Weight Loss Drugs: What To Know
Prescription weight loss drugs like Ozempic and Qsymia have garnered a lot of media attention recently. Although my focus as a dietitian and health coach is on making healthy living accessible and using nutrition and lifestyle approaches to support mental health (rather than focusing on weight loss), I’ve fielded a number of questions about what these drugs are, how they work, and whether I’d recommend them. I thought it would be helpful to share some information with you, so let’s dive in!
Just a note: while Ozempic and Qsymia are the medications I discuss in this post, there are others available, and while they may have similar mechanisms of action, it’s always a good idea to have a conversation with your healthcare provider about the nuances of each is discussing the pros and cons of each for you.
While both Ozempic and Qsymia can help to curb your appetite and lead to weight loss, they work differently to have this effect.
Ozempic, known generically as semaglutide, was approved in 2017 by the U.S. Food and Drug Administration (FDA) for use in adults with type 2 diabetes. Ozempic, which is injected under the skin on your stomach, thigh, or upper arm, works by mimicking the effects of GLP-1, a naturally occurring hormone that stimulates insulin secretion and lowers glucagon secretion from the liver. As the GLP-1 hormone levels rise, the molecules go to your brain, telling it you’re full. Ozempic also slows digestion by increasing the time it takes for food to leave the body. This is similar to the effect of bariatric surgery.
Though Ozempic can treat obesity – the Centers for Disease Control and Prevention estimates 42% of Americans are obese and for them, Ozempic and anti-obesity medications are being hailed as a major triumph – experts warn that the drug is not designed for people who want to drop a few pounds. In fact, the Cleveland Clinic encourages people with a BMI lower than 30, to make use of diet and exercise to maintain a healthy body weight rather than turning to the drug. This is because when you take Ozempic, your body makes more GLP-1. This increase in GLP-1 not only suppresses appetite but also changes how your body responds to weight loss, which in the long-run can have an adverse impact on your appetite and metabolism, and can lead to malnutrition.
Another very popular weight-loss drug, Qsymia, is an extended-release capsule combination of phentermine and topiramate, and like Ozempic, is used to treat obesity. The phentermine component of Qsymia suppresses the appetite to aid in weight loss, while the topiramate component is typically used to treat epilepsy and prevent migraines, but with a common side effect of weight loss. According to the FDA, “Qsymia should be used alongside a reduced-calorie diet and increased physical activity for chronic weight management” in adults who have a BMI of 30 or more.
Though both Ozempic and Qsymia can be life-changing medications for many people trying to lose a significant amount of weight, we are very much still learning about both drugs. In fact, it bears mentioning that neither drug is intended to be used long-term (no more than 12 weeks is the current recommended duration) and that diet, exercise (especially strength training which is optimal for protecting against muscle loss) and other lifestyle changes still need to be part of the weight loss and weight management journey, unless you want to stay on these medications long-term, which again, is not recommended.
There are some additional considerations related to the use of these weight-loss drugs:
- As with all medications, both Ozempic and Qsymia can present significant side effects. For Ozempic, these can include nausea, stomach pain, constipation, diarrhea, and vomiting, and for Qsymia, these can include numbness or tingling in the hands, arms, feet, or face, dizziness; changes in the way foods taste or loss of taste, trouble sleeping, constipation and dry mouth.
- While most insurance companies cover Ozempic when it’s prescribed to treat type 2 diabetes, it is not generally covered for weight-loss. Conversely, Qsymia is covered by many commercial healthcare plans, though certain plans may require prior authorization. This could change over time, however.
- For your own safety and well-being, it’s important that when taking either of these medications, you are followed closely by a medical provider.
- Though research is still ongoing, studies so far have shown that if you stop taking either medication without having made lifestyle changes like the ones noted above, you may have a higher chance of gaining weight back.
- Weight loss drugs can lead to muscle loss, which in excess, is not good for your body. Lean muscle mass is healthier and associated with a more active metabolism, so when you lose lean mass, you lose some of our metabolic function. In fact, the more muscle mass a person has, the better the resting metabolic rate (the number of calories burned at rest), which is why incorporating strength training and adequate protein intake to support muscle building and maintenance of muscle is important.
- Weight loss drugs, though effective for some, don’t teach about lifestyle changes, so diet and lifestyle education still plays a role in long-term weight loss.
- Again, both drugs are still being researched, so it’s important to proceed with caution.
If you’re considering taking Ozempic or Qsymia (or similar drugs) for weight loss, I encourage you to consider that it’s still important to make sure you eat balanced meals and make make exercise a habit. If you’re new to movement, here here are some tips for safely starting an exercise routine.
I hope you’ve found this information both helpful and informative. If you’d like to read more, check out these media features I have done on the topic of weight loss drugs:
- Is Psyllium Husk A Cheap Alternative to Ozempic?
- Experimental New Weight Loss Drug Retatrutide May Rival Ozempic, Study Finds
- What is Berberine, the Supplement TikTok-ers are Calling “Nature’s Ozempic?”
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