Jeron Smart started taking weight loss injections a year and a half ago because of severe ankle pain.
Mr. Smart, who weighed 285 pounds, worked as a caterer in Savannah, Georgia. After standing on his feet for long periods of time, his ankles would sometimes “swell up like a soccer ball,” he said. She was walking with a limp. An orthopedic surgeon diagnosed her with Achilles tendonitis and recommended she lose weight to alleviate symptoms. Smart started taking the brand name GLP-1 Ozempic.
As a result of appetite suppression, I lost weight quickly at first.
“At first I lost 30 pounds without changing anything,” said Smart, 48. But then I realized that I couldn’t lose any more weight.
GLP-1 quickly became one of the most popular types of weight loss drugs in America. According to a survey by health information nonprofit KFF, which includes KFF Health News, nearly one in five people have taken it at least once. But doctors say it takes more than regular injections for patients to reach their long-term weight goals.
Here’s what you need to know:
Old rules about weight loss and health still apply
Regular exercise, making smart food choices, getting enough sleep — these basic, healthy lifestyle choices can help you not only lose weight with weight loss pills, but also keep it off, says Dafina Allen, a bariatric physician with a clinic in Saginaw, Michigan. For example, some people may feel like they eat less after taking GLP-1, but “your health isn’t improving because you’re not exercising, and the quality of the food you’re eating isn’t improving,” Allen says. Your path to weight loss also depends on your hormones, metabolism, and genetics.
After her weight loss plateaued during Ozempic, Smart realized she needed to start moving. “I go to the gym six days a week now,” she said. “My weight went from 285 pounds to 175 pounds.” The swelling and pain in my ankles also went away.
Mental health is also important
The mind and body are deeply connected. Food and body image can be particularly emotional, Allen says. “I’ll tell you about patients I’ve helped lose 50 pounds, patients I’ve helped lose 100 pounds, and they still don’t look in the mirror and are satisfied.”
Gerald Onuoha, who practices internal medicine in Nashville, Tennessee, says it’s important to seek mental health help along the way. “I think it helps a lot to make sure you talk to people about your problems, whether it’s family members or qualified professionals,” he says.
Work with your doctor to monitor your dose carefully
Onuoha said if you increase the dose of GLP-1 too quickly or don’t follow the recommended schedule, you could run into serious problems. He has seen patients come to the hospital with pancreatitis, gallstones or acute kidney injury. “I always ask patients who are on GLP-1: How long have you been on it?” he said. “Are they following the instructions? Because those are the things that determine whether complications occur.”
Part of the problem, Allen said, is that GLP-1 is relatively easy to obtain through online pharmacies and websites and is often much cheaper, but those providers may not educate patients about dosages or side effects. “So they might go online and find some random company that will send the medication to their home, where they don’t even know the dosage of the medication they’re taking or whether it’s safe for patients with the medical condition they have,” she says.
people and policy
GLP-1 drugs can be expensive, and most insurance programs, public or private, do not cover drugs for weight loss. Medicaid, a government program that covers 69 million Americans, covers GLP-1 for medically recognized conditions such as diabetes, but only about a dozen state Medicaid programs cover GLP-1 for obesity treatment, according to KFF. The federal government will allow older Americans on Medicare temporary coverage of GLP-1 for weight loss starting in July.
Nashville Public Radio’s Katherine Rappelt contributed to this report.
HealthQ is a health series from reporters Carla Anthony and Blake Farmer that provides an approachable guide to the inaccessible health care system. This is a collaboration between Nashville Public Radio and KFF Health News.
