When it comes to weight loss, medications like Ozempic and Wegovy are currently all the rage in Hollywood. Seemingly overnight, celebrities including Rebel Wilson, Kathy Bates and Sharon Osbourne have shed pounds, inspiring the general public to follow in their footsteps.
However, these medications are not for everybody and must be taken with caution, as many of their long-term side effects are still unknown.
During Trinity Health Mid-Atlantic’s latest episode of Beyond the Stethoscope, Aley Tohamy, MD, a bariatric and general surgeon at Mercy Fitzgerald Hospital, explains that the weight loss aspect of GLP-1 medications was founded by pure coincidence about a decade ago.
Though they were originally intended to solely treat type 2 diabetes, their purpose expanded to weight loss thanks to the discovery of a common side effect: a decreased rate of digestion. This causes the patient to feel fuller for longer and, thus, consume fewer calories per day.
The popularity of these medications in Hollywood has led to increased use by individuals who are not qualified to take them. The FDA only approves a small population—those with a BMI over 30 and medical comorbidities like diabetes, heart disease and sleep apnea—to use GLP-1s for weight loss.
According to Dr. Tohamy, the results of weight loss medications have been astounding. He says, “Within one year, patients can lose up to 23% of their excess weight. It’s almost similar to the sleeve gastrectomy.”
However, the popularity of these medications in Hollywood has led to increased use by individuals who are not qualified to take them. The FDA only approves a small population—those with a BMI over 30 and medical comorbidities like diabetes, heart disease and sleep apnea—to use GLP-1s for weight loss.
“You have to have some medical comorbidity or medical disease that’s related to obesity,” says Dr. Tohamy. “Unfortunately, the public and some of the physicians who are prescribing these medications without looking at the indications for it has caused a significant shortage of these medications in the market. It’s crazy how this medication has been abused, not only in the United States, but also all over the world.”
Unlike surgical weight loss, which has been around since the 1950s, medical weight loss is still in its early stages. Therefore, the full extent of its long-term side effects remains unknown. So far, several have emerged, including gut paralysis and increased risk for thyroid cancer. Because of the latter, patients with a history of thyroid or pancreatic cancer are ineligible to take GLP-1 medications.
Even some celebrities are already seeing negative outcomes. Osbourne, 72, says she regrets taking Ozempic, as it caused her to lose too much weight. After dropping 42 pounds, she now weighs under 100 and is struggling to get back to a healthy BMI.
“We have decades of experience managing patients with gastric bypass, sleeve gastrectomy, duodenal switch. We have many, many years. We know exactly what we’re dealing with. When it comes to these new medications, we don’t have the same experience yet,” says Dr. Tohamy. “I read a paper on GLP-1 medications. Some can cause blindness, especially if the patient has uncontrolled diabetes. So these are things that we are learning about it now, but 10 years from now, we might have more stuff.”
Currently, explains Dr. Tohamy, only 29% of people in the U.S. are at a healthy weight. The CDC declared obesity as a disease in 2013 and the numbers have only grown since then, especially among younger people. Dr. Tohamy has seen an increase of patients with diabetes in their 20s and teens with sleep apnea.
“If the patient is coming to my practice thinking that they’ve done their best by taking a pill or taking an injection or having a surgery done and there’s nothing else they need to do, that’s absolutely wrong. Unless they engage in a healthier lifestyle and good food choices and exercise, this weight will come back.” — Aley Tohamy, MD
Though witnessing the medical weight loss success of their favorite celebrity might inspire someone to take Ozempic without thinking twice, they should consult with their physician to make sure it’s the best option for them. Still, stresses Dr. Tohamy, there is no magic pill, nor is there a magic surgery, that will fix the problem by itself.
“If the patient is coming to my practice thinking that they’ve done their best by taking a pill or taking an injection or having a surgery done and there’s nothing else they need to do, that’s absolutely wrong,” says Dr. Tohamy. “Unless they engage in a healthier lifestyle and good food choices and exercise, this weight will come back.”
At Mercy Fitzgerald Hospital, Dr. Tohamy and his team takes a multidisciplinary approach to ensure that patients have lasting weight loss success. This includes conversations with a dedicated dietician, who teaches them how to read labels and practice healthy eating habits.