Weight-loss medications, particularly GLP-1s, have gained immense popularity due to their ability to help individuals shed pounds and control hunger. However, the benefits of these medications are accompanied by a range of potential side effects, some beneficial and others less desirable. Medications like Ozempic, Wegovy (semaglutide), Saxenda, and Mounjaro (tirzepatide) are commonly used for weight loss, although not all are officially approved for this purpose. Below, we examine both the positive and negative aspects of these drugs.
Negative Side Effects: What to Watch Out For
Muscle Loss
A significant concern for those using GLP-1 medications is the potential for muscle loss. Research shows that as users lose weight—sometimes up to 15 to 25 percent of their body mass—a substantial portion of that weight may be lean muscle. For example, a study on liraglutide (Saxenda) found that individuals who engaged in strength training four times per week were able to maintain their muscle mass better than those who relied solely on medication or exercise. Experts recommend ensuring that your diet is rich in protein to help preserve muscle tissue.
Erectile Dysfunction (ED) and Low Testosterone
Men using semaglutide (Wegovy) have reported a higher incidence of erectile dysfunction and lower testosterone levels compared to those not taking the medication. This is believed to be due to the drug’s potential impact on the body’s signaling mechanisms involved in testosterone production. However, the risk appears to be relatively small, and more research is needed to fully understand the connection.
Nausea
One of the most common side effects of GLP-1s is nausea, which is caused by the drugs interacting with a chemoreceptor zone in the brain. This area is responsible for triggering the sensation of nausea when the body detects something unpleasant. To manage this, doctors often recommend adjusting meal timing, though the severity of nausea can vary from person to person.
Gallstones
The rapid weight loss induced by GLP-1 medications can disrupt the balance of bile in the digestive system, increasing the risk of gallstones. This is due to both the medications’ effects on bile flow and the changes in bile composition caused by quick weight reduction. Symptoms of gallstones include sharp, severe pain in the upper right abdomen, typically occurring after meals. If these symptoms arise, immediate medical attention is required.
Skin Laxity
“Ozempic face,” a term referring to the sagging of skin due to rapid weight loss, is another concern for users. As the skin is stretched by significant weight gain and then loses elasticity during weight reduction, it can lead to visible sagging, particularly in the face. While not exclusive to GLP-1 use, those experiencing this side effect can consult a dermatologist or plastic surgeon for potential treatments such as topical products, injectables, or even surgical options.
Positive Side Effects: The Health Benefits
Cardiovascular Health
On the positive side, GLP-1 medications have been linked to significant improvements in cardiovascular health. Studies have shown that these drugs can reduce the risk of heart attacks, strokes, and death from cardiovascular diseases by addressing multiple risk factors simultaneously, including high blood pressure, elevated cholesterol, blood sugar levels, and inflammation.
Alzheimer’s Disease Risk Reduction
Interestingly, semaglutide has been associated with a lower risk of Alzheimer’s disease in individuals with type 2 diabetes. Research shows that patients who took semaglutide were 70 percent less likely to develop Alzheimer’s compared to those who only took insulin. Other GLP-1 drugs also showed promise in this area, though to a lesser extent.
Reduced Cravings and Addiction Control
GLP-1 medications can also help reduce cravings, not just for food but for other addictive behaviors, including smoking, alcohol consumption, and opioid use. This is due to the overlapping brain circuits that govern appetite and addiction, which these drugs appear to influence, offering a dual benefit for those struggling with overeating or substance abuse.
Liver Health
For individuals with excess weight-related liver issues, such as Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), GLP-1 medications can be a game-changer. A weight loss of 10 percent or more has been shown to significantly reduce liver fat, and these medications are proving to be more effective than other diabetes treatments at addressing liver fat accumulation.
Improved Blood Sugar Control
Originally developed for diabetes management, GLP-1 medications excel in lowering blood sugar levels and reducing A1C, a key marker of long-term glucose control. In doing so, they also reduce the risk of diabetes-related complications, such as kidney failure and nerve damage, which can lead to amputations.
Conclusion
GLP-1 medications offer a powerful solution for weight loss, but they come with both positive and negative side effects. While they can improve heart health, reduce the risk of Alzheimer’s, and help with cravings and liver health, users must be aware of potential issues such as muscle loss, gallstones, skin sagging, and the risk of erectile dysfunction. As with any medication, it’s essential to consult a healthcare provider to fully understand the risks and benefits before starting treatment.
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