Dr. Mansur Shomali, Endocrinologist and Diabetes Expert
Almost 30% of Canadians and 40% of Americans are considered obese, and we all know how difficult it is to lose weight. There is much excitement about the new medications that help with weight loss. Ozempic and Mounjaro are medications approved for lowering blood glucose levels in people with diabetes. Wegovy contains the same medication as Ozempic but is used for weight loss in people who don’t have diabetes. These medications help with weight loss by mimicking the effects of a natural hormone called GLP-1. Mounjaro also mimics the effects of an additional hormone called GIP.
All these drugs are dosed once a week using an easy-to-use pen injection device.
· In the STEP-1 study, 50% of participants who used the 2.4 mg dose of Wegovy lost 15% of their body weight.
· In the Surmount-3 and -4 studies with tirzepatide (the active ingredient in Mounjaro), the weight loss was an impressive 26%.
Barriers to Using These Medications
Although the weight loss results are exciting, there are significant barriers for using these medications.
· Costs: Clinicians who prescribe Mounjaro and Ozempic for people without diabetes are doing so in an “off label” manner. This is because Mounjaro and Ozempic are not approved by the U.S. FDA and Health Canada for weight loss). When prescribed “off label” this often means insurance companies will not cover their costs.
· Side effects: There are also potentially serious side effects. Nausea, vomiting, abdominal pain, diarrhea, and constipation are common. More serious side effects such as pancreatitis or gallbladder disease affect less than 1% of individuals.
· Weight gain if meds are stopped: Finally, when people using these medications discontinue them, their weight frequently goes back up.
So, should you take one of these medications?
If you have diabetes and need a medication that can control glucose and prevent many of the complications of diabetes, one of these drugs makes sense and you should seriously discuss it with your diabetes care team. If you don’t have diabetes, and need to lose weight for medical reasons, such as to improve obstructive sleep apnea, it is a conversation worth having. If the weight loss would be just for cosmetic reasons, the risks from these medications may not be worth the benefit.