Assessing The Risks vs. Benefits Of Weight Loss Drugs
- TV personality and The Real Housewives of New Jersey star Dolores Catania, 54, is warning about the side effects of GLP-1 weight-loss drugs like Ozempic (generic name: semaglutide) and Mounjaro (generic name: tirzepatide).
- GLP-1 agonists have positively impacted many peopleโs lives, providing remarkable outcomes in weight loss and blood sugar control.
However, like any drug, these popular weight loss medications come with potential side effects. The most common have to deal with the stomach and digestion. - โMost 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,โ Dr. Holly Lofton, director of the Medical Weight Management Program at NYU Langone Health in Manhattan, tells SurvivorNet.
- Common side effects, such as nausea [something Catania understands all too well], 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 โ so itโs important to keep your medical team informed about any side effects you experience.
Catania, who hasn’t been shy to admit she’s taken GLP-1 medications (drugs like Ozempic, Wegovy, and Mounjaro), has revealed that the major side effect she endured while being on these type of medication was nauseaโand it’s something she combated with a medication for motion.
Read MoreShe also hopes her story will help others understand they should do whats best for them when it comes to weight loss drugs, telling E! news, “Don’t not do it because you’re afraid of what somebody else thinks.”
Remember, itโs incredibly important to keep your medical team updated if you’re experiencing any side effects when taking any type of medication.
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Not only did the TV personality and philanthropist’s decided to spread awareness on the side effects of weight loss drugs, she also encouraged others to see a doctors “if you ever feel a flutter in your chest,” as she was has a heart condition called A-fib.
According to Johns Hopkins Medicine, A-fib is a type of arrhythmia, or abnormal heartbeat, which is caused by extremely fast and irregular beats from the upper chambers of the heart (often more than 400 beats per minute).
“A normal, healthy heartbeat involves a regular contraction of the heart muscle. A contraction happens about once per second at rest and increases with exercise. Each contraction pushes blood from the atria (the two upper chambers) to the ventricles (the two lower chambers). The ventricles then contract and push the blood to the lungs or to the rest of the body,” Johns Hopkins explains.
“But in a person with Afib, faulty electrical signals make the atria contract irregularly and much faster than normal. The atria then get out of sync with the ventricles. Blood can pool in the atrium, which may lead to blood clots and strokes. Afib that causes the lower chambers to beat too quickly can cause heart failure.”
Exploring the Benefits of Popular Weight Loss Drugs
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Catania further explained to E! News, noting that she needed to stop taking Mounjaro for the heart procedure she underwent. “That’s [flutter in your chest] not something to ignore. Sometimes people think it’s anxiety, just go to a cardiologist and just get a checkup.
“I gained probably 15 pounds in over a month. Now that I’m back on, I’m healthy and I feel much better. I’m down 10.”
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She added, referring to the procedure she underwent for her A-fib, “It’s an immediate fix. I had to relax for a couple of weeks. Don’t tell my doctor that I was on a plane a week later. Probably shouldn’t have done that, but I think it was the best thing I ever did.
“I love my doctors and I was able to get back to my GLP-1, which I missed terribly.”
Speaking on the “Two Ts in a Pod” podcast earlier this year, Catania offered more insight into the surgery, saying, “They went through my groin, which is really sore, and into my heart. And they kind of shock your heart and cauterize it. And then they’re like, ‘Wake up, heart. We’re doing it this way.'”
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Dolores Cataniaโs Usage of Blockbuster Weight Loss Drugs
Speaking on โWatch What Happens Live With Andy Cohen,” in a previous interview, Catania said, according to People, how she chose to go on Ozempic before a โReal Housewivesโ reunion.
When Cohen joked, โWhat housewife isnโt on Ozempic?โ she replied, โNot oneโฆ I wasnโt going to come to [the] reunion looking bigger than anyone else, so I got on the bandwagon.โ
She also toldย The U.S. Sunย in 2023, โIโm down 20 pounds. Iโm being realistic. Right now, Iโm 137. I was 157 when I started. I jumped to 163 โฆ I was going there. Like, I was gaining weight every month. So then when I finally kicked inโฆ the problem is, like, if you donโt start it, it takes time to work.
