Assessing The Risks vs. Benefits Of Weight Loss Drugs
- GLP-1 agonists have positively impacted many people’s lives, providing remarkable outcomes in weight loss and blood sugar control.
- Like any drug, these popular weight loss medications come with potential side effects. The most common have to deal with the stomach and digestion.
- “Most commonly reported is nausea, and patients tend to have more side effects the first time they take medication, and it tends to decline as they take that same dose again,” Dr. Holly Lofton, director of the Medical Weight Management Program at NYU Langone Health in Manhattan, tells SurvivorNet.
- Common side effects, like nausea, stomach upset, and bowel changes, tend to improve over time.
- More serious side effects, like pancreatitis (inflammation of the pancreas) or gallbladder issues, can occur — so it’s important to keep your medical team informed about any side effects you experience.
The advent of GLP-1 agonists like semaglutide, liraglutide, and dulaglutide has transformed how doctors manage diabetes and obesity, providing remarkable outcomes in weight loss and blood sugar control. However, like every other drug, these medications come with potential side effects and risks.
If you’re considering or currently using these treatments, it’s essential to understand the possible challenges and risks, so you can make informed choices and manage your treatment effectively. Read MoreCommon Side Effects: What to Expect
When starting a GLP-1 medication, many patients experience mild and temporary side effects, especially during the first weeks as the body adjusts. Issues related to the stomach and digestion, like nausea, upset stomach, diarrhea, and constipation, are the most common.“Most commonly reported is nausea, and patients tend to have more side effects the first time they take medication, and it tends to decline as they take that same dose again,” Dr. Lofton explains.
“The next most commonly reported side effect will be stool changes of either type, either constipation or loose stools. And we try to mitigate this risk by giving patients some dietary changes to make or maybe some over-the-counter medications.”
There are steps patients can take to help reduce these side effects. For example, to avoid upset stomach, patients can try eating smaller meals, eating slowly, and staying hydrated. Increasing fiber intake can help with digestive issues.
Other potential side effects patients should be aware of include:
- Loss of appetite
- Fatigue
- Dizziness
- Headaches
As Dr. Lofton mentioned, these initial side effects typically diminish significantly after the first month of treatment, allowing many patients to continue long-term without significant discomfort.
More Serious Risks: What To Watch For
Though less common, there are more serious risks associated with GLP-1 agonists. It’s crucial to know these so you can act quickly if symptoms occur and can easily report to your healthcare provider.
“There are certain risks of the medication that can outweigh the benefits and should lead to discontinuation of a GLP-1. One of the most problematic risks of taking GLP-1s, which is reported less than 1% of the time, is pancreatitis,” Dr. Lofton explains.
Pancreatitis (inflammation of the pancreas)
“Pancreatitis is a swelling of the pancreas, which is an organ in the GI system. So in patients who are taking GLP-1 at any time, if they develop abdominal pain with vomiting, potentially fever, then we want to really do some investigation,” Dr. Lofton explains.
“If pancreatitis is found, we discontinue the medication and usually don’t restart it again because that carries too much risk.”
Symptoms of pancreatitis include:
- Severe abdominal pain, especially if it radiates to the back or worsens after eating
- Persistent nausea or vomiting
- Unexplained fever or chills
If you experience these symptoms, seek immediate medical attention.
Gallbladder Problems
Rapid weight loss can sometimes lead to gallstones or inflammation of the gallbladder. It can precipitate or worsen the pain in patients with prior gallbladder issues.
“There is a risk of gallbladder problems or gallbladder stones [forming]. And this is also less than 1%, but when it occurs, a patient may need to have a surgery to remove their gallbladder or use medications to keep them from forming more gallstones. So this is another potential risk of taking GLP-1s,” Dr. Lofton explains.
“But if someone does have gallbladder issues or forms gallstones, they can continue the medication as long as that risk is decreased by treating that gallbladder problem.”
Symptoms of gallbladder issues include:
- Sharp upper-right abdominal pain
- Pain that may extend into your back or shoulder
- Nausea, especially after fatty meals
- Dark urine or pale stools
Talk to your doctor immediately if you suspect gallbladder issues.
Long-Term Unknowns: Risks vs. Benefits
GLP-1 medications have been studied extensively, but research on their long-term effects is still relatively limited. The medical community continues to monitor long-term safety, especially related to heart health, cancer risks, and kidney health.
Understanding that these medications, though promising, aren’t without risks helps you work proactively with your healthcare provider to ensure safe and effective treatment.
To reduce risks and your chances or developing side effects, consider the following steps:
- Start slowly: Your doctor may gradually increase your dosing over weeks or months to minimize side effects.
- Stay hydrated: This is important especially during episodes of nausea, vomiting, or diarrhea.
- Report symptoms early: Early detection and management of side effects can prevent serious complications.
Questions To Ask Your Doctor
- Am I at higher risk for side effects based on my medical history or current medications?
- What symptoms should I report immediately?
- What’s the best way to manage common side effects at home?
- How often will we check for potential complications like thyroid issues, pancreatitis, or gallbladder problems?
- If I have a thyroid cancer history (or family history), can I still safely use a GLP-1 medication?
- How long do I need to take GLP-1 medication?
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