The landscape of weight management is undergoing a transformation with the emergence of injectable medications like Ozempic and Zepbound. While these treatments are gaining popularity, it’s essential to understand their role in a broader, long-term approach to weight loss.
Christine Fennema, 42, from Burke, Virginia, has struggled with her weight since childhood. Over the years, she has tried various diets, including Weight Watchers, Jenny Craig, and calorie tracking with the MyFitnessPal app, without lasting success. Despite knowing the necessary steps to lose weight—like reducing carbs and sugar—she found herself battling persistent hunger and cravings. “The problem is that I’m still really freaking hungry. My brain is always going, ‘What am I going to eat?’” she shares.
In October 2024, after consulting her doctor, Fennema began using Zepbound, one of several injectable medications for weight loss. Within eight weeks, she lost 20 pounds. “I call it my miracle drug,” Fennema says. “The cravings have just been completely turned off in my brain. That’s wild. That’s awesome.”
While patients like Fennema report significant success, health professionals caution that these medications are part of a broader treatment plan, not a quick fix. Dr. Pamela Brandt, Director of Obesity Medicine at Inova, emphasizes that obesity is a complex condition requiring sustained lifestyle changes alongside medication. “There is no quick fix,” Brandt explains. “Obesity is a complicated disease that requires comprehensive tools to help manage it.”
The most well-known weight loss injectable is Ozempic, which was originally approved by the FDA in 2017 for Type 2 diabetes management. Though not approved for weight loss, doctors often prescribe it off-label for this purpose. In 2021, the FDA approved Wegovy, a similar drug designed specifically for weight management. Both medications contain semaglutide, a GLP-1 agonist that regulates appetite, blood sugar, and digestion. The key difference is that Wegovy is available in higher doses tailored for weight management.
Zepbound, another emerging option, contains tirzepatide, which activates both GLP-1 and GIP receptors to regulate body weight. Developed by Eli Lilly, Zepbound was FDA-approved in 2023 for weight loss. However, despite the availability of these medications, access remains a significant challenge. Many individuals face high out-of-pocket costs—ranging from $900 to $1,300 a month—though recent improvements in drug supply have alleviated some of these issues. In November 2024, President Joe Biden proposed legislation requiring Medicare and Medicaid to cover weight loss medications, potentially providing access to 7.4 million people.
Data from the Gallup National Health and Well-Being Index suggests that about 6% of U.S. adults—roughly 15.5 million people—have used weight loss medication. A study published in JAMA in November 2024 estimates that up to 136 million Americans could benefit from Ozempic. According to the CDC, 74% of adults in the U.S. are overweight or obese, underscoring the widespread need for these medications.
However, eligibility for these drugs is restricted. For example, Wegovy and Ozempic are recommended for individuals with a body mass index (BMI) of 30 or higher, or for those with a BMI of 27 and at least one weight-related health condition. Dr. Pamela Alexander, an internal medicine physician at Kaiser Permanente, stresses the need for individualized care: “Prescribing weight loss medication must be tailored to each patient’s unique circumstances. It’s not as simple as just starting a medication.”
These medications should be viewed as part of a comprehensive approach to weight loss, which also includes dietary modifications and regular physical activity. Many healthcare providers, including those at Kaiser, work closely with patients to address triggers for overeating, recommend nutritional changes, and support exercise regimens. Dr. Alexander points out that muscle and bone mass, not just fat, are also affected by weight loss, making exercise an essential component of any weight management plan.
While these medications offer promise, they are not without potential side effects. Nausea, constipation, bloating, headaches, and dizziness are common, and people with certain medical conditions, such as a history of pancreatitis or thyroid cancer, may face increased risks. Long-term effects remain a concern, as these drugs are still relatively new. However, many physicians argue that the risks of untreated obesity—such as diabetes, high blood pressure, and heart disease—outweigh the potential downsides.
Not only are these drugs showing promise in weight loss, but they are also having a positive impact on other health conditions. For example, Wegovy has been approved to reduce the risk of heart attacks and strokes in obese individuals. A study published in The New England Journal of Medicine in November 2024 also found that tirzepatide can prevent, rather than just treat, Type 2 diabetes.
Despite their effectiveness, Brandt believes that the benefits of these medications must be weighed against the potential risks. “Obesity is directly linked to approximately 40% of cancers in the U.S.,” she says. “By treating obesity, we could reduce the risk of cancers such as colon, breast, and pancreatic cancer, which are often difficult to treat.”
For those who are unable or unwilling to take injectable medications, there are other options available. Alternative weight loss medications, such as Qsymia, Saxenda, and Orlistat, as well as bariatric surgery, offer different approaches. Intragastric balloons, a nonsurgical treatment, are also an option for some patients.
Ultimately, the success of injectable weight loss medications depends on the individual’s commitment to a healthier lifestyle. Dr. Thorn of VHC Health stresses that these drugs are not a substitute for healthy eating and regular exercise. “The medication can help, but it’s up to the patient to make the necessary changes in their behavior,” he says. “If you’re doing everything else right, you may reach a point where you no longer need the medication.”
For residents like Rebecca Geller, who has been using Mounjaro since 2022, the combination of medication, healthier eating, and regular exercise has led to a significant weight loss of 70 pounds. She remains uncertain about when or if she will stop using the drug. “For many people who have struggled with weight their entire lives, this is a game changer,” Geller says. “It’s not something to be ashamed of. Obesity is a chronic disease, just like high blood pressure or diabetes, and these medications are a success of modern medicine that should be celebrated.”
Related Topics:
