Have you ever noticed that all drug commercials are basically same? The words might change. But in the end, all of them portray happy people and happy families.
TV ads for GLP-1 agonists are some of the worst. These are those drugs you see advertised on TV to support weight loss and help manage blood sugar levels. Some of the brand names include Trulicity, Byetta, Victoza, Rybelsus, Monjauro and Ozempic.
Most of the advertisements for these meds include a feel-good catchphrase or jingle. Some of them even contain subliminal messages. The Ozempic commercial is a perfect example of this.
“Oh, Oh, Oh, Ozempic Oh-oh-oh-ohhh” to the tune of “Oh, Oh, Oh, it’s magic, you know-oh-ohhh!”
That’s some great marketing because, even without the visuals of smiling families at the arcade or climbing rock walls, that bouncy tune from the 1970’s alone can make anybody feel good. We all believed in magic back then.
But do these GLP-1 agonists really provide a magical solution to your A1C and weight problems?
The Rebound Effect
While most GLP-1 drugs are approved for the management of diabetes, the real reason people are clamoring for them is to help them drop pounds.
Only a few of them are actually approved for weight loss. These include Wegovy, Saxenda and the newly approved Zepbound. Still, many of the others are prescribed off-label for use as weight loss drugs.
But you should be aware that if you do drop pounds taking one of these drugs – whether it is approved for weight loss or not – the weight will likely rebound once you stop taking it, especially if your diet and general lifestyle are the same as they were before taking the drug.
For example, people who took semiglutide (Wegovy, Ozempic, Rybelsus) for 68 weeks and then stopped taking it regained two-thirds of their weight loss during the following year.
When patients stopped taking the new drug, Zepbound (tirzapatide) after 36 weeks, they regained about half of their weight. Those who did not discontinue the drug were able to maintain their weight loss.
In other words, to keep off the weight, you would need to continue taking the drug the remainder of your life.
And, of course, the longer you take it, the greater your chances of some very serious health risks and side effects.
The Dark Side of GLP-1 Agonists
There has always been disturbing news about the side effects of GLP-1 drugs. Nausea, vomiting, constipation and bowel obstructions are at the top of the list.
In fact, Pfizer recently cancelled trials on their twice daily oral GLP-1 tablets (danuglipron). Even though the drug was effective for weight loss, more than half of the participants stopped taking the pills due to the side effects. Specifically, up to 73% of the patients experienced nausea, 47% vomiting, and up to 25% developed diarrhea.
But these are the least of the problems associated with GLP-1 agonists. Over the past several years, the risk of acute pancreatitis has become a growing concern when it comes to this class of drugs.
A November 2023 analysis published in JAMA finally quantified that risk. The researchers found that, compared to the older weight loss drug bupropion-naltrexone, GLP-1 agonists are associated with a nine times higher risk of pancreatitis.
GLP-1 users also had more than a four-fold risk of developing a bowel obstruction and about three and a half times greater risk of stomach muscle paralysis.
Other side effects that have come to light over the years include higher risks of gallbladder disease, medullary thyroid cancer and suicidal ideation. Sounds like these drugs should come with “Black Box” warnings the FDA requires for the major risk factors proven to be associated with those drugs…..oh wait they did!
If you are or have been considering taking one of these medications to lose weight, you need to be acutely aware of these side effects and adverse reactions. More so if you are in your 60’s, 70’s or 80’s.
Personally, I recommend making lifestyle changes – ditching unhealthy foods in favor of foods that support healthy gut and weight loss, and taking part in regular physical activity – over taking a pill.
But if you feel you need a weight loss medication to get you started, the older bupropion-naltrexone weight loss drug is a much safer option.
SOURCES:
Wilding JPH, Batterham RL, Davies M, Van Gaal LF, Kandler K, Konakli K, Lingvay I, McGowan BM, Oral TK, Rosenstock J, Wadden TA, Wharton S, Yokote K, Kushner RF; STEP 1 Study Group. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022 Aug;24(8):1553-1564.
Aronne LJ, Sattar N, Horn DB, Bays HE, Wharton S, Lin WY, Ahmad NN, Zhang S, Liao R, Bunck MC, Jouravskaya I, Murphy MA; SURMOUNT-4 Investigators. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial. JAMA. 2023 Dec 11:e2324945.
Pfizer Announces Topline Phase 2b Results of Oral GLP-1R Agonist, Danuglipron, in Adults with Obesity. Pfizer. Press Release. Dec 2023.
Singh S, Chang HY, Richards TM, Weiner JP, Clark JM, Segal JB. Glucagonlike peptide 1-based therapies and risk of hospitalization for acute pancreatitis in type 2 diabetes mellitus: a population-based matched case-control study. JAMA Intern Med. 2013 Apr 8;173(7):534-9.
Sodhi M, Rezaeianzadeh R, Kezouh A, Etminan M. Risk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss. JAMA. 2023 Nov 14;330(18):1795-1797.
He L, Wang J, Ping F, Yang N, Huang J, Li Y, Xu L, Li W, Zhang H. Association of Glucagon-Like Peptide-1 Receptor Agonist Use With Risk of Gallbladder and Biliary Diseases: A Systematic Review and Meta-analysis of Randomized Clinical Trials. JAMA Intern Med. 2022 May 1;182(5):513-519.
Lisco G, De Tullio A, Disoteo O, Piazzolla G, Guastamacchia E, Sabbà C, De Geronimo V, Papini E, Triggiani V. Glucagon-like peptide 1 receptor agonists and thyroid cancer: is it the time to be concerned? Endocr Connect. 2023 Sep 27;12(11):e230257.
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