If you are overweight, losing that weight can be quite challenging as you know personally.
And then keeping it off … well, that is another story.
There truly have been countless diets proposed and touted, whether fad or so called based on scientific evidence. In the end, if one of them worked predictably and well, we all would be following it. However, that is just not the case.
Enter the “magic” pill which can make most diets less relevant and important: Ozempic. Though this is the most well-known of a class of drugs that can lead to substantial weight loss, there are several others as well that are effective.
If you’re thinking about taking Ozempic, Mounjaro or another GLP-1 agonist – or maybe you’re already on one – you’re aware of the benefits regarding weight loss. This class of medication has gained tremendous popularity and is all over the news and in social media. The reason: they are very effective in addressing the ever challenging and relentless problem of losing weight that is faced by countless millions of people.
While these medications offer significant benefits and can be a game changer, it’s essential to be aware of and consider their potential short-term and long-term health risks in your decision making. Let’s look at this in more depth.
Please note that though the drug name “Ozempic” is frequently stated below, the information refers to all the other medications in this class as well.
Using Ozempic or Other GLP-1 Agonists for Weight Loss: Considerations and Risks
While Ozempic was initially developed to manage Type 2 diabetes, its ability to promote weight loss has made it a popular choice for individuals seeking to shed excess pounds. The drug works by slowing gastric emptying, reducing appetite and altering the brain’s response to food intake, leading to significant weight loss in many users.
However, along with the good are downside risks.
Short-Term Considerations
- Gastrointestinal Distress: Many users experience nausea, vomiting, diarrhea and constipation, which can make it challenging to stay on the medication.
- Loss of Muscle Mass: Rapid weight loss, particularly without adequate protein intake and resistance training, can lead to a reduction in muscle mass, potentially impacting metabolism and overall health.
- Hypoglycemia Risk: Individuals without diabetes who use Ozempic may still experience blood sugar fluctuations, leading to dizziness, weakness and confusion.
Long-Term Considerations
- Metabolic Adaptation: Some individuals may experience a decrease in their metabolic rate over time, making it difficult to maintain weight loss after stopping the medication.
- Potential Organ Damage: Long-term risks such as kidney issues, pancreatitis and thyroid concerns remain areas of ongoing research, particularly for individuals using Ozempic solely for weight loss.
- Impact on Mental Health and Libido: Changes in neurotransmitter activity in the brain can contribute to mood changes, anxiety, depression and a reduction in sexual desire.
- Development of Bezoars and Gastrointestinal Obstruction: Prolonged slowing of gastric emptying can increase the risk of the formation of bezoars (hard masses in the bowel), leading to bowel obstructions and requiring medical and/or surgical intervention.
- Premature Aging and Facial Changes: Rapid weight loss associated with Ozempic use has been linked to facial volume loss, sagging skin and a more aged appearance, often referred to as “Ozempic face.” The reduction in fat stores may contribute to a hollowed look, and decreased skin elasticity can make wrinkles and fine lines more prominent. Additionally, some research suggests potential impacts on tissue aging at a cellular level, possibly involving stem cells. However, further studies are needed.
Short-Term Health Risks That May be Experienced
Gastrointestinal Issues
The most commonly reported side effects of GLP-1 agonists are gastrointestinal in nature. Users often experience nausea, vomiting, diarrhea or constipation, especially during the initial stages of treatment or when increasing the dosage. These symptoms are usually temporary but can be bothersome and problematic.
Injection Site Reactions
Some individuals may notice redness, swelling or itching at the injection site. These reactions are typically mild and resolve on their own.
Hypoglycemia
When combined with other diabetes medications, GLP-1 agonists can increase the risk of low blood sugar (hypoglycemia). This can be associated with light headedness, fatigue, weakness and even passing out. It’s crucial to monitor blood sugar levels regularly and adjust medications as needed under medical supervision.
Long-Term Health Risks to Consider
Pancreatitis
There have been concerns about an increased risk of pancreatitis (inflammation of the pancreas) with GLP-1 agonist usage. While some studies have reported cases, a direct causal relationship hasn’t been definitively established. Nonetheless, individuals with a history of pancreatitis should use these medications cautiously.
Thyroid Cancer
Animal studies have shown an increased risk of thyroid tumors with the usage of GLP-1 agonists. However, human studies haven’t confirmed this risk. As a precaution, these medications are not recommended for individuals with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2.
Kidney Issues
Some research indicates a potential link between GLP-1 agonists and kidney problems, including acute kidney injury. Patients with existing kidney conditions should discuss the risks and benefits with their healthcare provider.
Eye Problems
Recent reports have highlighted cases of vision-related issues, including blindness, in individuals using GLP-1 agonists. While these instances are rare, they underscore the need for prompt medical attention if sudden vision changes occur.
Mental Health Concerns
There have been reports suggesting a possible association between GLP-1 usage and mental health issues including depression and suicidal thoughts. However, more research is needed to establish a clear connection. Patients are advised to monitor their mental health and consult healthcare providers if they experience mood changes.
Reduced Libido
Some users of GLP-1 agonists have reported a decrease in libido/sexual desire. There may be several causes of this including direct impact on the brain. While research on this specific side effect is limited, individuals experiencing a diminished sex drive should discuss their concerns with a healthcare provider to explore potential solutions or alternative treatments.
Development of Bezoars in the Bowel
GLP-1 agents slow the emptying of the stomach which can lead to the formation of bezoars – hardened masses of undigested material in the stomach or intestines. These can cause abdominal discomfort, nausea, vomiting and even bowel obstruction in severe cases. Patients experiencing persistent gastrointestinal symptoms should seek medical evaluation to rule out the presence of bezoars.
Premature Aging and Tissue Effects
Anecdotal evidence and emerging studies suggest that individuals who experience rapid weight loss with Ozempic may notice signs of premature aging. Fat loss in the face can lead to a gaunt appearance, increased skin laxity and deeper wrinkles. Additionally, some researchers are investigating whether GLP-1 medications may influence collagen production or tissue regeneration, which could have long-term implications for skin and muscle health. Maintaining hydration, incorporating strength training, and seeking guidance from dermatologists may help reduce these effects.
Research Studies on GLP-1 Agonist Risks
The short and long term issues and concerns regarding the GLP-1 agonists are not just anecdotal. They are real and there is science behind them. Several studies have already been published that actually investigate these issues scientifically and note their existence and the correlations. Many more studies are presently being conducted and likely there will be others initiated in the future.
Should You Take Ozempic?
Ozempic, Mounjaro and other GLP-1 receptor agonists can be amazing tools for weight loss but they clearly are not without risks. Before starting one of them or even continuing your treatment, you may want to thoroughly discuss with your doctor the potential risks and benefits and determine whether it’s the right fit for you.
You want to make sure that your weight loss journey is sustainable and safe.
Your Consultation
If you have been successful in your weight loss and are now faced with the consequences of lax, drooping skin and a less than desirable appearance, you may now want to reward yourself with cosmetic plastic surgery.
Maybe you are considering a tummy tuck, a breast augmentation, a breast lift or something else. Regardless, if you want to have a personal complimentary consultation with me and explore your options, you can contact the Arizona Center for Aesthetic Plastic Surgery either by calling us at (480) 451-3000 or by sending an email.
Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona