Weight loss drugs are slimming America’s waistline, but this miracle cure may come at a hidden cost.
One in eight adults are now taking GLP-1 medications, according to a Kaiser Family Foundation poll. That adds up to over 30 million people and the figure is only expected to rise after a pill version of Wegovy secured FDA approval, adding a needle-free option to the market.
Doctors have praised the drugs for helping people shed pounds with little more than a weekly injection. And studies show that patients who lose weight slash their risk of heart disease, high blood pressure and dementia, among other conditions.
But amid the frenzy, some experts are issuing warns over a possible future epidemic, linked to GLP-1 drugs that threatens to save years off otherwise healthy lives.
Dr Marc Estes, an emergency medicine physician in Indiana, told Daily Mail: ‘One hundred percent of clients on weight loss drugs see at least some muscle loss. I don’t think anyone who is on actual weight loss doses will see zero percent muscle loss.’
Dr Douglas Ewing, a bariatric surgeon in New Jersey, added to Daily Mail: ‘Less than five or 10 percent of patients complain about muscle loss, but it is something that probably more people than that would notice if you dug deeper. Muscle wasting is rarely symptomatic.’
Doctors are warning over a silent epidemic that could be caused by weight loss drugs. The above is a stock image of Ozempic
Dr Estes pointed to analyses of eight large US and European studies, which suggest that, on average, 25 to 35 percent of the weight lost on the drugs is muscle, bone or other lean mass.
Other research has warned that the figure could be even higher, with some studies estimating that 40 to 60 percent of total weight loss is lean tissue.
Muscle is essential for movement, stability and overall health. Losing a significant amount raises the risk of falls and, with them, potentially debilitating injuries, experts warn.
With the average Ozempic user being 50 to 64 years old, according to the same KFF poll, experts fear the drugs could accelerate the muscle loss already experienced around that age and raise the risk of sarcopenia, progressive decline in muscle mass due to aging.
That increases the risk of falls that lead to head injuries, broken bones and other complications that can reduce lifespan.
But muscle loss could also affect younger adults in their 30s and 40s, experts say, if they suffer from falls.
Dr Will Haas, a weight loss doctor in North Carolina, warned ‘I do believe that could be the potential if the trend isn’t turned around and the right education and support are not in place.
‘If the nation sees people losing weight during their 30s and 40s, and also losing muscle mass, that trend could follow them well into other decades of life.’
Alexandra Collett, 31, from the UK, lost 136lbs on Ozempic, but afterward found herself spending thousands removing loose skin and having a breast reduction
The CDC says that unintentional falls are already the leading cause of injury-related death among adults over the age of 65 years, with more than 41,000 dying from them every year.
The death rate from falls among adults aged 65 years and older is also rising. The CDC said the rate increased 70 percent from 2003 to 2023 among adults aged 65 to 74 years, and more than 75 percent for those aged 75 to 84 years. Among the over-85s, it has more than doubled.
It is not clear why this is happening, but experts have suggested it is down to the use opioids and antidepressants in older adults, which can cause dizziness and leave these adults at greater risk of losing their balance. Weight loss drugs may only add to this trend.
Users of Ozempic and other weight loss drugs are urged to eat a high-protein diet and do strength training at least twice a week to help prevent muscle loss while on the drugs.
But doctors report trouble getting patients to follow these guidelines.
It is not clear what proportion of patients on weight loss drugs may not be following diet or exercise recommendations, but in a comparable paper from 2004, where scientists tracked 4,000 obese adults taking prescription weight loss drugs, researchers found only 27 percent reported eating fewer calories and following the physical activity recommendations from doctors.
Dr Ewing added: ‘Compliance, overall, is a difficult problem when you are dealing with diet and exercise.
‘If you don’t have continual follow-up in the clinic, if you don’t have the educational resources, if you don’t have objective criteria, then you are less likely to be able to coax your patients slowly into better habits.’
Shown above is Dr Douglas Ewing, who raised concerns about the future because of weight loss drugs
He said that about 60 to 75 percent of patients at his clinic comply, but that when this does not happen, they provide patients with extra resources to encourage them to follow the diet and exercise recommendations.
All weight loss plans lead to at least some muscle loss, doctors say, but add that normally this is only around 15 to 20 percent of total weight lost.
Overall, Dr Haas said that, for now, the benefits of weight loss drugs for obese individuals, when used with diet and exercise, outweigh the risks in his view.
He told Daily Mail: ‘For many patients, the rewards of true weight loss can absolutely outweigh the risks.
‘These changes can include positive effects on blood sugar levels, blood pressure, sleep apnea, joint pain and quality-of-life changes.
‘However, it is not just a function to promote weight loss but to promote good health. This is best achieved through weight loss coupled with preservation of muscle mass, nutritional support, and lifestyle changes.’
Other doctors disagreed that muscle wasting posed a major risk for users of Ozempic and other weight loss drugs.
Dr Holly Lofton, an obesity medicine expert in New York, told Daily Mail: ‘There are scientific articles which have demonstrated that there is no excessive muscle wasting in patients taking GLP-1s versus those losing weight without meds.
Doctors are expecting more people to start using weight loss drugs in the future (stock image)
‘It is important that the prescriber of GLP1s also provide the support for lifestyle management or refer to someone else skilled in such.’
Doctors also warned that weight loss drugs may raise the risk of gallstones, or hard deposits, like tiny pebbles, that form from digestive fluid in the gallbladder, a gland near the pancreas.
They noted the drugs may raise the risk of these complications because the rapid weight loss they cause can alter bile composition and reduce gallbladder emptying, causing bile to stagnate in the gland and become stones.
The stones are painful, but can be removed with surgery. Patients generally do not suffer long-term effects.
Dr Ewing told Daily Mail: ‘I tell my patients gallstones and gallbladder problems are one thing they should keep in mind. Any time you lose weight, you risk developing these.
‘We do see a lot of patients with gallbladder problems already. I can’t really say whether we are seeing an uptick.’
