1 of 3 | When used correctly, prescription weight-loss medications provide people battling severe weight management problems with life-changing — and, in some cases, life-saving — health benefits. Photo courtesy of Novo Nordisk A/S
People struggling with their body weight experienced joy when new, more effective prescription drug options became the rage in 2023, but it seems many folks stopped taking them in 2024.
Research published earlier this year suggests more than half of those using two of these drugs discontinued treatment within 12 months, perhaps due to the cost and side effects, experts told UPI. Advertisement
This is despite people with obesity, or being severely overweight, having “this disease for a lifetime,” said Dr. W. Timothy Garvey, a professor of nutrition sciences at the University of Alabama at Birmingham.
When used correctly, prescription weight-loss medications provide people battling severe weight management problems with life-changing — and, in some cases, life-saving — health benefits.
However, “when you go off these medications, the pathways that cause obesity come back full force,” Garvey told UPI in a phone interview. Advertisement
Although many users discontinue treatment once they have lost the desired amount of weight, others cite side effects as the reason, Garvey said, noting that the most common ones are gastrointestinal, primarily nausea and vomiting.
“We may have to reduce a person’s dose to manage these side effects, but it’s rare that we have to discontinue them because of side effects,” he added.
Cost seems to be a bigger factor — without insurance, a one-month supply of Wegovy, or semaglutide, can cost more than $1,600, while Zepbound, or tirzepatide, is priced at almost $1,300. The cost drops a few hundred dollars through prescription buying services, such as GoodRx.
Life-threatening issues
Up to 1 in 5 children and 2 in 5 adults in the United States are obese, the Centers for Disease Control and Prevention estimates. Having the condition increases the risk for potentially life-threatening problems, such as high blood pressure, heart disease, Type 2 diabetes and some forms of cancer, according to the agency.
Obese people also can experience breathing problems, trouble sleeping and chronic fatigue, CDC says.
However, those who take prescription weight-loss drugs lose, on average, up to 15% of excess body weight, Garvey said, which lowers their risk for related health complications, such as heart disease. Advertisement
“The health benefits are unprecedented,” he added.
As a cardiologist at Northwestern Medicine, Dr. Sadiya S. Khan prescribes the drugs “to reduce cardiovascular risk.”
“This focus on cardiovascular risk is important for the framing and consideration of these medications,” Khan told UPI in an email.
In her view, because of the benefits of weight loss on heart health, the drugs should be considered “cardiovascular meds and not just weight loss meds,” said Khan, a professor at Northwestern Feinberg School of Medicine.
Benefits after goals met
Positioning the drugs as treatments for chronic health conditions such as heart disease can help to encourage people to continue taking them even after reaching their weight-loss goals, according to Dr. Michael Lahey, a physician with My Weight Loss Partner in Michigan.
He recalls the case of a 42-year-old woman who met the criteria for and prediabetes, or blood sugar above healthy levels but below the threshold for diabetes.
On semaglutide, she lost 20 pounds over six months, but had to have her dose of the medication reduced due to side effects.
“After she had lost the necessary weight, she decided to stop taking the medication for good,” Lahey told UPI in an email.
Within a few months, she gained much of the weight back and asked to restart treatment, he added. Advertisement
“A lot of people may think, ‘I’ve lost weight, I feel better, I’m sleeping better, I don’t want to keep paying for this,'” medication, Garvey said.
“They think of them like diet pills, so once they lose weight they think don’t need them anymore,” he said.
To address this, Garvey asks patients prescribed a weight-loss drug to agree to a “contract” to continue taking the medication unless health reasons exist for stopping treatment.
However, the cost may discourage people from taking the drugs in the first place: research suggests that 1 in 4 people prescribed these drugs never fill their prescriptions, according to Garvey.
Availability issues
For some, the drugs may simply not be available, he added.
Given the high number of people in the United States with obesity, and the more than 30 million with Type 2 diabetes, these drugs have been among several drug classes that have experienced shortages and supply chain issues in recent years.
Most health insurance plans don’t cover these drugs for weight loss, although that could change now that Medicare and Medicaid, which are overseen by the federal government, may be cleared to do so.
A decision on the new proposal for the federally run healthcare plans could come in the early part of next year. Medicare and Medicaid recipients are covered when the drugs are prescribed to treat Type 2 diabetes — but not obesity. Advertisement
Lilly, which makes tirzepatide, earlier this month announced plans to expand a production facility in Wisconsin to meet increasing demand for that drug.
“We need to work on national policies to ensure cost and supply are not barriers, such as pharmaceutical coupon cards and assistance programs,” Northwestern Medicine’s Khan said.
