Ozempic, Wegovy, Mounjaro. You’ve probably heard these words in the news a lot lately. They are the names of what many consider a “wonder drug” for weight loss.
Developed to treat diabetes and obesity, these drugs have also become a not-so-secret remedy for everyone from celebrities to your next-door neighbor to trim excess weight.
Obesity medicine doctor Jean Domercant, MD, with Metamor, a bariatric and metabolic partnership between Our Lady of the Lake Physician Group and Pennington Biomedical Research Center, spoke with Brian Haldane of TALK 107.3 FM for a recent Medical Mondays segment.
Dr. Domercant has for many years treated patients struggling with obesity through catered diet and exercise plans, surgical weight loss procedures and prescribed appetite suppressants like Phentermine (known on the market as Atti-Plex P) to help patients curb their appetites.
Ozempic and similar drugs, generically known as semaglutide or tirzepatide, work differently. Where an appetite suppressant stimulates your brain to feel full, these drugs work deeper in your body as a hormone, activating other organs like the pancreas, liver and stomach in ways that cause you to feel full for longer and “train” your body to adjust the way it absorbs food.
“These medications are different because for the first time we have a type of medication that can achieve close to what we normally could only achieve with surgery,” Dr. Domercant says.
Because the drugs are relatively new and doctors are still learning how they work, medical experts are encouraging its use only for people with obesity — people who are suffering from chronic conditions that diet and exercise can’t correct on their own.
“This medication is not made for someone who is trying to lose 5 or 7 pounds before the summer, they are meant to treat for the disease of obesity, a BMI of 30, or a BMI of 27 with certain risk factors like high blood pressure, diabetes,” Dr. Domercant says.
Dr. Domercant shares more of what you should know about these drugs.
Working on Your Brain and Your Gut
While an appetite suppressant works to trick your brain into thinking it’s full, these drugs also help you burn fat and change how your body responds to food.
“We don’t quite understand how it makes you go through the process of burning fat in addition to suppressing your appetite,” Dr. Domercant says. “When it goes to your brain, you feel full very quickly, but in other areas of the body, we suspect it’s having other effects that are making you burn fat. We don’t quite understand how it’s working — all we know is that it’s working and it’s working well.”
Positive Outcomes for Weight Regain
Dr. Domercant says early trials with this type of medication have shown that when patients stopped taking it but continued with regular exercise and a healthy diet, average weight regain was about 30%, which is much less than the results seen when the use of appetite suppressants is discontinued.
Long-term Use
The general wisdom, Dr. Domercant notes, is that these medications are safe to be taken long term. When prescribed for diabetes, patients can stay on it as long as it takes to get the condition under control.
And because every patient’s experience is different, Dr. Domercant stresses that usage of the drug needs to be supervised by your primary care provider.
Minimal Side Effects
Side effects related to these medications can include nausea, vomiting, constipation and sometimes diarrhea. These conditions are usually mild and tend to go away after a few weeks of using the medication.
Your primary care provider can also suggest certain types of foods that can help ease these side effects.
“That’s why you need a provider to help you through it, because not only can they help you manage the symptoms in the beginning, they can also coach the patient in what to expect and what should be OK and not OK,” Dr. Domercant says.
In rare cases, some patients have dealt with more severe symptoms such as dehydration and depression. Because the medications are still new, there isn’t enough research yet to explain these side effects.
There is also a very low risk of thyroid cancer, and Dr. Domercant suggests people with a family history or personal history with thyroid cancer should not take these medications.
Diet and Exercise are Still Necessary
Dr. Domercant stresses that these medications are not miracle drugs. They should be used in combination with a healthy diet and regular exercise to be the most effective and result in long-lasting positive outcomes.
“Exercise and diet will always have a role and is the first step toward good health regardless of if you’re losing weight or not,” he says. “This is not a situation where diet and exercise won’t matter anymore.”
Taken with a Doctor’s Supervision
Because of their popularity, these medications have become easier to obtain online through virtual clinics.
Dr. Domercant says it’s important that they be taken in consultation with your primary care provider so they can monitor your progress, address any issues or side effects that come up, and suggest changes to your dosage based on your individual needs.
