Do weight loss injections work?

How do weight loss injections work?

Weight loss injections work by making you feel fuller and less hungry. There are plenty of weight loss medication options to choose from. The most popular ones are glucagon-like peptide 1 (GLP-1) agonists, which are used to help control blood sugar and weight. Those specifically approved for weight loss are:

• Semaglutide (brand name Wegovy)
• Tirzepatide (brand name Zepbound)
• Liraglutide (brand name Saxenda)

Liraglutide isn’t used as often anymore, according to Yusupov. It requires daily injections and is less effective than the newer GLP-1 medications. Studies show you can lose about 8% of your body weight while taking Saxenda.

On the other hand, Wegovy and Zepbound are only taken once a week and are commonly used for weight loss. Ozempic is the brand name for semaglutide and is approved for diabetes. Mounjaro is the brand name of tirzepatide, which is also approved for diabetes. You wouldn’t take these brand names if you were only looking to lose weight.

Zepbound acts on two gut hormones, GLP-1 and glucose-dependent insulinotropic polypeptide (GIP), and can result in even greater weight loss than Ozempic or Wegovy. You can lose up to 21% of your body weight on the maximum doses of Zepbound and about 15% of your body weight on Wegovy.

Are weight loss injections safe?

Weight loss injections are generally safe under the supervision of a health care provider who’s experienced in these medications. You also want to get all medications from a reputable pharmacy.

» MORE: How to get weight loss injections

Side effects

Gastrointestinal side effects such as nausea, vomiting and diarrhea are most common. To help ease those side effects, you can increase the dose you’re taking slowly. Other ways to help with these side effects, according to Yusupov, include:

• Eating smaller portions
• Avoiding fried or fatty food
• Drinking plenty of water
• Not eating three to four hours before bed

Ashley, a 39-year-old from Dallas, Texas, had minimal side effects after starting compounded semaglutide last year. Healthy eating and working out didn’t seem to be helping her weight gain. “My dosage is very small and (my primary care provider) doesn't have me increasing every month like normal dosages do,” she said. “For the first few months I would occasionally get nauseous and throw up, but that hasn't happened in a while.”

Rarely, Yusupov says you can have more serious side effects, including:

• Pancreatitis, or when the pancreas becomes inflamed
• Problems with your kidneys, usually from severe dehydration
• Gallstones
• Vision changes
• Mood changes

“Another possible health risk that’s not often discussed is muscle loss as a result of significant weight loss,” said Yusupov. “Strength training, like using resistance bands or free hand weights, can prevent excessive muscle loss and frailty.”

Julie, a 46-year-old from Maple Grove, Minnesota, took compounded semaglutide for seven months. She had a plan in place with her health care provider to taper the dose once she reached a certain weight. “I saw her every two months and we did a body scan and looked at weight and muscle mass. I went to the gym daily and gained muscle during the process,” she said.

Who should avoid weight loss injections?

These weight loss medications aren’t for everyone. Yusupov says people with certain medical conditions and situations shouldn’t take weight loss injections such as:

• Having a personal or family history of medullary thyroid cancer
• Multiple endocrine neoplasia syndrome Type 2 (MEN 2)
• Being pregnant, breastfeeding or planning a pregnancy

How much do weight loss injections cost?

Weight loss injections can be expensive, especially if your insurance company doesn’t cover them. Without insurance, Wegovy currently costs $1,349 for a month's supply, and Zepbound costs about $1,086 a month.

Medicare doesn’t currently cover any weight loss medications, including injections. Commercial insurances may or may not cover the cost of weight loss injections. Most of the time, they will only pay for these medications if you have another health condition related to weight gain, such as diabetes or sleep apnea.

Steve, a 52-year-old from Apple Valley, Minnesota, has been taking Ozempic for about four months to add to his Type 2 diabetes treatment with the benefit of weight loss. Because of his diagnosis, Steve is able to get Ozempic through insurance for $25 a month. “With additional treatments related to diabetes, the skyrocketing insurance rates as well as prescription costs steadily increasing, all medical costs are becoming a barrier. But the new rate of $25 per month helps significantly,” he said.

Because of a shortage of GLP-1 medications in 2022, there was a rise in compounded medications. But the shortage has been resolved, and the FDA has declared grace periods for compounding pharmacies to stop making them. Compounded GLP-1s aren’t FDA-approved, but they filled the gap for those who needed them during the shortage. It costs about $250 to $300 for a month’s supply, depending on the compounding pharmacy.

Ashley uses a compounding pharmacy through her primary care provider. “Going through all of these websites that promise you'll qualify for the GLP-1 medication prices was insane and had my PCP not agreed to start it, I wouldn't have been able to,” she said. Right now, with her lower dose, she pays about $200 for a 2-mL vial that lasts her about five months.

Compared to weight loss injections, oral pills can be more cost-effective. For instance, Qsymia, a combination medication of phentermine/topiramate, is about $134 for a month’s supply out of pocket.

Are weight loss injections worth it?

GLP-1 medications are effective for weight loss. They can help you lose more weight in a shorter timeframe than with lifestyle changes alone. But while this is an appealing benefit, you also have to think about the risks — including bothersome side effects — and the price tag. Plus, some people may not be enthusiastic about injecting themselves once a week.

You and your provider will review your medical history to find out if weight loss injections are right for you, and if you are a good candidate. In general, weight loss medications are appropriate if you have a body mass index (BMI) over 30 or a BMI of 27 or more with a weight-related health condition.

Ashley has been on semaglutide for six months now and feels like after she loses another 10 pounds, her goal will be met. “The weight loss has slowed down so I will discuss that with my PCP. I am very happy with the results — It's definitely working. The food noise in my head is gone and the hunger feeling has decreased. It's slowly coming off which I prefer to a drastic quick change as there's more of a chance it won't stay off,” she said.

Julie ended up getting pregnant two months after stopping her GLP-1 medications. She’s lost almost all of the weight she had gained during pregnancy. “I was definitely more hungry, though!” she said.

Food and mental health struggles are still present for Steve, but taking Ozempic has helped. “It’s given me guard rails for my eating, and changed my behavior and cravings enough to give me more successful days of healthy eating and weight management than in the past,” he said.

Long-term use of weight loss medications

You also want to think about how long you’ll be on these medications, according to Yusupov. The lack of insurance can be a barrier for people, especially if they want or need to take it long-term. And stopping these medications without a plan in place with your health care provider can lead to weight regain.

Recent research has shown you could gain back an average of 21 pounds within a year of stopping GLP-1 medications.

“People can stay on the medication indefinitely, similarly to medications for high blood pressure or other chronic diseases, as long as they are doing well, maintaining the weight and not experiencing side effects,” explained Yusupov. She recommends to her patients that they stay on GLP-1 medications for a year before trying a lower dose that might be as effective.

Twice in the past, Steve has been able to lose weight and get his blood sugar under control. “Both times I have chosen to go off the GLP-1 and gained weight back, and my diabetes became uncontrolled,” he said. He understands he’ll likely have to remain on GLP-1 medications as long as he can afford it. “The cost is definitely worth it for me to have my diabetes controlled. It’s definitely not a cure-all as many are stating. With the help of GLP-1’s I went from approximately 298 lbs down to 240 lbs,” he said.