One in four adults would use a weight loss drug without consulting a physician
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Key takeaways:
- Patients may skip a consultation because of costs or insurance coverage.
- A researcher underlined that weight loss drugs are not one-size-fits-all and can have various risks and side effects.
A quarter of adults would consider using an injectable weight loss drug without consulting a health care provider, according to the results of a survey from The Ohio State University Wexner Medical Center.
“I was surprised at how many people were willing to consider medications without a prescription,” Shengyi Mao, MD, an associate professor of clinical medicine at The Ohio State University College of Medicine, told Healio.
A survey asked 1,006 adults what factors — if any — would cause them to not consult a doctor about using a weight loss drug like Ozempic (semaglutide, Novo Nordisk), Wegovy (semaglutide, Novo Nordisk) or Zepbound (tirzepatide, Eli Lilly).
Overall, 25% of respondents said they would consider using a weight loss drug without consulting a doctor. The percentage of respondents who would forgo a consultation was highest among those aged 18 to 29 years.
The study identified several reasons why respondents would opt to use medications without consultation, which included:
- the drugs being available at a lower cost online or at a medical spa (18%);
- the drugs not being covered by the individual’s insurance (15%);
- the individual not being able to receive a prescription from their provider (9%); and
- the lack of availability through a pharmacy (6%).
The use of anti-obesity medications has seen substantial changes in the last couple years. glucagon-like peptide-1 receptor agonists increased by 600% among adolescents and young adults from 2020 to 2023, with a particularly significant rise in young women and girls.
However, greater access to weight loss drugs has also led to concern and spotlighted potential risks for adverse events related to the medications.
There are several risks from side effects of weight loss drugs, “such as gastrointestinal symptoms, which are common,” according to Mao.
“More serious effects like pancreatitis, kidney damage [and] hypoglycemia are rare but should be monitored,” she told Healio. “The FDA has issued warnings that dosing errors from compounded medications have resulted in serious complications, with some requiring hospitalization. There is also a concern for thyroid c-cell tumors that were seen in animal studies, so there is a black box warning on these medications for that. Working with a physician can help to minimize risks, monitor side effects and evaluate for efficacy.”
How can physicians address these issues?
“I would ask permission to discuss weight and listen,” Mao explained. “This may allow for an open dialogue to start a partnership in reaching their goals in a safer way.”
She pointed out that more research is needed on the efficacy and safety of weight loss drugs when used over a long period of time.
“We also need to better understand how long patients need to be on these medications or if it’s lifelong,” she said.
Perspective
Back to TopThe current demand for weight loss medication outstrips the available supply of FDA- approved agents. Many patients don't have a strong relationship with a primary care doctor because of an insurance change, changing or losing a job, etc. When people don't have a trusted primary care doctor, they tend to seek one-off solutions from isolated online medical shops or medical spas. Sometimes patients obtain off-label compounded medication, but these products aren't regulated by the FDA.
The important thing for patients to remember is that medications like Ozempic were studied in those who also had dietary and exercise recommendations from a well-trained physician. The success of any weight loss program hinges on consistent lifestyle change paired with appropriate weight loss medication or surgery. I encourage all patients to develop a relationship with their primary care doctor to determine the best plan for their health.
Perspective
Back to Top
Injectable medications are revolutionizing the weight loss industry and focusing new attention on obesity as a serious and complex disease process. Unfortunately, supply chain challenges and the high cost of these medications — which are sometimes excluded from insurance prescription drug coverage have led many to seek prescriptions without interaction with the physician who manages their routine care. This potentially exposes patients to serious harm.
All medications have side effects. The safety, risk and anticipated benefit of any medication must be measured against the risk of the underlying disease and potential comorbidities that the medication is intended to treat. This is a complex analysis involving a deep understanding of medicine, pharmacology and medication side effects, and the patient’s holistic health situation, factoring in their medical history, family history, other medications, previous attempts at weight loss, and environmental factors. If the conversation between the patient and the physician reveals that the risks of an injectable weight loss medication outweigh the benefits, the conversation can transition to alternative options to support the patient on their weight loss journey. If an injectable weight loss medication is deemed appropriate, the patient and physician can discuss side effect management and plan an exit strategy so that once the medication is discontinued, the patient can maintain the weight loss and enjoy improved health and wellness.
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