โIt doesnโt happen overnight. It doesnโt come off easy. I took Ozempic, stopped and then began Mounjaro. I was medically prescribed for both because I am insulin resistant/pre-diabetic and have a thyroid issue.โ
Catania continued, โYou know, everyoneโs losing so much weight [on it]. Itโs questionable, what are the repercussions of this when everyoneโs done? Is there side effects? All the doctors that I spoke to said โno.โ
โI stopped taking it because it was expensive and everything. But being healthy and living a healthy lifestyle is cheap โ itโs free!โ
She noted how she continues to prioritize exercise on a daily basis, adding, โThere is no easy fix for weight loss and I have to watch what I eat.โ
All About GLP-1 Receptor Agonists
GLP-1 receptor agonists (GLP-1RAs) are a group of medications primarily used to manage type 2 diabetes. They help lower blood sugar levels by mimicking a natural hormone in the body that regulates insulin release and appetite. In recent years, these drugsโlike semaglutide (Ozempic, Wegovy) and liraglutide (Victoza, Saxenda)โhave also gained popularity for their effectiveness in promoting weight loss.
In the past year or so, story after story has been published about the surprising effects these drugs can have. In addition to weight loss, there have been reports that the drugs can reduce peopleโsย urge to drink,ย help themย quit smoking, and evenย resolve certainย fertility issues. Itโs been touted in the media as a sort of miracle drug, however, much more research is needed.
Scientists have long known thatย obesity is linked to higher cancer risk,ย but whetherย GLP-1RAsย could reduce this risk had not been extensively studiedโuntil now.
These drugs, like semaglutide, work by impacting the glucagon-like peptide-1 (GLP)ย GLP-1 hormone.
Semaglutide is a GLP-1 receptor agonist, meaning that itย mimics the effects of GLP-1 in the body.ย Given as weekly subcutaneous injections, it is normally prescribed to manage blood glucose levels in diabetic patients. It also leads to a significant amount of weight loss in these patients.
Integral to blood sugar control,ย GLP-1 is a hormoneย released by the gut in response to food. It causes the pancreas to release insulin. A rising blood insulin level causes all the body tissues to start absorbing glucose (blood sugar) from the bloodstream, thereby lowering blood glucose levels. GLP-1 also prevents the release of glucagon, which is a hormone that raises blood sugar levels by stimulating liver cells to release glucose and helps people feel full for longer. These effects can also cause people to lose weight.
Although semaglutide has been approved for blood sugar control in people with type II diabetes under the brand name Ozempic, and for weight loss under the brand name Wegovy, it has not been approved for use as an immune booster or cancer preventive. Thus, it should not be prescribed for that purpose. Those taking it to control their diabetes or weight, however, can expect the additional benefit of improving their immunity, as per a recent study, and lowering their cancer risk, as a link between weight and cancer does exist.
Itโs important to note there are a variety of drugs available right now for weight loss, like Novo Nordiskโs semaglutide โ which can be purchased under brand names Ozempic, Wegovy, and Rybelsus โ and Tirzepatide, sold under the brand names Mounjaro and Zepbound. Others include Phentermine (Adipex-P, Lomaira), a prescription medication that reduces appetite; Contrave (naltrexone/bupropion); and bupropion (the generic form of Wellbutrin).
Common Side Effects: What to Expect
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.
“The most commonly reported side effects with GLP-1 agonists tend to be gastrointestinal [relating to the stomach and intestines] in nature because this is a gastrointestinal hormone,” Dr. Holly Lofton, director of the Medical Weight Management Program at NYU Langone Health in Manhattan, tells SurvivorNet.
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.”
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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.
โThere 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)
โPancreatitis 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.
โThere 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?
Contributing: SurvivorNet Staff
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