colorado School of Medicine who has focused on diabetes for her entire career and is an expert in endocrinology and metabolism. She also just finished up her tenure as chair of the Food and Drug Administration’s Endocrinologic and Metabolic Drugs Advisory Committee.
“I was lucky enough to be in the advisory committee meeting where the substance that makes up Ozempic and Wegovy was discussed before it was approved,” she says. “We were just absolutely bowled over by the magnitude of the A1C lowering (measured blood glucose levels) and the weight loss.”
GLP-1 stands for glucagon-like peptide-1, a hormone the body produces naturally. It essentially slows digestion, reduces hunger and improves blood sugar control, according to the Westchester Medical Center Health Network.
GLP-1 injections were first approved by the FDA in 2005, the same year “Harry Potter and the Goblet of Fire,” “Brokeback Mountain” and “Star Wars: Episode III – Revenge of the Sith” came out. They were originally approved to treat type 2 diabetes by controlling blood sugar, but a host of other benefits were soon discovered, including significant weight loss and reduced risk of cardiovascular disease. Some studies, according to the Stanford School of Medicine, have shown results around addiction treatment, from opioids to alcohol, nicotine and more. Research even suggests GLP-1s might help women manage polycystic ovarian syndrome thanks to their impact on insulin resistance.
Easier access
GLP-1s are not only more popular these days, but they are also much easier to access.
The FDA recently approved GLP-1s specifically for weight loss, not just for diabetes, as well as the first GLP-1 pill, which (pun intended) may be easier to swallow than regular injections.
As of November, weekly injections were estimated to cost about $1,000 per month even with insurance, according to Capital Blue Cross. Some pharmaceutical manufacturers have begun selling GLP-1s below that price (about $500 per month) if purchased directly without insurance. Some have worked out deals with retailers, such as Costco Wholesale, to sell the drugs at a discount.
The Trump administration announced a plan in November to bring prices down even further through a direct-to-consumer platform, TrumpRx, which would bring the cost of Ozempic, Wegovy and Zepbound to about $350 per month if purchased through the platform, according to AARP. Alternatively, the daily Wegovy pill could cost about $150 per month, depending on the dose.
“Getting insurance companies to cover these medications has been a big issue,” Low Wang says. “Having obesity and [being] overweight seen as a medical condition and having insurance companies willing to cover that as opposed to just covering diabetes medication brings down the cost.”
Ultimately, having these medications available is a good thing, she says. They are important tools in the toolbox, and no one drug is right or will work for everyone, so having options matters.
The downsides
Still, Low Wang doesn’t think GLP-1s should be in the drinking water.
“Hopefully people are talking with their health care provider about whether or not it’s an appropriate medication,” she says.
It’s important to work with them to ensure you’re starting at the right dose and learn whether it will interfere with other medications or if you are predisposed to adverse effects, she says.
Some common side effects of GLP-1s include loss of appetite, nausea, vomiting and diarrhea, according to the Cleveland Clinic. Others can include dizziness, increased heart rate, infections, headaches and indigestion. Rare, more severe side effects can include medullary thyroid cancer, pancreatitis, kidney injury and worsening diabetes-related retinopathy.
Sometimes GLP-1s can cause “Ozempic face,” a term used to describe some of the cosmetic side effects of rapid weight loss, such as a hollowed, sunken look around the eyes and cheeks, sagging or loose skin, thinning lips and more visible lines and wrinkles, according to UCLA Health.
Many patients lose weight while taking GLP-1s even if they aren’t eating healthy or exercising. But that isn’t harmless. According to UVA Health, loss of muscle mass can have a negative impact on patients’ long-term metabolic health, frailty and overall longevity.
When people stop taking GLP-1s, they often gain weight back as their appetite increases and cravings return. Some studies show that one year after stopping Ozempic, patients gained back about two-thirds of the weight they originally lost. Most people’s blood pressure also returned to their pre-Ozempic levels, according to GoodRx. Those who are most successful in keeping the weight off are those who establish healthy eating habits and regular exercise routines.
“We counsel people upfront about making sure you are choosing some healthy, high-quality foods with higher protein and complex carbs, maintaining muscle mass through resistance training and staying active,” Low Wang says.
Too easy to get?
There are people who take GLP-1s who don’t need them, Low Wang says. Part of the reason is that people can access GLP-1s without going through traditional health care providers.
Low Wang has seen ads on social media and heard them on the radio for compounding pharmacies, or places that offer non-FDA approved versions of semaglutide as generic GLP-1s. Many weight loss clinics operate using compounding pharmacies, such as Northern Colorado Medical, a telehealth weight loss clinic in Fort Collins.
Compounding pharmacies offer medications that aren’t commercially available by making them onsite, usually to meet a specific need, according to Harvard Medical School. Someone might need to use one if they:
- Need a certain dose or strength that is not commercially available
- Need a different form of medication
- Are allergic to something like lactose or gluten
- Need flavored medication for a child
Compounded drugs are supposed to always contain FDA-approved ingredients, according to Harvard, but the formulations aren’t reviewed by the FDA for purity, safety or effectiveness.
So, there’s a chance you won’t end up with the drug you think you paid for.
In 2023, for example, the FDA found fraudulent compounded semaglutide and tirzepatide, another popular GLP-1, marketed in the U.S. The FDA also seized dozens of units of counterfeit Ozempic in December that made its way into the drug supply chain.
The FDA recommends patients only get GLP-1s using valid prescriptions through state-licensed pharmacies. But like Low Wang says, medication costs have been a barrier to patients seeking help.
As of 2022, nearly 70 percent of Weld County residents were overweight or obese, and 11.4 percent of Weld County’s population had been diagnosed with diabetes (up from 10.1 percent in 2019), according to the 2022 Community Health Survey. The Health District of Larimer County’s 2022 Community Health Survey states that 32 percent of Larimer residents were overweight and 22 percent were obese at that time.
Roxanne Menges, owner of Northern Colorado Medical, says her clinic offers telehealth weight loss management, personalized care and competitive pricing. The affordability is thanks to the telehealth system and reducing the overhead costs associated with running a facility, she says.
The clinic is overseen by Anjmun Sharma, a family medicine physician based in Colorado Springs who only partners with compounding pharmacies that have been 503A and LegitScript certified, Menges says.
Northern Colorado Medical is clear on its website that the therapies are “not the FDA-approved branded medications, but they are carefully formulated to support metabolic health and weight management goals under physician supervision.”
Menges started using GLP-1s herself after menopause.
“I was dealing with high blood pressure, and my cholesterol levels were climbing each year,” she says. “I gained a few pounds every year no matter what I did. And I was hardly eating.”
She never thought she’d be able to get back down to her goal weight, but with the help of the medication, which she no longer needs, she’s been there for two years. Her blood pressure and cholesterol are also back to normal.
Her clinic works with compounding pharmacies to increase access for others.
“We mail the vial to you. It is your prescription, and you get your supplies,” Menges says. “We can talk you through the injection on the phone, and we have instructional videos.”
Sometimes people think the medication is a silver bullet, she says.
“We really encourage them to use it as a tool to help them get a hold of a healthy lifestyle,” she says.
