Answering the biggest concerns surrounding weight-loss medication

Introducing our new program: Mayo Clinic Diet for Weight-Loss Medications.

If your doctor has recommended you take a weight-loss medication like semaglutide (sold as Wegovy), it is understandable you may have concerns. It's completely normal to feel hesitant, as any medication carries potential risks and side effects.  

Here we provide answers to some of the most common concerns and doubts.  

Will I regain all the weight back after I stop taking the medication?

While it's true that some weight regain is common after discontinuing weight-loss medications, it is not an inevitable outcome. The key is to view the medications as tools to facilitate lifestyle changes, not as a permanent solution. With the right approach, it is possible to maintain significant weight loss long-term, even after stopping the medication. The essential elements are: 

• Continuing lifestyle changes: Adopting sustainable healthy eating and exercise habits is crucial for maintaining weight loss. 
• Gradual dose tapering: Healthcare providers often recommend gradually reducing the medication dose to ease the transition. 
• Ongoing support and monitoring: Continued guidance from a healthcare team can help prevent relapse and ensure long-term success. 
• Ongoing self-monitoring: Individuals who are successful in maintaining their weight loss often continue to track their weight, food intake, and exercise for several months until the changes become fully ingrained in their lifestyle. 
• Individualized approach: The likelihood of weight regain can vary, so working closely with your provider to develop a personalized plan is important. 

The key to preventing weight regain is to view weight-loss medication as a tool to jumpstart and facilitate lifestyle changes, not as a permanent fix. With the right support and ongoing commitment to healthier habits, significant weight loss can be maintained even after stopping the medication.  

Is weight-loss medication a substitute for diet and exercise?

No. Medications aren’t an easy way out or magic bullet. To lose weight — and keep it off — you will still need to eat a balanced diet and move more. Medications are a tool to help you, not a substitute for healthy habits. In fact, based on the scientific evidence behind weight-loss medications, the FDA approved GLP-1s for weight loss as part of a weight-management program: the drugs were never designed to be taken alone. 

There are many ways that you can work to maximize your weight loss results on Wegovy, Ozempic, or other GLP-1s. Getting proper sleep, managing stress, and practicing a physically active lifestyle are just a few ways. 

How expensive is weight-loss medication?

The cost of weight-loss medications can vary significantly, but in general they tend to be quite expensive and can be over $1,000 per month. The cost can vary depending on your insurance coverage, plan, and medical condition. 

To get a more accurate idea of the cost for your situation, it's best to check with your healthcare provider and insurance provider directly. They can provide you with the most up-to-date information on the out-of-pocket expenses you can expect for the weight-loss medication prescribed.  

Is weight-loss medication covered by health insurance?

The coverage of weight-loss medications by health insurance can vary widely. Here's a general overview of the insurance coverage landscape for these types of medications: 

1. Medicare and Medicaid Coverage: Medicare Part D and Medicaid plans generally do not cover weight-loss medications, with a few exceptions. Some state Medicaid programs may cover certain weight-loss drugs, but the coverage is limited. 
2. Private Insurance Coverage: Coverage for weight-loss medications by private insurance companies can be inconsistent. Some plans may cover certain FDA-approved weight-loss drugs, while others may completely exclude them. The level of coverage can also vary, with some plans requiring higher deductibles or copays for these medications. 
3. Employer-Sponsored Insurance: Employers have the discretion to decide whether to include weight-loss medications in their health insurance plans. Some larger employers may choose to cover these medications as part of their wellness or disease management programs. 
4. Affordable Care Act (ACA) Plans: Under the Affordable Care Act, weight-loss counseling and screening are considered preventive services and must be covered by ACA marketplace plans. However, the coverage for weight-loss medications themselves can still vary across different ACA plans. 

The coverage and specific requirements can also change over time, and they may differ based on the state and the individual insurance plan. To determine if a weight-loss medication is covered by your health insurance, it's best to: 

• Check with your insurance provider directly to inquire about the specific coverage details. 
• Review your plan's formulary or list of covered medications. 
• Discuss the options with your healthcare provider, as they may be able to assist in navigating the insurance coverage requirements. 

Some pharmaceutical companies also offer patient assistance programs or co-pay assistance to help make weight-loss medications more affordable for individuals who may not have adequate insurance coverage. 

Already taking GLP-1s? Discover our companion to weight-loss medications from the experts at Mayo Clinic.

Is weight-loss medication addictive? 

Weight-loss medications approved for long-term use, like semaglutide (Ozempic, Wegovy) and liraglutide (Saxenda), are not considered addictive. The key reasons are as follows: 

• They do not act on the brain's reward centers like addictive substances. 
• People do not experience withdrawal when stopping the medication. 
• While people may develop a physical dependence, this is not the same as addiction. 

