Being overweight or obese in the United States has grown to critical levels over the past few decades. Throughout 1970-1980, foods with added sugars surged in popularity. The obesity rate in the United States in the 1970s was 15%. Today, in 2023, it is more than 42% of the adult population. Sugar intake increased in children back then, and our addiction has continued to spiral out of control. Recently, prescription drugs meant for diabetics have come into focus as celebrities and many doctors have promoted the benefits of using them to reach weight loss goals more quickly. However, off-label use of these drugs could spell a recipe for disaster, especially since their long-term effects are currently unknown.

There have been many medications and ingredients used for weight loss over the years, and while they may have been proven to work in the short-term, long-term effects have been observed and have even led to some of these substances being banned altogether due to their unsafe nature. Remember Fen-Phen? It was pulled off the market in 1997 due to damage that the drug was doing to users’ heart valves. Phentermine itself is still prescribed on its own to patients but can cause many side effects, including a risk of addiction and dependence, and has even had rare side effects such as heart, lung, and mental health problems. How about Metabolife? It contained ephedra, which was linked to causing heart attacks, strokes, seizures, and even sudden death. Yes, you could lose weight with these drugs and OTC products, but you could also be doing quite a bit of damage to your body and health.

Most of these medications and products either speed up the metabolism or severely decrease and suppress the appetite. Food is unappetizing, or the user becomes sick if they try to eat too much. Most weight loss drugs used in the past, and those still in use today, typically require a reduction of calories to around 500 per day, which is an extreme Very Low Calorie Diet. Being on such a diet can cause the body to regain weight very quickly once stopping the prescription. In essence, you are “breaking” your metabolism. Your body will adjust to low calories and slow down the metabolism to a point that if you end up going above and beyond that range, it will retain everything you eat and drink as fat. You’ll gain the weight back very rapidly.

Two of the newest hyped drugs have been Wegovy and Ozempic, injectable medications made of semaglutide, which lower blood sugar levels and suppress the appetite. Semaglutide is a synthetic version of the hormone GLP-1 that your body already produces to help you feel satiated, giving you that feeling of fullness. It also reduces the release of glucagon in your body, which is a hormone that controls blood glucose.

While taking these drugs, you should not eat fried or fatty foods, or choices containing much sugar. Alcohol should be limited since it already lowers blood sugar itself. These drugs do come with side effects: nausea and diarrhea are common with usage of these drugs. The sometimes-intense side effects can lead some to think they are having a digestive or heart related issue and will end up making a trip to the emergency room. There have been several instances of hospitalizations reported due to severe diarrhea and digestion problems. Often times, doctors will prescribe other medications to combat the symptoms of Wegovy and Ozempic. Other issues that can arise are stroke, kidney failure, serious allergic reactions, gallbladder problems, and issues with vision. Those with type 1 diabetes should not take these drugs. They have also been noted to cause thyroid tumors in rats, but it is unknown if they increase the risk of thyroid tumors in humans. The risk of pancreatitis increases, as well as kidney damage.

Then, there is the weight loss sustainability factor. Within a few days of quitting the injections, appetite returns with a vengeance. Everything will look and taste really good after having eaten small portions and bland tasting food (which are recommendations from the drug companies themselves for your diet while on the medication). Weight gain is quite rapid after stopping usage, and it is recommended to stay on Wegovy or Ozempic FOR LIFE to be able to keep the weight off. Within a year of stopping, most users have gained back all, if not more, of the weight they lost while on the drugs. Sometimes, as much as 20 pounds will come back within just a couple months.

With rising popularity, there has been a well-documented shortage of semaglutide. These medications were intended for diabetics and people who have severe obesity, and symptoms of high cholesterol, high blood pressure, and heart disease. The drugs would help them reduce their weight, reduce their other medications, and potentially save their lives. Now that the drugs are becoming scarcer, prices are soaring. Many insurance companies will not cover them for off-label use. Patients who desperately need semaglutide injections for their health or diabetes are having trouble filling their prescriptions. Expect to pay upwards of $400 per month for the injections, all the way up to well over $1000.

When all is said and done, proper weight loss still comes down to nutrition, exercise, and a lifestyle overhaul, even when on a medication. However, by focusing on education and how to keep the weight off for the long term, wouldn’t it be best to still enjoy the foods you like to eat in moderation, control your portion sizes, change your lifestyle, and create a healthy relationship with food? There is still no “magic pill” solution. Looking ahead to the future, we are unsure of what health issues may arise from these new drugs used for weight loss. Eating right for life seems like a recipe for health, rather than staying bland and injecting medication for life, which could lead to disaster.