Glucagon-like peptide 1 receptor agonists are rapidly growing in popularity, with prescriptions for Ozempic and similar drugs quadrupling in less than three years, according to a September report from The Washington Post.
While Ozempic is approved to treat Type 2 diabetes, some providers are prescribing it off-label for weight loss, according to the Post. A different version of the drug, Wegovy, is approved for weight loss, and other GLP-1 drugs approved for diabetes or weight loss have also entered the market.
While these medications could have potentially positive impacts on patient care, they do not come without documented risks.
Two physicians told Becker's why they are skeptical about weight loss medications.
Lali Sekhon, MD. Neuro and Spine Surgeon at Reno (Nev.) Orthopedic Center: Like most things, it's "wait and see." I currently only see patients getting approved for morbid obesity with diabetes. If there is just obesity, insurance does not seem to authorize GLP-1s. Know what's better than weight loss medications? Regular, simple exercise like walking and dietary management. Prevention does not seem to be valued as highly as treatment. It's the American way: a pill or surgery or shot rather than self actualization, taking responsibility and doing the work.
Michael Finamore, DO. Anesthesia Provider for the Orthopaedic Surgery Center (Youngstown, Ohio): From the perspective of an anesthesiologist, the most notable concern is that of aspiration secondary to delayed gastric emptying. This is of particular concern the first 20 weeks of starting the medication, but may reduce significantly with longer duration of use. Given this documented concern, the American Society of Anesthesiologists has published guidelines for the perioperative management of all the GLP-1 inhibitors, like Ozempic. Briefly, daily dosed GLP-1 inhibitors should be held the day of surgery and weekly dosed drugs should be held for a full week. This has led to delaying, changing and at times cancellation of elective cases because those guidelines are not followed. Unfortunately, that includes all the negative consequences associated with cancellations the day of surgery. As with any new drug, the more familiar everyone becomes, unwanted consequences should decrease.