A Comprehensive Guide to Weight Loss Medications Like Wegovy® & ZepBound™

Until recently, bariatric surgery was indeed the only long-term weight loss solution for patients suffering from morbid obesity. Though many would consider surgery to lose weight as a drastic measure, living with the ravages of obesity over long periods has shown to affect virtually every part of the body and even cause or worsen certain forms of cancer. Unfortunately, due to a combination of fear, stigma, and insurance qualification criteria, many patients who would benefit from surgery never get it. The result is that hundreds of thousands, if not millions, of people around the US, have a reduced quality of life and risk early death.

The Introduction of GLP-1 Receptor Agonists for Weight Loss

GLP-1 receptor agonist medication is nothing new. These medications were developed in the late 1980s and commercialized in the 1990s. Since then, they have been refined. Medications like Ozempic® and MounjaroTM have been available for patients with type two diabetes for quite some time and have shown exceptional effectiveness in reducing blood sugar levels. It became clear, however, that GLP-1s were also a mechanism for weight loss. These drugs alter hormonal secretions and make patients feel full sooner. The result is the aforementioned weight loss.

With a worsening obesity crisis and the lack of options beyond physician-supervised weight loss and before surgery, drug makers Novo Nordisk and Lilly were quick to start trials for a weight loss indication. While Ozempic and Mounjaro were being prescribed off-label for weight loss, the lack of FDA approval for weight loss limited the market and ultimately made the cost of the drug out of reach for many patients.

Early in 2023, an Ozempic craze began with social media influencers and celebrities discussing off-label use. Later, in 2023, with the approval of Wegovy and then Zepbound, higher dose formulations of Ozempic and Mounjaro, respectively, there was an immediate shortage of these drugs. If you follow financial news, it has become a windfall for these two drug makers. They can’t make enough despite costs exceeding $1000 per month without insurance coverage.

Today, almost a year later, the popularity of the drugs has not waned despite a distinct drop in media coverage. And Ozempic has become a household name. Of course, with the popularity of the drug and its widespread use, we are hearing about possible complications, including G.I. concerns, gastric motility issues like gastroparesis, and gallbladder and pancreas problems. Some of these, in addition to various aesthetic concerns, result from the significant weight loss that these drugs provide.

Will They Replace Bariatric Surgery?

Whether weight loss medications will replace bariatric surgery will be discussed in greater detail on another page. However, the two weight loss modalities can work symbiotically. For some bariatric patients, these weight loss drugs may be suitable as a postoperative reset or maintenance tool. It can even be used preoperatively to reduce surgical risk. However, these drugs typically will not be helpful for higher BMI patients in the obesity range – in other words, for those over 40 or so BMI, the weight loss drugs won’t offer sufficient weight loss.

The Bottom Line

GLP-1 receptor agonists are a revolution in weight loss, and most bariatric specialists have embraced them as a necessary part of weight loss and maintenance. They come with risks; not all patients will be suited to these medications. We expect these injections, as well as oral medications will be refined over the next several years such that there will be more options than ever before for patients who are suffering from excess weight or obesity-related concerns.

In the meantime, anybody suffering from obesity should have a frank and open conversation with their primary care physician and metabolic or bariatric specialist to understand more about the weight loss options available to them. Whether medication or surgery, the most crucial part is that patients begin to address any excess weight concerns to eliminate weight-related issues and return to a better quality of life and long-term health.

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