Waiting on Medications to Lose Weight

Glucagon-like peptide-1 (GLP-1) medications have shown incredible promise for treating multiple conditions, but they have also caused a fair amount of frustration for people trying to take them.

If GLP-1 doesn’t sound familiar, the name brands for these medications may be more recognizable – Ozempic and Wegovy or Mounjaro and Zepbound, among several others.

GLP-1 medications were first used to treat type 2 diabetes, then prediabetes and now obesity. Additionally, new study results have led to GLP-1s being approved for those with cardiovascular diseases. The SELECT trial – released in November 2023 – studied people with obesity, but not diabetes, who also had a history of stroke, heart attack or PAD. The study found there was a 20% decrease in major cardiovascular events such as cardiovascular death, heart attacks and strokes when these people took a GLP-1.

With GLP-1s showing promise for treating multiple conditions, they are being prescribed more frequently. Unfortunately, supplies of the medications are not keeping up with demand.

“We have over 1,000 patients waiting on backorder medications right now,” says Rick Couldry, vice president of pharmacy and health professions at the health system. “The FDA is approving more indications for these drugs. So that expands to more people that can get the medications, and then all of that also increases demand.”

 

While pharmaceutical companies are increasing production, regulations prevent simply opening new factories. So they are still struggling to catch up.

It is understandably frustrating to not be able to get a medication that shows great promise – or to be unable to continue taking a medication you have started. In some cases, you may be able to take a different GLP-1 that is more easily accessible.

Cliff Erwin, a patient at the health system, described how he began taking Mounjaro but had to switch to Wegovy because of insurance coverage. After Wegovy got too expensive, he transitioned to taking Zepbound. Because these medications work on the same hormone, you may be able to change your prescription to one that has more accessible stock.

The experts at the health system also strongly recommend focusing your efforts on lifestyle changes while you wait to get medication. For example, starting to create an exercise habit and shifting your mindset around exercise is beneficial in general as well as when you’re on a GLP-1.

“Exercise is important. Even if someone doesn't lose a pound at all, it improves their health,” says internal medicine physician JoHanna Peterson, MD. “Changing that mindset to exercise not being tied to the number on the scale is important.”

Maintaining your activity – both cardiovascular exercise and strength – is important to prevent excessive loss of skeletal muscle mass when you’re losing weight.

“There isn't just 1 tool to treat obesity,” says John Thyfault, PhD., leader of KC-MORE. “(GLP-1s) alter liver metabolism, which affects nerve neuronal signaling to the brain and satiety. Exercise will actually help maintain that appropriate signal from the liver to the brain.”

Meeting with a registered dietician is also a good idea. Learn how to identify high-quality foods and understand the importance of protein.

Steve Herrmann, PhD, director of the University of Kansas weight management program, suggests building your team while you’re waiting to start medication.

“Physicians and nurses and registered dietitians or health educators and personal trainers, people that they can surround themselves with to really leverage the best of those medications and to build healthy habits,” Herrmann says.

All the health system experts strongly caution against getting compounded versions of GLP-1s. The FDA allows pharmacies to make compound versions of drugs during shortages, but these formulations are not regulated.

“I think even saying that it (compounded GLP-1) is a generic version of the same product is incorrect,” says Couldry. “I don't know that you can guarantee what those products are – how they're going to work. I think that the risks and not knowing what you're using, and not having that assurance is dangerous.”