Obesity doctor answers common questions about weight loss injectables

Atlanta - They are weight loss medications with names like Wegovy, Mounjaro and, now, Zepbound.

Dr. Alicia Shelly, a Wellstar Center for Best Health obesity physician and internist, says the medications, delivered by tiny needles you inject just under the skin, have been a breakthrough for her patients with weight-related health problems.

"I'm seeing people who are getting off their blood pressure medication," Shelly says.  "They're not needing as much medication for their diabetes, their cholesterol is improving, and they're able to move better."  

Shelly says she gets asked about injectables a lot.

"I think the main question that people ask me are, you know, first of all, is about side effects: what should I expect when I take this medication," Shelly says.

With all of the medications, she says, nausea and vomiting are the most common side effects.

"Some people can experience diarrhea," Shelly says. "They can experience constipation. There are a subset of people who have experienced some slowing of their gut, or a slowing of their intestine, called gastroparesis, and there are some people that, if they have a history of pancreatitis, it can be triggered."

The GI symptoms can happen at any time, Shelly says, but you typically see them as people switch to a higher dose.

"So, if they're experiencing a lot of the nausea and vomiting symptoms, I would kind of decrease the dose for them and see how they do if it continues," she says. "And, we may have to try a different medication.

Another big question: are these medications safe?

Dr. Shelly says a 2023 study found for patients with pre-existing cardiovascular disease, taking semaglutide, one of the weight loss medications, actually lowered their risk of dying from cardiovascular disease or having a non-fatal heart attack or stroke.

"So I do tell them that this is safe, especially in people that have pre-existing cardiovascular disease," Shelly says. "So, you should feel reassured that you're okay to take this medication for a long time, especially if you have no cardiovascular disease."

If you're wondering if you're a candidate, you typically need to have a BMI or body mass index of 27 or greater and a weight-related health problem such as high blood pressure, or you have a BMI of 30 or greater without a related health issue.

Another common question Shelly gets is whether health insurance providers will cover the cost of the medication.'

"That is a big question," she says.  "And, a lot of times, you know, I'll ask the patient to call their insurance. But, the majority of the time, we just have to submit it to the pharmacy and fill out the documents, because sometimes it's not quite clear whether insurance covers it or not."