FAQs for Medications for Weight Loss

Prescription drugs can be one tool in the toolbox needed for long-lasting weight loss. While these drugs can help reduce appetite and curb cravings, even those taking medication will still need to make changes to their eating and exercise behaviors for weight loss to occur. Medications are neither necessary nor sufficient for long-lasting weight loss, but they can be used as part of a comprehensive treatment program.

Semaglutide is part of the GLP-1 class of medications that have been used for many years to treat diabetes. The drugs mimic the effects of the hormone glucagon-like peptide 1, which increases insulin production and promotes feelings of satiety through delayed gastric emptying. Also, GLP-1 receptors are present in brain regions believed to be involved in reward and addiction, so these medications may lead patients to find food less rewarding and less pleasurable.

Both Wegovy® and Ozempic® contain semaglutide as their active ingredient. Ozempic® received FDA approval for the treatment and prevention of Type 2 diabetes in 2017, whereas Wegovy® was approved specifically for weight loss by the FDA in 2021. Both require a prescription from a doctor, and both are delivered via weekly injection.

Side effects of both Wegovy® and Ozempic® are similar and mostly of the gastrointestinal variety. Side effects due to Wegovy® tend to be more severe compared with Ozempic® (because there is a higher dose of semaglutide in Wegovy® than in Ozempic®). Common side effects are nausea, constipation, diarrhea, stomach pain, and vomiting. Additionally, some patients have reported more severe gastrointestinal issues, including gall bladder and pancreas issues.

Both Ozempic® and Wegovy® need to be prescribed by a physician, and this physician should be monitoring reactions to the drugs weekly and then monthly. A doctor will also need to adjust the dosage of the drugs over the first few months to optimize effectiveness and minimize side effects. Currently, there is a shortage of both drugs, so there may be a lag between when a patient is prescribed the drug and when they can actually retrieve it from the pharmacy.

Like any other medications, semaglutide will stop working when the drug is discontinued, and weight regain is common. For this reason, some doctors will suggest that patients need to stay on the drug for a lifetime. For others, using the drug as a jump-start to weight loss can be sufficient, as long as the patient is able to sustain the behavior changes that were learned while taking the medication.

Yes, Structure House is currently partnering with a compounding pharmacy that can supply the drug within the same week participants receive the prescription from our doctor. The doctor at Structure House will meet with participants weekly to determine the correct dosing. Additionally, Structure House is the only residential program in the country to offer additional supportive programming (in the areas of nutrition, fitness, and behavior/psychology) so that participants can optimize their weight loss outcomes and learn strategies to make their weight loss permanent — regardless of whether they continue to take the medication for the rest of their lives. Furthermore, Structure House offers this supportive programming for participants who are prescribed weight loss medication by their home doctors.

No, weight loss medications do not work for everyone, unfortunately. Many people will determine that the risks and side effects of the medication are not a worthwhile trade-off. Furthermore, not everyone will respond to the medications, especially if they are not simultaneously taking steps to change their behaviors. There is no silver bullet here. Medications, when effective, are just a single tool in the toolbox.

For optimal results, patients are encouraged to exercise while taking these medications, and strength training is even more important for these patients (compared with someone losing weight via behavior change alone). There is a risk for muscle loss, which can lead to a decrease in functional fitness, if strength training does not become a key part of one’s routine and regimen.

At the end of the day, individuals will only be successful with long-lasting weight loss if they change their behaviors around nutrition, exercise, and self-care. Medications, by increasing satiety and reducing cravings, can make this endeavor a bit more comfortable, but the physics of weight loss (intaking less energy than one is using) will always remain the same. Thus, an excellent alternative to weight loss medication is an immersive environment (like Structure House) where participants learn new ways of relating to food, novel strategies to become more active in their day-to-day lives (even without formal exercise in a gym), and different ways to cope with life’s ups and downs. Weight loss surgery is another alternative to weight loss medication.