Injectable weight loss medications
Cameron Johnson, PharmD | 06/17/2024
Weight loss medications are all the craze right now. Semaglutide (Ozempic or Wegovy) and Tirzepatide (Mounjaro and Zepbound) are a class of medications called GLP-1 agonists. Initially these medications were studied for their effect in lowering glucose levels for people with type 2 diabetes but they quickly gained attention for the amount of weight loss associated with them. You probably know someone who has tried them and lost weight without much effort. Are they the miracle drug they seem, are they too good to be true or somewhere in between?
How they work
These medications work by mimicking a hormone in your body called glucagon-like peptide-1. GLP-1 prompts several bodily responses: stimulating insulin production from the pancreas, inhibiting glucagon release (which promotes glucose production by the liver), slowing stomach emptying to induce a feeling of fullness, and signaling satiety to the brain. Moreover, Mounjaro and Zepbound utilize an additional mechanism involving gastric inhibitory polypeptide (GIP) to enhance the sensation of fullness.
Are these medications something you should try?
To get any of these medications you need to talk to a doctor to see if they are right for you. All medications come with risks.Some of the possible side effects include: Nausea, Diarrhea, decreased appetite, vomiting, constipation, pancreatitis and acute kidney injury. You and your doctor can talk about what those risks are and if the benefits of using these weight loss medications are worth the risks.
What weight are you losing? Any time you lose weight it will be a combination of fat tissue and muscle. Weighing yourself on a scale won’t tell you how much of each you are losing though. We can use Dexa Scans to differentiate how much fat and muscle you have. Getting a scan when you start your weight loss journey and periodically during will tell you what changes your body is making. You can use this information to further discuss with your doctor if the benefits of the medication are still outweighing the risks.
Don’t forget the basics.
Don’t lose sight of what your ultimate goal is though. While the number on the scale can be discouraging and hard on our self-esteem, at the end of the day it’s just a number. Another way you can look at your health is: can you do the things that you really want to do? Are you fit enough to play with your kids or grandkids as much as you would like? Are you fit enough to pursue the hobbies that you enjoy? Do you feel strong and capable? Do you have energy? Are you getting good rest? Are your lifestyle choices promoting a healthy enjoyable life?
While these medications can be used as a tool to get you to your fitness goals, there is no substitute for setting a base of regular physical activity and eating good nutritious food.
References
"Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes." New England Journal of Medicine, 2016.
"GLP-1 Receptor Agonists in Type 2 Diabetes Mellitus: Efficacy and Potential Pathophysiological Implications." Diabetes, Obesity & Metabolism, 2018.
"Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults." The Obesity Society, 2020.
"The Use of Dual-Energy X-ray Absorptiometry in Obesity." Current Opinion in Endocrinology, Diabetes, and Obesity, 2018.
National Center for Biotechnology Information (NCBI). Glucagon-like peptide-1 (GLP-1) Agonists. In: Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551568/#:~:text=Glucagon%2Dlike%20peptide%2D1%20( [Accessed June 17, 2024].
PubMed. Glucagon-like peptide 1 (GLP-1) receptor expression in human brain. Available from: https://pubmed.ncbi.nlm.nih.gov/17928588/#:~:text=Glucagon%2Dlike%20peptide%201%20(GLP,is%20expressed%20in%20these%20cells. [Accessed June 17, 2024].
National Institutes of Health, U.S. National Library of Medicine. Wegovy (Semaglutide) prescribing information. Available from:https://www.dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79 [Accessed June 17, 2024].