Some older weight-loss drugs, like phentermine, may have a higher potential for abuse. But the newer, long-term weight-loss medications are not viewed as addictive substances when used as directed under medical supervision. 

Can weight-loss medication affect my fertility?

The potential impact of weight-loss medications on fertility can vary, depending on the specific medication and the individual's health status. Here's a general overview:  

• Semaglutide (Ozempic, Wegovy): Semaglutide is approved for long-term weight management. There is limited data on the direct effects of semaglutide on fertility, as the clinical trials did not specifically assess fertility outcomes. However, since semaglutide can help improve glycemic control and reduce body weight, it may indirectly improve fertility in individuals with conditions like polycystic ovary syndrome (PCOS) or obesity-related infertility. 
• Liraglutide (Saxenda): Liraglutide is another GLP-1 receptor agonist approved for weight loss. Similar to semaglutide, there is limited data on the direct effects of liraglutide on fertility. However, improvements in weight and metabolic parameters may positively impact fertility in some individuals. 
• Phentermine/Topiramate (Qsymia): This combination medication is approved for short-term weight loss. Topiramate, one of the active ingredients, has been associated with an increased risk of birth defects when used during pregnancy. Healthcare providers generally recommend avoiding Qsymia in individuals who are pregnant or planning a pregnancy. 

Obesity itself can be a contributing factor to fertility issues, and weight loss through a combination of lifestyle changes and medication can potentially improve fertility outcomes in some cases. 

If you are considering weight-loss medication and are planning a pregnancy, it's crucial to discuss the potential impacts with your healthcare provider. They can assess your individual situation and provide guidance on the appropriate course of action to optimize your fertility and overall health. 

In general, it's recommended to discuss family planning goals with your provider before starting any weight-loss medication, as they can help you make an informed decision and address any fertility-related concerns. 

Does semaglutide make you tired?

Some may wonder why you feel more tired or fatigued when using a semaglutide. Fatigue and tiredness from semaglutide can occur because it decreases hunger and as a result the amount of calories consumed. Especially during the first few weeks of use, it is important to make sure that the meals you eat are providing proper nutrition and that you are getting a good night's sleep in order to avoid fatigue and tiredness while using semaglutide.  Weight loss can also cause tiredness. 

Is weight-loss medication safe for me?

Weight-loss medications like semaglutide go through extensive clinical trials and safety evaluations by regulatory bodies like the FDA before being approved for use. This ensures they meet strict safety standards. The benefits of these medications in helping people achieve significant, sustainable weight loss are carefully weighed against the potential risks. 

Saying that, there are certain individuals who should not take semaglutide, the active ingredient in Ozempic and other GLP-1 receptor agonist medications. Here are the key groups of people who should avoid taking semaglutide: 

1. A personal or family history of medullary thyroid carcinoma (MTC): Semaglutide has been shown to cause thyroid C-cell tumors in animal studies, and its use is contraindicated in patients with a personal or family history of MTC. 
2. If you have multiple endocrine neoplasia syndrome type 2 (MEN 2): MEN 2 is a rare genetic disorder that increases the risk of developing certain types of endocrine tumors, including MTC. Semaglutide is not recommended for use in these patients. 
3. If you have a history of diabetic ketoacidosis (DKA): Semaglutide may increase the risk of DKA, a serious complication of diabetes, in some patients. Caution is advised, and the medication should be avoided in those with a history of DKA. 
4. If you have a severe gastrointestinal disease: Semaglutide can cause gastrointestinal side effects, such as nausea, vomiting, and diarrhea. Patients with severe gastroparesis, inflammatory bowel disease, or other severe gastrointestinal conditions may be at higher risk of complications and should not take semaglutide. 
5. If you have a history of pancreatitis: There have been reports of pancreatitis associated with the use of GLP-1 receptor agonists, including semaglutide. Caution is advised in patients with a history of pancreatitis, and the medication should be avoided in those with active pancreatitis. 
6. If you have severe renal impairment or end-stage renal disease: The use of semaglutide in people with severe renal impairment or end-stage renal disease has not been thoroughly studied, and the medication should be used with caution in these populations. 
7. If you are pregnant, planning to become pregnant, or lactating: Semaglutide is generally not recommended for use in pregnant or lactating women as there is limited data to support the safety. 

It’s important to work with your healthcare provide and inform them of any pre-existing conditions or concerns you may have before starting this medication. 

The Mayo Clinic Diet can support you

If you are interested in exploring weight-loss medications, it is essential to work closely with an experienced healthcare provider to determine if it is the right treatment option for you. A comprehensive weight-loss program that includes diet, exercise, and lifestyle changes is also recommended in conjunction with weight-loss medications to achieve the best results. 

Using GLP-1s? The Mayo Clinic Diet now supports your journey with a special Companion program for weight-loss medication.