Special to The Island News
If you’ve struggled to lose weight through diet and exercise alone, you may be wondering whether a GLP-1 medication could help.
The answer depends on several factors, including your current weight, overall health, medical history and long-term health goals.
“Not everyone who wants to lose weight is a candidate for weight loss medications,” explains board-certified obesity medicine specialist Dr. Yvette-Marie Pellegrino, who sees patients at Beaufort Memorial Lady’s Island Internal Medicine and leads the Beaufort Memorial Healthy Weight Program. “Eligibility depends on an individual’s medical history, health risks, treatment goals and ability to participate in ongoing medical care.”
GLP-1 receptor agonists are medications that help regulate appetite, slow stomach emptying and increase feelings of fullness. As a result, many patients consume fewer calories and achieve meaningful weight loss over time.
“These medications can be highly effective, but they are intended to treat obesity as a chronic medical disease, not to provide a quick fix for occasional weight gain,” says Dr. Pellegrino.
Who are the best candidates for GLP-1 weight loss treatments?
Adults with obesity (BMI 30 or higher): A BMI of 30 or above is generally the threshold at which prescription weight loss medications may be recommended as part of a medically supervised treatment plan.
“For many patients, excess weight contributes to chronic inflammation, joint pain, reduced mobility and increased risk of serious diseases,” says Dr. Pellegrino. “Losing even 5% to 10% of body weight can lead to substantial health improvements.”
Adults with a BMI of 27 or higher and weight-related health concerns: Patients who are overweight but not obesity may still qualify if they have weight-related health concerns, including:
- Type 2 diabetes
- Prediabetes
- High blood pressure
- High cholesterol
- Sleep apnea
- Heart disease
- Fatty liver disease
- Arthritis and chronic joint pain
People who have tried diet and exercise without lasting success: Patients who have repeatedly lost weight and regained it despite genuine effort may benefit from medical treatment that addresses the biological drivers of obesity.
Who are NOT good candidates for GLP-1 medications?
People looking for fast cosmetic weight loss: Patients hoping to lose a small amount of weight for a wedding, reunion or vacation may not meet the medical criteria for treatment.
GLP-1 medications are intended to treat chronic obesity and obesity-related issues, not help patients reach a solely aesthetic goal.
People seeking an “easy button”: While these medications can be powerful tools, they cannot replace healthy lifestyle habits. The most successful patients view medication as one component of a comprehensive treatment plan.
People who can’t commit to ongoing care: Patients taking GLP-1 medications should participate in regular visits to their healthcare provider to:
- Monitor progress
- Adjust dosages
- Manage side effects
- Ensure safe and effective treatment
Individuals with certain medical histories: Some patients may not be good candidates due to personal or family medical history.
This is why physician-supervised evaluation is essential before starting treatment. An obesity medicine specialist can determine whether GLP-1 medication is appropriate and safe.
Potential risks, side effects of GLP-1 weight loss medications
Loss of muscle mass and bone density: Research suggests that a portion of the weight lost on GLP-1 medications may come from lean body mass, including muscle tissue.
“Another possible risk is potential reduction in bone density during significant weight loss, particularly among older adults and postmenopausal women,” Dr. Pellegrino says. “I often encourage patients taking GLP-1 medications to prioritize adequate protein intake and participate in regular strength-training exercises to help preserve muscle and bone health throughout their weight loss journey.”
Digestive side effects: The most frequently reported side effects are gastrointestinal, and may include:
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Abdominal discomfort
These symptoms most often occur when treatment begins or when doses are increased and may improve over time as the body adjusts.
Increased risk of gallbladder disease and pancreatic problems: GLP-1 medications have been associated with an increased risk of gallstones and gallbladder inflammation, especially when weight loss happens quickly. Symptoms may include upper abdominal pain, nausea, vomiting or fever.
Vision complications: Vision-related concerns have emerged as an area of ongoing research; patients with diabetes or existing eye disease should discuss these risks with their healthcare provider and maintain regular eye examinations while taking these medications.
Weight regain after ending medication: Research has shown that many patients regain a substantial amount of lost weight after stopping their medication. In a follow-up study of semaglutide users, individuals regained approximately two-thirds of the weight they had lost within one year of stopping the medication.
“These findings reinforce the importance of viewing GLP-1 medications as one component of a comprehensive, long-term wight management strategy,” Dr. Pellegrino explains. “Sustainable nutrition habits, regular physical activity, behavioral changes and ongoing medical support remain critical for maintaining results over time.”
If you’re curious whether a GLP-1 medication could help you achieve your health goals, the first step is talking with an obesity medicine specialist who can evaluate your unique needs and develop a personalized plan for sustainable success.