GLP-1 and Weight Management: Is It Safe, Effective, and Right for You?

BY DR. RETHABILE MOLEFE
Jul 1
3 min read

Give or take a year ago, had you mentioned Ozempic in conversation you would have been met with many confused faces. Now fast forward a year later, it has taken the beauty and weight loss industries by storm.

What are GLP-1’s?

Ozempic is classed in a group of drugs called GLP -1 agonists (Glucagon like peptide) medications. Other names that you may have heard of include Wegovy, Mounjaro and Suxenda just to name a few.

This class of drugs mimics the natural GLP-1 hormone that is naturally found in our bodies which helps regulate blood sugar and appetite. They work by increasing insulin release, slowing stomach emptying leading to feeling fuller for longer, reduced appetite and potential weight loss. Most of these drugs, however, are approved for the treatment of diabetes and are being used off label for weight loss as it is a side effect of them.

GLP-1 medications have taken the internet and the world by storm with many celebrities like Oprah, Whoopy Goldberg and Elon Musk admitting to using them to aid their weight loss. Many content creators on social media platforms have sung the praises of these drugs leading to widespread use and more demand.

Who should be taking GLP-1 medications?

Even though many advocate for its use and efficacy, there have been a few ethical considerations around these medications that have been raised. There was a worldwide shortage of Ozempic specifically in America, promoting the questioning of popular off label use of these drugs because of the weight loss effects while thousands of diabetics could not access this medication to control their illness, in some cases, leading to complications.

As of today, the United States Food and Drug Administration (FDA) has approved a few of these GLP-1s for weight loss namely Wegovy, Saxenda and Zepbound. All the others are being used off label. To be prescribed a GLP1 by a physician you need to at least meet criteria- a BMI of more than 30 which puts one in the “obese” category and at least one complication of obesity such as insulin resistance. However, many are taking these drugs without meeting criteria, and are even sourcing these medications on the black market which perhaps prompts a larger conversation about beauty standards and the relentless pursuit of thinness in our society.

What are the side effects of GLP-1?

The results are real, but so are the risks: Studies show that the average weight loss from GLP1 medications is 10-15% of your starting weight in a year. These results, however, are not without side effects. The most reported side effects are nausea, vomiting and episodes of diarrhoea which are manageable, however on the other side of the scale are rare but serious side effects such as loss of bone density, pancreatitis, intestinal failure and a risk of thyroid cancer. Another common phenomenon known as “Ozempic face” is caused by the rapid loss of muscle mass, leading to a “hollowed out” appearance of the face and body.

And of course, not to be ignored are the psychological effects; a focus on one’s body image can lead to increased risk of anxiety and depression.

Is there still room for natural weight loss?

Absolutely. In fact, even on these medications one needs to maintain a healthy lifestyle of a balanced diet and regular exercise. While it can take historically longer, it is more sustainable as even weight lost through medical assistance can be regained if not paired with lifestyle change. Also to note, GLP-1 medications do not come cheap. In South Africa depending on the drug, they can set you back R1 500 to R5 000 every month. So, if you still have weight loss goals, do not be discouraged, put in the work and you will see results.

So, where do we go from here?

GLP-1 medications have undoubtedly reshaped the wellness landscape as a saving grace for those who have struggled with weight loss due to metabolic conditions, but it opens a conversation on the ethics of weight loss. There are no short cuts to sustainable weight loss.

These medications can be effective tools, but they are not magic wands. Weight loss is a deeply personal journey and chasing cookie cutter or viral wellness trends may lead to further distress. So, before hopping onto any bandwagon, ask yourself if it is aligned with your needs, in all spheres - always do what’s best for you and your health.