GLP-1 medications like Ozempic and Wegovy have revolutionized obesity and Type 2 diabetes treatment, but their long-term effects and accessibility raise critical questions for patients and healthcare providers.
GLP-1 medications, including Ozempic, Wegovy, Mounjaro, and Zepbound, have significantly transformed the treatment landscape for obesity and Type 2 diabetes. Currently, approximately 29 million American adults are using these medications, with prescriptions for children and teenagers increasing by an astonishing 700% in recent years.
As the use of GLP-1 drugs continues to rise, several important questions emerge. How long should individuals remain on these medications? What are the implications when treatment is discontinued? What long-term effects might these drugs have on growing children or aging individuals? Additionally, how can patients afford and access these often expensive treatments?
On July 24, a briefing hosted by American Community Media brought together experts to discuss the public health implications of GLP-1 medications and the pressing questions they pose as they reshape the management of obesity and chronic diseases in the United States.
Dr. Jena Shaw Tronieri, an investigator at the Center for Weight and Eating Disorders at the University of Pennsylvania, highlighted the challenges of achieving weight loss through lifestyle changes alone. “For individuals whose health or quality of life could improve with weight loss, achieving that through diet and exercise is quite difficult,” she stated. Tronieri explained that GLP-1 medications facilitate greater weight loss compared to lifestyle modifications alone, as they alter the body’s hunger signals, making it easier for individuals to consume less.
Many patients report that they eat smaller portions, snack less frequently, and find that while food remains enjoyable, it occupies less of their mental space. Tronieri emphasized that dietary changes are crucial for effective weight loss, noting that “weight loss tends to be greater with eating changes than with physical activity, or with both combined.”
However, Tronieri also pointed out that the most common side effects of GLP-1 medications are gastrointestinal, including nausea, vomiting, constipation, and diarrhea. These symptoms are typically most pronounced during the initial weeks of treatment. Additionally, individuals with diabetes may face specific risks, such as retinal complications. “If someone has a very bad reaction to how they’re feeling, I would never want them to continue it,” she cautioned.
Dr. Fatima Cody Stanford, an Associate Professor of Medicine and Pediatrics at Harvard Medical School, addressed the historical context of obesity among Black women in the United States and the ongoing inequities in access to GLP-1 medications. She noted that sustained exposure to stress can alter the body’s fat storage and appetite regulation.
Stanford argued that the current disparities in obesity rates among Black women are not solely due to modern dietary habits but are deeply rooted in the lasting impacts of slavery, chronic stress, and generations of unequal access to education, healthy food, and healthcare. She described the high prevalence of obesity among Black women as “a predictable outcome of nearly two centuries of accumulated stress physiology, economic exclusion, and a healthcare system that was not designed with Black women’s health in mind.”
Even well-meaning programs can inadvertently perpetuate these disparities if they do not account for inequities in access to GLP-1 medications, Stanford warned. She highlighted the Medicare GLP-1 Bridge program, which began on July 1, 2026, and is set to conclude on December 31, 2027. This program allows eligible Medicare beneficiaries to access one of three GLP-1 medications. However, many Black Americans reside in states that have historically been slow to expand Medicaid benefits, potentially making these medications unaffordable for those who would benefit most. The program also requires prior authorization, which could reintroduce disparities into the system. “It’s a bridge, not a permanent fix,” she noted.
Dr. Dan Cooper, Professor Emeritus of Pediatrics at UC Irvine, discussed the unique challenges associated with prescribing GLP-1 medications to children and adolescents, a time when bones and muscles are rapidly developing. He cautioned that interfering with this developmental process could have severe long-term consequences, such as increased risk of osteoporosis later in life.
Cooper acknowledged the harsh reality of treating severe childhood obesity, noting that he encounters children as young as 12 weighing 300 pounds. While he recognizes that medication may sometimes be necessary, he advocates for increased investment in preventive measures, including enhanced opportunities for physical activity, especially in lower-income communities.
Cooper referred to GLP-1 medications as “behavioral medications” and stressed the need for caution in their use among children, given the unknown long-term effects. “We certainly cannot use them without intensive lifestyle interventions,” he stated.
Jasmyne Cannick, an award-winning journalist, shared her personal experience with GLP-1 medications for weight loss. Two years ago, Cannick weighed 250 pounds at a height of 5 feet 6 inches and joined Kaiser’s medical weight-loss program after nearing a diabetes diagnosis. Seeking to avoid bariatric surgery, she began taking Ozempic and lost between 30 to 40 pounds before her weight loss plateaued. After experiencing hospitalization due to dehydration, she realized she had not been adequately informed about the importance of fiber and water intake. She subsequently switched to Zepbound and now weighs 185 pounds.
“I didn’t want to end up like some of my relatives with amputations,” Cannick reflected. “It was always about being healthy for me.”
While she noted that the medication helped lower her A1C levels and resolved her sleep apnea, Cannick expressed concerns about side effects, long-term use, and costs. Her monthly out-of-pocket expense for Ozempic escalated from $25 to nearly $800. “I don’t feel like there’s enough information out there for us to know all the pros and the cons of GLP-1s,” she remarked. “I don’t want it to be a lifetime commitment for my wallet.”
Cannick continues to prioritize healthier eating while taking Zepbound and is contemplating a maintenance dose once she reaches her goal weight. “I’m paying attention to what healthcare providers are covering, but also keeping myself in check about how I want to be and how I want to live,” she stated.
In response to Cannick’s story, Stanford noted that most patients will require long-term treatment with GLP-1 medications. “If you withdraw these medications, weight gain ensues in approximately 90% of patients,” she explained, emphasizing that lifestyle changes, including strength training, remain crucial. Stanford also called for a more compassionate approach to obesity care, urging that “we need to treat patients with obesity with kindness, dignity, and respect,” according to India Currents.