In recent years, GLP-1 medications like Ozempic, originally developed for managing diabetes, have become the latest trend in diet culture, increasingly popular as a quick weight-loss solution. These drugs promise rapid results, presenting an appealing alternative to traditional weight management approaches. But what is the true cost of using these drugs?
This is a complex topic, and I can’t begin to tackle all of the narratives around this new generation of weight loss drugs. But I feel compelled to weigh in through the lens of what I am seeing in my private practice. For perimenopausal and menopausal women in midlife, the implications extend beyond personal health, impacting families, relationships, finances, and the eating behaviors of future generations—your children and grandchildren.
What Are GLP-1 Medications?
Ozempic and Wegovy are part of a group of medications called GLP-1 (glucagon-like peptide-1) receptor agonists. GLP-1 receptor agonists mimic the action of a hormone in the body that regulates blood sugar and appetite. This GLP-1 hormone was first discovered by an endocrinologist in Toronto in 1984. The active ingredient in these drugs, semaglutide, works by imitating the GLP-1 hormone. Results from ensuing clinical trials in diabetes care have been truly remarkable, leading to Ozempic’s FDA approval in 2018. Today, GLP-1 receptor agonists play a crucial role for those managing diabetes.
So, how did they become popular as weight-loss drugs? Since these medications affect the brain’s appetite centers, they reduce hunger and promote satiety, leading to weight loss. In 2021, Wegovy was approved specifically for weight management, and media attention quickly followed, with outlets praising the “miracle” effects of these drugs for weight loss. This surge in popularity has led to their widespread use as a weight loss tool, particularly popular for women in midlife for whom weight gain can feel especially difficult to manage due to natural shifts in hormone levels in the body.
The Appeal and Growing Market for GLP-1s in Weight Loss
During perimenopause and menopause, hormonal changes, especially declines in estrogen and progesterone, make weight management uniquely challenging. Fluctuating hormone levels often lead to metabolic changes, increased abdominal fat, and reduced muscle mass, all of which impact weight. With these natural changes in midlife, it’s understandable that many women turn to quick-fix options like GLP-1s. In fact, women have become a primary target market for these medications: in November 2024, Hims & Hers increased their ad spend to $180 million in a single quarter marketing GLP-1s, primarily to women who feel they’ve tried everything else.
While the appeal of GLP-1s is clear, it’s essential to consider both their benefits and risks, especially as new research continues to reveal their broader impact.
Understanding the Benefits and Risks of GLP-1s
I’ve been following the research on GLP-1 medications, and there simply isn’t enough data yet on their long-term impact. Much of the key research has come from the STEP trials, conducted by the drug companies themselves. While these results are promising, these trials have excluded certain key demographics. This makes sense at a trial level, but it creates assumptions about the drug’s effects on a population that, in reality, is largely made up of these very demographics. Below is a look at some of the key findings:
Benefits of GLP-1s:
GLP-1 medications have shown effectiveness in promoting weight loss, with roughly ⅓ of users in clinical trials experiencing reductions of 20% or more in body weight. Moreover, GLP-1s have been associated with improved cardiovascular health overall, particularly in patients with type 2 diabetes or metabolic syndrome. Research has shown that GLP-1 receptor agonists may lower the likelihood of heart attacks and strokes, further supporting their use in at-risk populations. When managing these particular health issues, GLP-1s are an attractive option for comprehensive health management.
In addition, for individuals with a very high BMI who lack access to necessary healthcare resources, these medications might offer substantial benefits.
Risks and Drawbacks of GLP-1s:
Despite these benefits, GLP-1s come with a range of side effects and potential long-term health risks that require careful consideration. Digestive issues are common, with many patients reporting nausea, vomiting, diarrhea, and constipation. These gastrointestinal side effects can significantly impact quality of life and are a leading reason why some patients discontinue the medication.
Additionally, there are concerns about more serious risks. For example, GLP-1 medications have been linked to conditions such as pancreatitis and gallstones. The available research indicates that while these risks are considered rare, they do pose a concern for individuals taking GLP-1s over an extended period. Other potential side effects, including thyroid tumors in some cases, underline the need for caution and regular monitoring.
A particular issue for menopausal and postmenopausal women is the impact of rapid weight loss on bone density. Studies indicate that quick reductions in body weight can accelerate bone loss, leading to a greater risk of osteoporosis and fractures, which is already a serious concern for older women. Weight-bearing activities that help strengthen bones are often recommended, but the weight loss induced by GLP-1s can counteract this, worsening bone density issues.
