Taking GLP-1? Doctors say don’t forget about exercise and mental health – KFF Health News

Emily Sener, Nashville Public Radio and Cara Anthony and Blake Farmer, Nashville Public Radio

Severe leg pain forced Jaylon Smart to start taking weight loss injections a year and a half ago.

Smart was 285 pounds and worked as a caterer in Savannah, Georgia. After she was on her feet for long periods of time, her feet would be “swollen like a football.” She was walking with a limp. An orthopedic doctor diagnosed him with Achilles tendinitis and prescribed weight loss to relieve the symptoms. Smart started taking the brand name GLP-1 Ozempic.

Appetite suppression initially caused her to drop pounds rapidly.

“I lost 30 pounds at the beginning without changing anything,” said Smart, 48.

GLP-1s have quickly become one of the most popular types of weight loss drugs in America. Nearly 1 in 5 people have bought them at some point, according to research from KFF, the nonprofit health information organization that includes KFF Health News. But doctors say it takes longer than a regular shot for patients to achieve their weight goals in the long run.

Here’s what to know.

The old school rules of weight loss and health still apply

Regular exercise, better food choices, more sleep — these basic, healthy lifestyle choices will not only help you lose weight on weight loss pills but also help you keep it off, said Daphina Allen, an obesity medicine doctor who runs a clinic in Saginaw, Michigan. For example, some people find that they eat less in GLP-1, “but they don’t improve their health because they don’t exercise. They don’t improve the quality of the food,” Allen said. The path to weight loss is also guided by hormones, metabolism, and genetics.

After hitting her Olympic plateau, Smart realized she needed to start moving her body, too. “I’m in the gym six days a week now,” she said. “I went from 285 to 175” lbs. Her swelling and inflammation also went away.

Mental health issues too

Mind and body are deeply connected. Food and body image can be particularly emotional, Allen said. “I can tell you about patients that I’ve helped lose 50 pounds, that I’ve helped lose 100 pounds, and they still look in the mirror and they’re not happy.”

The key is to seek help for mental health along the way, said Gerald Onoha, who practices internal medicine in Nashville, Tennessee. “Making sure you talk to people about your problems, whether it’s a family member or a licensed professional, I think goes a long way,” he said.

Work with a doctor to closely monitor your diet

Onoha said people can run into serious problems if they take their GLP-1 dose too quickly or don’t follow the recommended schedule. He has seen patients come to the hospital with pancreatitis, gallstones, or acute kidney injury. “I always ask patients who are on GLP-1s: How long have they been on it?” he said. “Are they following the guidelines? Because those things determine whether or not you’re going to have these complications.”

Part of the issue, Allen said, is that GLP-1s are relatively easy to access — and often very cheap — through online pharmacies or websites, but those providers may not educate patients about their dosage or side effects. “So they might go online, find a random company that will ship it to their home, where they don’t even know what drug they’re taking, or even if the drug is safe for them as a patient with their medical conditions.” she said

People and policy

GLP-1 drugs can be expensive, and most insurance programs—public or private—don’t cover the drug for weight loss. Medicaid, a government program that covers 69 million Americans, covers GLP-1 for medically recognized conditions like diabetes, but only a dozen state Medicaid programs cover GLP-1s for obesity treatment, according to KFF. For older Americans with Medicare, the federal government plans to allow temporary coverage of GLP-1s for weight loss in July.

Kathryn Rupelt at Nashville Public Radio contributed to this report.

HealthQ is the health series from journalists Cara Anthony and Blake Farmer, an accessible guide to the inaccessible health care system. This is a collaboration between Nashville Public Radio and KFF Health News.

KFF Health News is a national newsroom that produces in-depth journalism on health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling and journalism. Learn more about KFF.

Use our content

This story can be republished for free (details).