New diabetes and weight loss medications bring both benefits and risks.
You’ve likely seen ads for “miracle” weight loss solutions online or on TV. But a new class of medications is offering real hope for individuals struggling with weight management or Type 2 diabetes: Ozempic®, Wegovy®, Zepbound™, and Mounjaro®.
What are the benefits and risks? And how can you determine if one of these medications might be right for you? Here’s what you need to know, according to Karen Earle, M.D., an endocrinologist with Sutter Health.
How These Weight Loss Medications Work
These medications generally operate similarly, whether you have Type 2 diabetes or are overweight.
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Ozempic and Wegovy are brand names for semaglutide, a peptide that mimics a natural hormone (GLP-1) that signals to your brain that you’re full. Semaglutide also slows digestion, meaning food stays in your stomach longer. Ozempic is prescribed for diabetes, and Wegovy is prescribed for weight loss. Both are injected once a week. Studies show that people can lose about 15% of their weight, although much of it can return if the medication is stopped.
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Mounjaro and Zepbound are brand names for tirzepatide, a peptide that mimics two hormones (GLP-1 and GIP). These drugs tend to result in more significant weight loss—about 20%. Mounjaro is marketed for diabetes, and Zepbound is marketed for weight loss. Like the semaglutide medications, they are injected weekly.
Some pharmacies may offer compounded versions of semaglutide, but the FDA warns that these are unapproved and may not be safe or effective.
Finally Feeling Full
“A lot of my patients tell me they feel ‘full’ for the first time in years,” Dr. Earle shares. “Before, they never felt satiety and would keep eating. These drugs help them experience fullness, which changes their relationship with food.”
Dr. Earle only prescribes these medications to those who meet clinical criteria—patients with diabetes or those who are overweight (BMI 27+) with related health issues such as high blood pressure or cholesterol.
She notes that her office receives many inappropriate requests for these medications from people who only want to lose a small amount of weight. She is concerned that the high demand for weight loss treatments could lead to national shortages.
Benefits vs. Risks
These medications are typically taken long-term or even for life. Dr. Earle explains that most people regain weight when they stop using the drugs, with some regaining all the weight and others regaining about half of it.
However, she also notes that patients who have made changes to their diet and lifestyle often retain some of the weight loss. “The medications can provide the motivation needed to adopt healthier habits,” she says, “and those patients are the most likely to maintain some weight loss.”
Common side effects when starting these medications include nausea, bloating, diarrhea, and constipation. In some cases, patients may experience vomiting, requiring them to discontinue the medication. Generally, side effects subside within a week of starting or adjusting the dosage.
(Note: The FDA warns that in rare cases, Zepbound and Mounjaro have caused thyroid tumors in rats, but it’s not known if this risk applies to humans.)
Cost and Access
Access and cost remain significant concerns. “These medications are expensive, and not everyone can afford them,” Dr. Earle says. The cost can range from $1,000 to $1,500 per month. Health insurance typically covers the cost for patients with Type 2 diabetes, but often doesn’t cover those who are simply overweight—despite meeting criteria like a BMI over 27 with high blood pressure or cholesterol.
“The number of people who could benefit from these medications is large,” Dr. Earle notes. “They’re effective, but their current prices could place a significant strain on healthcare resources.”
She hopes that ongoing research will lead to more affordable alternatives and a broader range of available medications.