The mental health implications of GLP-1s are also noteworthy. Rapid changes in body weight may lead to shifts in body image and self-perception, which can, in turn, contribute to feelings of anxiety and depression. A study on athletes and weight loss found an association between rapid weight loss and disordered eating patterns. This is especially concerning for those who already struggle with body image, as the medication’s effects may exacerbate unhealthy eating behaviors.
Another limitation of GLP-1s is the likelihood of weight regain after discontinuation. Since these medications suppress hunger by acting on brain appetite centers, stopping the drug often leads to a return of hunger and cravings. This can make it challenging to maintain weight loss over the long term, raising questions about whether GLP-1s should be viewed as a short-term or lifetime commitment for those seeking weight management support.
Social Implications: The Message We Send to Our Children
The decision to use GLP-1 medications doesn’t just impact personal health—it also sends a message to children, and in particular, our daughters. Studies have consistently shown that children internalize their parents’ attitudes toward body image, food, and weight management. Watching a parent use medications for rapid weight loss can inadvertently communicate that thinness is worth any health trade-off. Research on social learning has shown that adolescents exposed to weight-focused behaviors in their parents are more likely to engage in restrictive eating or dieting practices themselves.
This effect is especially concerning for young girls, who already face immense pressure from social media and popular culture to maintain unrealistic beauty standards. The normalization of quick-fix weight-loss methods may encourage these harmful ideals, setting up young women for years of body dissatisfaction, anxiety, and self-worth challenges.
I believe that it is our responsibility as parents to take a strong stance against diet culture and weight stigma which can fuel the development of disordered eating and eating disorders. This is hard work, the work that I do every day with my own girls. Because the downstream ripple effect is that I don’t want to see your daughters in my private practice in five years.
GLP-1 Medications for those at risk of or living with eating disorders
For those with a predisposition to disordered eating GLP-1 medications may exacerbate restrictive eating behaviors. By suppressing hunger, these medications can lead to prolonged periods without food, a pattern commonly seen in restrictive eating disorders. What I am seeing in my own clinical practice is that the use of appetite-suppressing drugs can lead individuals to ignore natural hunger cues, disrupting the body’s natural regulation of hunger and fullness.
This suppression of appetite creates the possibility of a dependency on the medication for appetite control, which can create an unhealthy relationship with food. For those in midlife who may have spent years working toward a healthier relationship with food, GLP-1s may undermine this progress, as it removes the need to listen to and trust the body’s hunger and fullness cues.
Beyond Individual Health: The Societal Impact of GLP-1 Marketing
The aggressive promotion of GLP-1 medications has moved beyond diabetes management, pushing weight loss as a primary objective. With billions spent on diet-related marketing, the pressure on women is constant and unyielding, reinforcing harmful cultural norms about weight and body image.
Should we be reframing the conversation? Are we focusing too much on weight as an indicator of health, rather than on fostering sustainable wellness practices? Could we better support midlife women by shifting from weight-centric approaches to addressing deeper health, body image, and eating behavior challenges that support long-term, sustainable transformations in their relationship with food?
Reframing Health and Body Confidence for the Next Generation
As women in midlife, we have a unique opportunity to model healthy attitudes around body image, food, and self-care to the next generation. By choosing wellness strategies that support both physical and mental health, we can teach our daughters, nieces, and granddaughters that their worth is not measured by their appearance. A more compassionate, balanced approach to health allows us to redefine what it means to care for ourselves—an approach that doesn’t hinge on quick fixes or fleeting solutions.
Let’s Continue the Conversation
Navigating weight, health, and self-image in today’s world isn’t easy. But with honest conversations and a thoughtful approach, we can create a healthier, more balanced way forward.
I’d love to hear your thoughts on these issues, or, if this is something you are struggling with, reach out to me directly through the link to my calendar here: BOOK NOW
References:
- STEP trials: Semaglutide 2.4 mg for the Treatment of Obesity: Key Elements of the STEP Trials 1 to 5
- Glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes:real-world evidence from a Mediterranean area
- Association of Glucagon-Like Peptide-1 Receptor Agonist Use With Risk of Gallbladder and Biliary Diseases: A Systematic Review and Meta-analysis of Randomized Clinical Trials
- Weight loss and bone mineral density in obese adults: a longitudinal analysis of the influence of very low energy diets
- The Link Between Rapid Weight Loss and Bone Health: Ensuring Healthy Weight Loss in Women
- Prevalence of disordered eating and its relationship with rapid weight loss amongst male and female combat sport competitors: A prospective study
- Parent Conversations About Healthful Eating and Weigh: Associations With Adolescent Disordered Eating Behaviors
