What's the skinny on weight-loss drugs like Wegovy, Ozempic?

Dr. Zachary Gray, Chief Medical Officer at Torrance Memorial Medical Center, offers his insights on the rise of GLP-1 drugs and their current uses, limitations, and future possibilities.

GLP-1 receptor agonists, such as Ozempic, have become a hot topic in the world of medical weight loss. Initially developed to manage diabetes, these drugs have now expanded into the realm of obesity treatment, with their potential applications continuing to grow.

What are GLP-1s and How Do They Work?

GLP-1s, or Glucagon-Like Peptide-1 receptor agonists, are medications that work by mimicking a hormone in the body that regulates blood sugar and appetite. Originally designed to treat Type 2 diabetes, they help increase insulin production while slowing digestion. This makes them powerful tools for lowering blood sugar and assisting with weight loss. As Dr. Gray explains, "GLP-1 drugs are agonists for a particular receptor that modulates your metabolism. They essentially reduce appetite and promote weight loss by making patients feel fuller for longer."

One of the key mechanisms behind GLP-1 drugs is their effect on glucagon, a hormone that increases blood sugar levels by mobilizing energy stored in the liver and muscles. While insulin helps the body store energy, glucagon has the opposite effect, and GLP-1 agonists help regulate this balance. This dual action helps not only in controlling diabetes but also in achieving significant weight loss.

When Should You Consider Using GLP-1s?

The use of GLP-1 drugs has expanded beyond just treating diabetes to managing obesity, particularly in people with co-morbid conditions like heart disease or severe obesity. "If you're in a group of people where bariatric surgery is being actively discussed, I would strongly recommend trialing drugs like this first," says Dr. Gray. "It's reversible, unlike surgery, which permanently alters your body."

However, these medications are not for everyone. GLP-1 drugs like Ozempic and Wegovy are most suitable for those who meet specific criteria for obesity treatment. Dr. Gray cautions against the growing trend of non-obese individuals using these drugs for cosmetic weight loss: "Already, certain celebrities are taking them without being anywhere near obese. These drugs are incredibly expensive, and insurers only cover them for people with genuine medical need."

There are also side effects to consider. Nausea is common, with some patients developing severe enough symptoms to discontinue treatment. Additionally, GLP-1 drugs can delay gastric emptying, which poses risks for patients undergoing surgery, particularly under anesthesia. Long-term effects, such as the loss of muscle mass, are also being explored. "Muscle is metabolically active tissue, and losing it can lead to other health complications, especially if you're not healthy to begin with," warns Dr. Gray.

How Much Do These Drugs Cost and What Are They Worth?

The high cost of GLP-1 drugs is a major barrier for many patients. According to Dr. Gray, "These drugs are extremely expensive, and for the vast majority of people to afford them, they have to be covered by insurance." Without coverage, the out-of-pocket cost can be upwards of $1,000 to $1,500 per month.

Despite this, demand for GLP-1s has skyrocketed. Ozempic, one of the most well-known drugs in this class, saw a surge in popularity not just for diabetes management but also for weight loss. Pharmaceutical companies like Novo Nordisk and Eli Lilly, which produce Ozempic and Mounjaro respectively, have seen their revenue skyrocket. In 2023 alone, Novo Nordisk’s sales of GLP-1 drugs reached over $11 billion, with forecasts suggesting this market could continue growing exponentially as the demand for obesity treatment expands.

Are GLP-1s the Future?

There is a lot of enthusiasm around GLP-1 drugs, and their potential applications go beyond weight loss. "We’ll continue to explore other ways these drugs can be useful—whether in treating cardiovascular disease or perhaps other conditions—but much of that remains speculative for now," says Dr. Gray.

Though still under investigation, GLP-1s could become a cornerstone of metabolic treatments, offering hope for individuals who struggle with conditions ranging from diabetes to severe obesity. However, as with any new drug, time will tell whether the benefits outweigh the risks in the long term.

Take Charge of Your Weight Loss Journey

If you're struggling with obesity or weight management, Torrance Memorial Medical Center offers comprehensive solutions to help you achieve your goals. Consider enrolling in our CORE 4 Adult Weight Management Program—an 11-week course led by a registered dietitian, designed to guide you through sustainable lifestyle changes that promote lasting weight loss.

You can also consider a consultation with one of our Medical Nutrition Therapists and Educators, who are Registered Dietitian Nutritionists with years of experience providing credible and reliable nutrition information. (Services are available by physician referral only to treat specific health conditions and illnesses. Many MNT services are covered by insurance.)