Weight Loss

All GLP-1 medications carry a "Black-Box Warning" for patients with either a personal or family history of Medullary Thyroid Cancer (MTC) or Multiple Endocrine Neoplasia Syndrome 2 (MEN2). This warning is based of animal models, however, to date, no human trials have demonstrated an increase in these conditiions.

GLP-1 Agonists are not approved in pregnant patients due to potential unknown side-effects.

Other potential risks include:
- nausea and vomiting
- diarrhea or constipation
- Mood changes (particularly those with diagnosed mood disorders)
- Gastroparesis - slowing of the stomach leading to bloating, and indigestion with meals. Most gastroparesis resolves with discontinuation of medication but there are rare reports of patients with persistent symptoms despite discontinuation of medication.
- Pancreatitis - a serious inflammatory disorder of the pancreas
- Gallbladder stones
- Increased heart rate (about 10 beats per minute increase)
-Thinning Hair.
- Muscle loss (which occurs with all weight loss)
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There are a number of strategies to avoid unwanted GLP-1 side effects
- Reduce meal portions to avoid bloating, nausea and vomitting
- Consume plenty of water to avoid dehydration, fatigue, and constipation
- limit foods with high grease or fat content as these foods slow the gut.
- avoid eating 2 hours before bed to reduce reflux
- ensure adequate protein intake (1g protien/kg body weight) or (0.5 g/lb bodyweight) to avoid muscle loss.
- regular exercise to promote proper gut function
- Strength training to avoid muscle loss.  

- Pregnant Patients
- Patients with a personal or family history of MTC or MEN2
- patients with a history of allergic reaction to any GLP-1 medication
- Patients with a known history of Gastroparesis
- insulin-dependent diabetics with difficult-to-manage diabetes.
- patients with known diabetic retinopathy
- use with caution in patients with a history of gastric bypass to avoid dehydration and nutritional deficiencies.

For mild-to-moderate symptoms, please reach out to your Valuemed provider for assistance. If you are experiencing severe or concerning symptoms (e.g. severe abdominal pain, uncontrolled vomiting, extreme weakness/fatigue), it is recommended that you seek care immediately in an Emergency Room.

Aside from impressive weight loss, the GLP-1 agonist Semaglutide has been associated with the following positive benefits:

-Reduced blood sugar/improved responsiveness to insulin
- a 20% reduction in heart attacks, strokes, and heart-related deaths
- Reduction in chronic kidney disease (based on preliminary results from the FLOW trial)
- Reduced need for insulin and other chronic medications due to reversal of weight-related diseases.
- possible reduction in alcohol consumption.

GLP-1 agonists are among the few weight loss drugs intended for long-term use. There is no absolute need to discontinue your GLP-1 Agonist. In general, the maximum benefit of these medications is seen somewhere between 68-72 weeks of use. Unfortunately, a subsequent trial published on Wegovy suggests that most patients will have subsequent weight regain upon discontinuation of the medication. That being said, GLP-1 medications can be stopped abruptly without withdrawal side effects. It is important to note that we have been using GLP-1 agonists uninterrupted for years in patients with Type 2 Diabetes with no significant medical issues.

The cost of the medication depends upon your insurance. Medication costs of semaglutide can range anywhere from $25 to $250 per month depending on your dosage and geographical location.

Ozempic, Wegovy, are patented FDA-approved GLP-1 agonists with the active ingredient Semaglutide available only from Novo Nordisk.

Mounjaro, Zepbound, are patented FDA-approved GLP-1 agonists with the active ingredient Tirzepatide available only from Eli Lilly.

Due to the nationwide shortage of these patented medications, the FDA currently allows compounding pharmacies to manufacture GLP-1 Agonists containing Semaglutide or Tirzepatide.

Compounded drugs are not FDA-approved, and the FDA does not verify their safety, effectiveness, or quality.

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