1. Will I have to take this medication forever?
3. How do I know if the medication is really working for me?
4. Do I really need to eat healthy and exercise while taking this medication?
5. What if I’m scared of injections?
6. Is it safe to drink alcohol while on these medications?
2. What happens if I stop taking the medication?
FAQs About GLP-1 and GIP/GLP-1s for Obesity
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7. Should I watch out for any rare or serious effects?
8. What if my insurance doesn’t cover the medication and I can’t afford it?
9. What are the long-term effects of the medication?
7. Will I still need to diet and exercise?
Simply put, “The medicine works while you’re taking it,” says Kumar, noting that it’s no different than taking drugs to control blood pressure or lower cholesterol. “If you stop, your body will try to go back to ‘factory settings.’”
Most people regain weight after they stop taking the medication, because the appetite-regulating hormones return to baseline. Stopping and restarting these medications can also lead to obesity sarcopenia, where muscle that was lost as part of the overall weight loss is replaced by fat when the medication is stopped. “People on GLP-1s are losing fat and muscle,” says Saleh. “When they stop these medications and gain weight, they gain weight in fat, not muscle.”
Weight loss is one sign, but it’s not the only one. Improvements in blood sugar, blood pressure, and cholesterol are all indicators that the medication is having a positive effect. Your provider will monitor your lab work and other health outcomes, in addition to tracking changes on the scale. You may also experience reduced cravings, better mobility, and more energy. “The number on the scale is one thing, but nonscale victories are the most amazing thing ever,” says Saleh. “When a patient’s blood pressure is lower, their blood sugars improve, they can take a medication out of their daily regimen … [sit] comfortably on an airplane without a seat belt extender, or [be] able to play with a young child without huffing and puffing, those are the changes that really improve quality of life.”
Yes, it’s important to make lifestyle changes while taking the medication. Think of it as an opportunity to learn healthier eating patterns. It’s also important to work with your doctor to begin an exercise routine, especially one that builds muscle mass, such as strength training. “When you lose weight on these medications, your body can’t distinguish between body fat, muscle, or collagen. With rapid weight loss, you lose all of it,” says Saleh. “That’s where you can get sagginess of the skin and hair loss.” To combat this, you need protein, which is the building block of muscles.
Even people who fear needles are often surprised at the simplicity of the injection pens, says Kumar. “Many people actually think it’s easier than taking a daily pill.” Ask your doctor to demonstrate how to inject yourself in the office or even guide your first injection over telehealth.
5. What if I'm scared of injections?
Yes, it’s important to make lifestyle changes while taking the medication. Think of it as an opportunity to learn healthier eating patterns. It’s also important to work with your doctor to begin an exercise routine, especially one that builds muscle mass, such as strength training. “When you lose weight on these medications, your body can’t distinguish between body fat, muscle, or collagen. With rapid weight loss, you lose all of it,” says Saleh. “That’s where you can get sagginess of the skin (Ozempic face) and hair loss.” To combat this, you need protein, which is the building block of muscles.
Most side effects of a GLP-1 or dual GIP/GLP-1 agonist are mild and often improve over time. The most common are constipation, fatigue, headaches, indigestion, nausea, and vomiting. Rare but important side effects to know about include the stomach emptying too slowly, which can lead to gastroparesis in people with prior stomach issues; potential thyroid risks in people with certain hereditary conditions (such as MTC and MEN2); and, very rarely, vision issues — such as irreversible nerve damage in the eye — which are usually linked to underlying conditions, such as diabetes. To minimize the risks, your doctor will review your personal and family medical history and explain what signs to watch for while taking the medication.
Heavy alcohol use raises pancreatitis risk and can hamper weight loss goals, so you may need to cut back on drinking. Moderation is key: It’s generally recommended that women have no more than one alcoholic drink per day and men have no more than two. Your alcohol tolerance may also change while taking a GLP-1 or dual GIP/GLP-1 agonist. People often feel alcohol’s effects faster, so having one drink feels like having two while taking these drugs, says Kumar.
Cost is one of the biggest barriers to taking GLP-1s or dual GIP/GLP-1 agonists. Insurance coverage varies by provider. Only a minority of state Medicaid plans cover GLP-1 drugs when prescribed for obesity, and Medicare does not cover obesity treatments. “Sometimes the choice between a GLP-1 and a dual GIP/GLP-1 agonist comes down to insurance acceptance,” says Kumar. “We’ll work with patients to see what’s covered and what programs may help.”
8. What if my insurance doesn't cover the medication and I can't afford it?
Although GLP-1 medications have been used for type 2 diabetes since 2005 (in lower doses than what is prescribed now for weight loss), it’s still too early to know the long-term effects of using them specifically for obesity. If you’re worried, talk to your doctor. “The key is making an educated decision with your physician,” says Saleh. “Not all people with obesity have to be on these medications. It’s not cookie cutter. We need to look at family history and personal history and weigh the risks and benefits.”
9. What are the long term effects of the medication?
