“Can’t I just try a prescription? I’ve tried everything else, and I have three friends who look amazing after their doctor’s prescribed weight loss pills.” That’s what Donna asked me when she came for a consultation, frustrated by the difficulty she was having losing weight.
Donna’s question was so familiar since the explosion of the off-label use for weight loss of drugs originally formulated to control diabetes, and her face fell when I told her I didn’t recommend it.
I can understand the appeal; who wouldn’t want to try a shot that seems to help when nothing else does? But I am NOT a fan of semaglutide or tirzepatide for weight loss. This prescription approach comes with some big problems, including the possibility of some pretty serious side effects.
Let’s take a look at what these drugs are and how they came to be seen as the next “miracle” in weight loss. Then I’ll give you three good reasons to explore an alternative (and in my opinion, much better) approach to weight loss.
What are these drugs, and how are they used for weight loss?
Semaglutide, the active ingredient in Ozempic, is a drug developed as a treatment for type 2 diabetes. It’s part of a class of medications called GLP-1 RAs, and it works by mimicking the naturally occurring GLP-1 hormone in your body. Ozempic lowers blood sugar through a few mechanisms. It increases the insulin your body produces after eating, decreases glucagon released into your blood, and makes food move more slowly to your stomach, helping avoid sharp blood sugar increases after eating. These effects also help lower some heart risks that can occur with diabetes.
Tirzepatide, the active ingredient in Mounjaro (also a diabetes drug), also mimics GLP-1, as well as another hormone, GIP. Working in similar ways as semaglutide, it also works to help decrease hunger signals to the brain.
Both semaglutide and tirzepatide are delivered through weekly injections. When moderate weight loss effects occurred for some research participants being treated for diabetes (in research sponsored by the company that manufactures Ozempic), word began to spread – especially on social media. In 2021 Wegovy, another drug with semaglutide as its active ingredient (at a higher dose than is present in Ozempic), was approved for treatment of obesity.
In 2022, Mounjaro hit the market, also to treat diabetes. The following year, in November, it was approved for use for chronic weight management and released as Zepbound.
A shortage of approved weight loss pills, and high demand for semaglutide and tirzepatide for weight loss, has seen more and more providers prescribing both Ozempic and Mounjaro for off-label use for weight loss. Semaglutide suppresses the appetite and reduces cravings, along with slowing the rate at which the stomach empties, which can leave you feeling full longer. Tirzepatide has similar actions, and can decrease feelings of hunger. When coupled with lifestyle changes, research has shown some significant weight loss results with both treatments. While many tout that as great news, I have some serious concerns about prescriptions as a go-to weight loss solution.
3 Reasons to Proceed with Caution When It Comes to Prescription Weight Loss
When something seems too good to be true, it generally is. That’s why use of semaglutide or tirzepatide for weight loss shouldn’t be an easy decision. While it may be the answer for some, it’s certainly not the “miracle” some have made it out to be. Here are three things to consider as you research this type of treatment for weight loss.
1. Who is behind the push to prescribe these drugs for weight loss?
I’ll give you a hint – it’s not those with your best interest in mind. These drugs can be very expensive, and when prescribed off-label, your insurance company might not approve them. Even worse, once you start using prescriptions like this to control your weight, you’ll likely need to continue for life. Because GLP-1 medications are designed to treat chronic conditions like diabetes, they are intended for long-term use. Research shows that ⅔ of the participants taking semaglutide for weight loss gained the lost weight back, plus 10 lbs, when they discontinued use. A study on tirzepatide had similar results, with participants gaining an 14% of lost weight back after 36 weeks while on a placebo.
Now think about it: who has a vested interest in keeping you on a costly drug forever? That’s right – the manufacturers of those drugs! Why wouldn’t they be marketing heavily to health care providers?
And that’s not the only way the pharmaceutical industry is impacting the popularity of semaglutide for weight loss. Even Oprah and Weight Watchers have jumped on board, using experts to talk about how these prescriptions can stop cravings, suppress appetite, and keep people on their diets. And guess who paid those experts?
2. Risk of serious side effects
Both semaglutide and tirzepatide carry a safety warning about the possibility of thyroid tumors, including thyroid cancer. And although that is a worst-case scenario, they also come with some more common side effects, including dizziness, gastrointestinal problems like constipation (50% of the time) excess gas, and diarrhea; headaches; fatigue and abdominal trouble such as nausea, bloating and pain. While those side effects might seem worth it to lose stubborn weight, there are some serious issues being reported that should make you think twice.
The FDA Adverse Event Reporting System (FAERS) has received over 22,000 reports of problems with semaglutide drugs and over 1,000,000 reports concerning tirzepatide. Many lawsuits against the companies that manufacture Ozempic and Mounjaro have been filed because of gastroparesis, a chronic condition that weakens the nerves and muscles in the stomach. Gastroparesis can lead to intestinal blockages and obstruction which cause serious health issues.
Other serious side effects include suicidal ideation, pancreatitis, kidney damage, and risk of gallbladder disease. In fact, the FDA is currently evaluating the need for regulatory action on both semaglutide and tirzepatide.
Those are some serious side effects to consider. While the risk might be worth it for those with obesity and hundreds of pounds to lose, for 20 or 30 pounds, there are much better options.
3. Without lifestyle changes, desired effects may not occur
Semaglutide/tirzepatide have been proven effective for weight loss only in conjunction with lifestyle interventions. So even if you have obesity and may otherwise be a good candidate for the drug, if you aren’t committed to making other changes to your lifestyle, you may be fighting a losing battle (and opening yourself up to the risks I mentioned above).
And you can’t rely on simple willpower to make that commitment for yourself. You’ll also have to fight the food industry. The rise of processed foods has destroyed Americans’ health, and they’re incredibly difficult to avoid. Obesity rates have skyrocketed since processed foods became the convenient norm, and there’s no easy way out of it. Billions of dollars are spent marketing processed foods, and their labels make all kinds of confusing claims designed to make you think their product is a better choice. The simple truth is, anything with ingredients you can’t pronounce is not a healthy choice.
Not only that, but the “noise of food” is hard to overcome. Our brains trick us into thinking we need to eat when we aren’t hungry at all. This has roots in our emotions, and the trauma we have experienced in our lifetimes and neurotransmitter imbalances. Weight loss drugs can “turn off” the noise, but only temporarily. Unless you are processing that trauma, testing and treating the neurotransmitters, when you stop taking the pills, the noise returns.
Changing your lifestyle habits is hard work, and if well known companies are shifting to a drug treatment protocol it’s easy to get fooled into thinking those habits don’t matter. But they do!
So what are my alternatives?
Difficulty losing weight isn’t a simple problem, and there isn’t a simple solution – no matter how much we wish there was. If you’ve been hearing the hype about semaglutide/tirzepatide and weight loss and hoped I’d say “Yes, go for it,” I’m sorry to say that I can’t. My conscience simply won’t allow it.
Donna’s face fell when I told her that, but I followed it up with some hope. I’ve been helping women lose weight for decades, and I have a number of recommendations that come at a lower cost, don’t require lifelong treatment, and don’t have the same risk for serious side effects.
My Drop20 Now™ Program can help you lose weight safely and quickly, with the support and coaching you deserve. And it even stops cravings, stops the noise of food, and decreases hunger.
I also have numerous articles about weight loss in my health library. In those articles, I explore factors that contribute to weight gain and difficulty losing weight, and offer practical suggestions for jump starting your weight loss journey. You don’t have to go it alone – and you don’t have to resort to a lifelong prescription!
