Two Downsides of Weight Loss Drugs

Two downsides of weight loss drugs are rarely mentioned.

There are many risks of Wegovy (called Ozempic when used for diabetes) and other weight loss drugs. They are expensive and usually not covered by insurance. There are many possible side effects, including nausea and other gastrointestinal symptoms. These symptoms are very common. Sometimes, they are more serious, including pancreatitis and gastroparesis, a weakness of the muscle of the stomach. The long-term risks are not known yet. Before you go on such a medication, you should talk to your doctor about the medical risks.

I want to mention two downsides of weight loss drugs that you may not have heard of or considered. They may not be deal-breakers for you, and you should discuss them with your doctor. I am asking you to consider these downsides.

If you start Wegovy or one of the similar medications called GLP-1 agonists, you are likely to lose 15% to 20% of your body weight. If you weigh 300 pounds, you may expect to lose 45 to 60 pounds or more, if you don’t stop the medication because of side effects. If you stop the medication, you are likely to regain 2/3 of the weight you had lost. Read the study here. Before I retired, many patients requested medication for weight loss. They wanted to use it to jump-start their weight loss. I told them they were likely to regain most of their weight when they stopped, and they answered that they would be careful. I always wondered how they would manage to be careful when they hadn’t been able to be careful before.

Do you want to use an expensive medication with significant side effects for the rest of your life? Putting the potential medical risks aside, you will be reminded of your weight problem every week when you inject yourself. The shot is virtually painless, but the constant reminder that you need a shot to maintain weight loss may be unpleasant.

Another downside of weight loss drugs is that you will not have lost weight on your own. There are many medical conditions that require medication, conditions that you cannot manage on your own. I have high cholesterol, but with rosuvastatin, it is in superb control. Despite daily exercise and a healthy diet, I still require the medication. Nothing I can do about it, and I am thrilled to have the medication. There are many conditions like this, including hypertension, which affects more than a third of Americans.

But, if you can manage your medical condition on your own, you will have a sense of accomplishment. As Ryan Holiday says in The Obstacle Is the Way, overcoming obstacles makes you better. Yes, some obstacles require the help of others to overcome, and perhaps obesity is one of these obstacles for you. But most people will be successful if they devote all their energy to a carbohydrate-based diet such as The Three Rules to Lose Weight and Keep It Off Forever, Second Edition. If you lose weight with a drug, you will miss out on this benefit, not to mention the other benefits of a healthy diet and exercise regimen. (That is a third downside of weight loss drugs that is rarely mentioned.

An analogy I like to use illustrating the benefit of doing it on your own is your kid’s homework. You can help your child do their homework. You can give them some or all of the answers. But if you want them to learn something and become a better student, it is better if they do the work themselves. Losing weight on your own will teach you that you can do it. If you slip up and regain the weight, you know you can do it again. Overcoming the obstacle of losing weight will make you better equipped to overcome other challenges.

I recommend you think about these downsides of weight loss drugs. Talk them over with your loved ones and your doctor, and choose what is right for you.