Medicated

Diabetes Drugs Are Being Used for Weight Loss. Are They a Safe Option?

written by Dr. Christine Bishara - Feb 6, 2023

Photo Credit: by Vidmir Raic, Pixabay.com

If you’ve been watching the news lately, you’ve seen that the latest celebrity trend in weight loss involves the use of diabetic medications such as Ozempic, Mounjaro (tirzepatide) and Rybelsus to promote weight loss, but the use of diabetic meds for weight loss is not a new concept.

So the question arises, if you’re not a diabetic but would like to use these medications to lose weight, is it a good idea? My answer is, it depends….. While these medications are extremely effective, I have a philosophy of always assessing risk vs benefits when starting my patients on any medication. For example, do you have risk factors for developing a chronic illness or serious complication that outweighs an adverse effect of the medicine? Risk factors such as obesity (BMI over 30), heart disease, diabetes, or a strong family history of chronic medical issues are all factors that affect overall morbidity.

Let's look at a summary of these medications and see if taking them is right for you.

Metformin:

Metformin works by Improving the body’s response to insulin–translating into better glucose levels. Metformin has been shown to induce weight loss when first administered but this benefit usually wears off after six months. Average weight loss with individuals started on metformin was approximately twelve pounds in the first six months with not many additional weight loss benefits after this time period. A serious but uncommon complication seen in metformin is something called lactic acidosis which can lead to serious kidney or liver failure.

Januvia:

Januvia works by increasing insulin production in the pancreas. There is some initial weight loss with Januvia, but it is not significant. Some common side effects with Januvia include muscle aches, or Gi disturbances. Average weight loss seen was three pounds in the first six months.

Jardiance:

Jardiance, also known as empagliflozin is a diabetes medication that works on glucose transport and allows more glucose to be excreted in the urine, thereby improving blood glucose control. Average weight loss with Jardiance was app 2% body weight within the first six months.

Then, there is the class of diabetic medications that are taking the weight loss trend by storm. The most popular ones are two injectables, Mounjaro and Ozempic. Rybelsus is the same medication as Ozempic (semaglutide) but can be taken orally. Both Mounjaro and Ozempic are weekly subcutaneous injections which you or a caregiver can be taught to administer. These medicines are expensive if you are paying out-of-pocket as no generic option is available in the U.S. market. Some, but not all insurance companies will cover the cost of these medications.

Mounjaro, Rybelsus and Ozempic

All work by mimicking the actions of glucagon-like peptide receptors in the pancreas which in turn enhance the release of insulin. They also have the added benefit of causing a significant amount of weight loss.

The good news: The average weight loss for Mounjaro was approximately eighteen to twenty-five pounds and for Ozempic (also available in a slightly higher dose and marketed with the trade name Wegovy) was approximately fifteen to twenty pounds in the first six months.

While the GLP-1 class have higher weight loss rates, they have been implicated in some serious adverse effects to be mindful of. A recent study found an increased risk of thyroid cancer in those who take these medications for a duration of one to three years.

Another study showed increased incidence of pancreatitis with this class of medications.

So the question arises, is it worth taking the GLP-1 diabetic medications?

My personal opinion is…. it depends. As with all medications, it’s very important to discuss the risks and benefits with your doctor. If you're a diabetic or significantly overweight and have chronic medical issues or at high risk of developing them, then the weight loss benefits may outweigh the risks. I am a big proponent of lifestyle factors being the most important changes one should make to lose weight, but I also see the short term benefits (six months or less) of these medications, especially if being used as a good motivator while a patient is starting their new lifestyle changes.

If your insurance is not covering for these meds, Canada Pharmacy Online has offered the best prices on:

Buy Rybelsus Online – Semaglutide Canada

Buy Januvia Online – Sitagliptin Canada

Buy Jardiance Online – Empagliflozin Canada

Metformin