In our culture, maintaining a healthy weight is viewed as the epitome of wellness. The quest for achieving a healthier weight is often met with challenges and frustrations. The emergence of injectable weight loss medications has sparked both hope and controversy.

Like any intervention, these meds come with their own set of pros and cons. They raise important questions about efficacy, safety, and long-term sustainability. As we navigate this complex landscape, it’s crucial to examine both sides to make informed decisions about your health.

How do these injectable weight loss medications work?

Currently there are two meds that are receiving the most attention surrounding their use for weight loss. The first is generically known as semaglutide, also known as Ozempic, Rybelsus, and Wegovy. The second goes by the generic name of tirzepatide, which is also known as Mounjaro and Zepbound. Both belong to a class of drugs called glucagon-like peptide-1 receptor antagonist (GLP-1 RAs). Made by different pharmaceutical companies they are slightly different in their approach, however here are the basics of how they work.

  1. GLP-1 Receptor Agonist: They mimic the action of the naturally occurring hormone glucagon-like peptide-1 (GLP-1). GLP-1 is released from the intestines in response to food intake and plays several roles in the body. These include regulating blood sugar levels, appetite, and digestion.
  2. Blood Sugar Regulation: One of the primary effects is to stimulate the release of insulin from the pancreas in response to elevated blood sugar levels. Insulin transports glucose from the bloodstream into cells. This is where it is used for energy, thereby lowering blood sugar levels.
  3. Appetite Regulation: They target receptors in the hypothalamus, a region of the brain involved in appetite control. This leads to feelings of fullness and satiety after meals. By decreasing appetite and promoting early satiety, you consume fewer calories.
  4. Slowing Gastric Emptying: These meds slow the rate at which the stomach empties its contents into the small intestine. This delay in gastric emptying stabilizes blood sugar levels by slowing the absorption of glucose from food and reducing spikes in blood sugar.

The Pros

These medications offer several potential benefits for individuals seeking to manage their weight and improve their overall health. Here are some of the key pros:

Convenience

Although it is injectable, which most people tend to steer away from, these involve less frequent dosing schedules. Most are taken with one injection weekly.

Improved health outcomes

Beyond weight loss, many injectable medications have been shown to improve other health markers, such as blood sugar levels, blood pressure, and cholesterol levels. For individuals with obesity-related health conditions like type 2 diabetes or hypertension, these medications may offer additional benefits beyond weight management.

Increased motivation

The initial success of weight loss experienced with these meds provides motivation. This momentum will assist with continuing to make positive lifestyle changes. Seeing tangible results early in the weight loss journey can reinforce healthy habits and encourage sustained efforts towards achieving weight loss goals.

While they do not give the same benefit for everyone, these injectable weight loss medications can be a valuable tool for individuals struggling with their weight. However, it’s essential to weigh these potential pros against the cons and consider individual factors such as medical history, lifestyle, and preferences when making your decision.

The Cons

While injectable weight loss medications offer potential benefits, it’s important to consider the potential drawbacks and limitations associated with these interventions. Here are some of the key cons:

Muscle loss

If using the number on the scale as the measure of weight loss you may be misled. While weight loss can

occur, it does not guarantee that the weight loss comes from fat. In fact, muscle loss is very common. Essentially muscle is your most metabolically active tissue, so losing muscle will impact your long term ability to keep your weight controlled.

Up to ten percent of muscle loss is acceptable. However further muscle loss is a red flag for decreasing your metabolic activity. There are two strategies to retain muscle while losing weight.

  1. Consuming adequate protein intake is vitally important to retain or grow muscle. Most people are not consuming adequate protein to begin with, then decreasing their appetite further reduces the amount of protein they consume.
  2. Creating resistance on the muscle will encourage muscle maintenance or maybe even growth. This means that exercise, specifically resistance training is crucial. This can be done using body weight, resistance bands, or more traditional weight lifting.

Measuring body composition, which measures body fat, lean muscle mass, and water balance is a much better way to assess changes in weight. This allows you to ensure that your weight loss is due to a reduction in fat versus muscle loss.

Side effects

Like any medication, injectable weight loss medications can cause side effects ranging from mild to severe. Common side effects include nausea, vomiting, diarrhea, constipation, and headache. In some cases, more serious side effects such as pancreatitis, gallbladder disease, or kidney problems may occur.

Cost

These meds are expensive, especially if they are not covered by insurance. The cost of the medication itself, as well as any associated medical visits or monitoring, will add up over time. For individuals without insurance coverage or with limited financial resources, cost is a significant barrier.

Limited long-term data

While some injectable weight loss medications have been studied for several years, long-term data on their safety and efficacy are still limited. Questions remain about the sustainability of weight loss achieved with these medications over the long term. The potential for rebound weight gain, especially in the presence of muscle loss, once the medication is discontinued is a great concern.

To combat that, the manufacturers of these meds recommend that the medication be a lifelong intervention in which you will not ever get off of the medication.

Barrier for positive lifestyle changes

Rather than use the medication for motivation, some people will use it as their primary means of weight loss. If used as a catapult to project you into making improved lifestyle decisions, they can be very useful. However many people continue with their poor eating habits, lack of sleep, and sedentary, stressful lifestyle which will hinder the ability to develop long term health and weight maintenance.

In summary, while injectable weight loss medications can offer benefits for some individuals, they also come with potential risks and limitations that should be carefully considered. Before starting any weight loss medication, it’s important to consult with a healthcare professional to discuss individualized treatment options, weigh the potential benefits and risks, and develop a comprehensive, long term plan for achieving and maintaining a healthy weight.

If you are interested in discussing using injectable weight loss medications, but not sure if it is the right fit for you, I would be happy to help you walk through the decision. Click here to make an appointment.