The Rise of GLP-1s: What every patient should know

Torrance Memorial physician Soohan Mansuri, MD, shares his perspective.

GLP-1 medications, like semaglutide (Ozempic and Wegovy), are making waves in health care. Originally created to treat Type 2 diabetes, these drugs are now popular for their ability to help people lose weight and possibly improve other health problems, like heart disease. With millions of prescriptions written in the United States in 2023 (around 51.9 million) and widespread attention in the medical field and on social media, many wonder: Are GLP-1s the breakthrough we've been waiting for, or do they come with important warnings? Here, Torrance Memorial physician Soohan Mansuri, MD, shares his perspective.

Have you noticed more patients asking about GLP-1s for weight loss or other health problems?

Yes, interest has grown a lot. Many of my patients, young and old, are asking about medications like semaglutide for weight loss and managing health conditions.

    * Patients must meet a certain medical criterion, such as a diagnosis of type-2 diabetes or obesity with associated health risks, to be prescribed a GLP-1 medication. Additionally, insurance coverage varies widely and many insurers do not cover GLP-1 medications for weight loss alone unless certain conditions are met.

What are some concerns to keep in mind?

1. Long-term Use:

Staying at a healthy weight with GLP-1s often requires using the medication for life. Studies, like the STEP trials, show that stopping the medication can lead to weight gain. This could be a problem if insurance no longer covers it or if the cost becomes too high.

2. Risk of Pancreatitis:

While rare, pancreatitis (inflammation of the pancreas) can happen, especially in people with risk factors like gallstones or alcohol use. It’s important to talk to your doctor about these risks.

3. Pregnancy Safety:

GLP-1 medications are not recommended during pregnancy because there isn’t enough information available to confirm their safety for the baby. People who could become pregnant should plan carefully and use birth control while on the medication. We also need more research on how rapid weight changes might affect pregnancy if one were to stop using these medications when they become pregnant. 

4. Regular Checkups:

Lab tests are needed to monitor things like kidney and thyroid health, especially when starting the medication or changing doses. Some people who get these medications online or from weight loss clinics may not get proper testing or medical advice as patients might not follow up with them after starting medication.

5. Muscle Loss and Protein Needs:

Losing weight quickly with GLP-1s can lead to losing muscle along with fat. This can affect your overall strength and health. Eating enough protein and doing strength exercises, like weight lifting, can help protect your muscles. Work with your doctor to create a plan that supports muscle health.

What kinds of results are you seeing?

The results have been impressive for many patients:

•           Weight loss: Many patients have lost a significant amount of weight.

•           Improved health conditions: Problems like type 2 diabetes, high blood pressure and cholesterol often improve with weight loss.

But success depends on factors like taking the medication as directed, using the right dose, and making lifestyle changes like eating healthier and exercising.

Are GLP-1s the solution for many health problems, and are you as excited about them as others seem to be?

These medications are groundbreaking. They can help with serious health challenges like obesity and diabetes. That said, they aren’t perfect and need to be used wisely. Deciding to use them should involve weighing the benefits and risks based on the patient’s needs. While they are powerful tools for improving health, they’re not meant for short-term goals like looking better for a vacation.