Is It Safe to Utilize Diabetes Medications for Achieving Weight Loss?
Written by Christine Bishara MD
So you might have been watching the news, or spending some time searching the net recently, and you’ve stumbled upon something that sounds almost too good to be true. There may actually be an easier way to get the weight loss results you’ve been desperately searching for. Could it possibly be true?
Well, the latest celebrity trend in weight loss involves the use of diabetic medications such as Ozempic, Mounjaro (tirzepatide). This has been a hot topic lately, but the use of diabetic meds for weight loss is actually not a new concept.
Are These Medications Right for You?
So the question may arise, if I’m not a diabetic, but I would like to use these medications to lose weight, is this a good idea for me? My answer is, it depends….. While these medications are remarkably effective, I have a philosophy of always gauging risk vs rewards when starting my patients on any medication. For instance, do you have certain risk factors for developing a chronic illness or serious complication that outweighs an adverse effect of the medicine? Risk factors that include such things as obesity (BMI over 30), heart disease, diabetes, or a strong family history of chronic medical issues are all factors that affect overall morbidity.
What are These Medications and What Do They Do? Let’s Take a Look at Some Diabetic Medications that are used for Weight Loss
Metformin:
Metformin works by improving the body’s sensitivity to insulin–translating into a better response of cells to insulin which equals=better glucose levels. Metformin has been shown to induce weight loss when first administered but this benefit usually begins to decline after six months. The average weight loss with individuals started on metformin was approximately twelve pounds in the initial six months with not many additional weight loss benefits after this time period. A serious but uncommon complication seen in metformin is something called lactic acidosis (the buildup of lactate in the body) which can lead to serious kidney or liver failure.
Januvia:
Januvia works by increasing insulin production in the pancreas. The organ that helps to regulate your blood sugar levels. There is some initial weight loss with Januvia, but it is not significant. Some common side effects with Januvia include muscle aches, or gastrointestinal (GI) tract disturbances. Average weight loss seen was three pounds in the first six months.
Jardiance:
Jardiance, also known as empagliflozin, is a diabetes medication that works on glucose transport. It also allows more glucose to be excreted in the urine, thus improving blood glucose control. The average weight loss with Jardiance was approximately 2% body weight within the first six months.
Mounjaro, Rybelsus and Ozempic:
Then, there is a class of diabetic medications that are taking the weight loss trend by storm. They have gained a lot of traction and popularity lately in the weight loss industry.The most popular ones are two injectables, Mounjaro and Ozempic
Rybelsus is the same medication as Ozempic (semaglutide) but can be taken orally. Both Mounjaro and Ozempic subcutaneous injections are taken weekly, which you or a caregiver can be taught to administer. These medicines are expensive if you are paying out-of-pocket as no generic option is currently available in the U.S. market. Some, but not all insurance companies will cover the cost of these medications.
Mounjaro, Rybelsus and Ozempic all work by mimicking the actions of glucagon-like peptide receptors in the pancreas which in turn enhance the release of insulin. They also have the added benefit of causing a significant amount of weight loss.
The Good News:
The average weight loss for Mounjaro was approximately eighteen to twenty-five pounds and for Ozempic (also available in a slightly higher dose and marketed with the trade name Wegovy) was approximately fifteen to twenty pounds in the first six months.
The Not So Good News:
While the GLP-1 class have higher weight loss rates, they have been implicated in some serious adverse effects to be aware of. A study recently found an increased risk of thyroid cancer in those who take these medications for a duration of one to three years.
Another study also showed increased incidence of pancreatitis with this class of medications.
So the question arises, is it worth taking the GLP-1 diabetic medications?
Again, my personal opinion is…. it depends. As with all medications, it’s very important to discuss potential risks and benefits of any medication with your physician. If you’re a diabetic or significantly overweight and have long-term medical issues or at high risk of developing them, then the weight loss advantages may outweigh the risks. I am a big advocate of lifestyle factors being the most important modifications one should make to lose weight, but I also see the short term advantages (six months or less) of these medications, especially if used to encourage a patient as they start their new lifestyle changes.
Reference articles:
GLP-1 agonists: Diabetes drugs and weight loss – Mayo Clinic