Wegovy and other weight loss-related prescription drugs are supposed to be used throughout the entirety of a patients' life to be effective.
But medical experts told FOX Business that a growing number of patients who have attempted the highly-sought after drugs are quitting within a few weeks or months because of how daunting the commitment is, the unknown long term side effects, lack of insurance coverage and even social stigma associated with these medications.
Wegovy and Ozempic are the same drug – semaglutide – but Wegovy was approved by the FDA for chronic weight management while Ozempic was approved for those with Type 2 diabetes with weight loss as a side effect. Mounjaro, which is the brand name for tirzepatide, was also approved for patients with Type 2 diabetes with weight loss as a side effect. However, the drug is expected to be approved by federal health officials for weight loss by the end of this year.
"I hear daily from patients: ‘I’ve tried Wegovy, I’ve tried Mounjaro, but I couldn’t stay on them’," North Carolina-based gastroenterologist and obesity medicine specialist Dr. Christopher McGowan told FOX Business. "They are looking for additional options and guidance."
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Dr. Daniel Maselli, an endobariatric physician and research associate director of True You Weight Loss in Atlanta, Georgia, told FOX Business that the concept of "lifelong commitment… is probably one of the more impactful influences as to why these aren't continued."
Maselli and McGowan are triple-board-certified in internal medicine, gastroenterology, and obesity medicine.
Maselli said he warns his patients beforehand that these drugs need to be taken for the rest of their life given that obesity is a chronic disease and that it should be coupled with a good diet and exercise.
Knowing this, many still decide they want to test out the drug. However, shortly after, a portion of Maselli's patients have had second thoughts. They come to the conclusion that they don't want to be on medications for the rest of their life and instead opt for a nonsurgical weight loss procedure, Maselli said.
Some patients also believe that they will be able to keep the weight off by continuing behaviors they learned while taking the drugs like staying more active, better nutrition and portion control.
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However, there are a few problems with this thought process. For one, most patients don't start losing weight until at least eight weeks because they have to build up to an effective dose, according to Maselli.
On top of that, weight recurrence is really common in most patients "even those who enjoyed tremendous success on these medications," once the medication is stopped, Maselli said.
"These medications are a treatment, but not a cure," he added.
In some cases, patients will also stop the drug because they are worried about not knowing the long term side effects. It was the very reason Tom Marino, a patient in North Carolina, decided to stop taking Ozempic.
Marino told FOX Business that he first learned about the drug after seeing a tweet from business magnate Elon Musk. He started on Ozempic in November 2022 after being prescribed the drug from an online pharmacy within a day. He stopped in January 2023.
"One day I was about to inject myself and stopped and basically said to myself, ‘do we really know the effects of this long-term?'" he said. "I just wanted to be more mindful of the things I can control myself without medication."
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Maselli understands this concern.
"It’s absolutely reasonable for patients to approach novel medications with caution and skepticism. It’s true: we don’t know what the effects of these medications," he said. "However, we do know that there are very real threats from excess body weight and chronic obesity-related medical conditions, such as Type 2 diabetes, fatty liver disease, heart disease."
Another North Carolina patient, Lucy Sams, stopped taking these drugs because her insurance. After only four months on Mounjaro, Sams told FOX Business that her insurance stopped covering it. Her bill shot up from a $25 co-pay to $1,000 per dose.
"I felt robbed once insurance no longer considered my medication," Sams said. "I was switched a total of three times to alternative/comparable weight loss drug aids, but I felt nervous with each switch. I was concerned about side effects due to such frequent changes."
Maselli said insurance coverage can be a substantial hurdle. Patients can run into issues if they change employers. But sometimes, even if patients are with the same employer, insurance companies can decide to no longer cover the medicine.
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"That can be so frustrating because they may have found a medication that works for them, that they tolerate and that they can afford and all of a sudden, the rug is pulled out from under them," Maselli said.
Although these medications offer "tremendous help for some patients, and the prospect of improved health," McGowan argued that we can’t assume that every patient can remain on them forever.
"We must be realistic that not everyone can, or wants, to take a long-term medication. This is where the personalized side of medicine is critically important," he said.
The good news is that "many of these barriers to long-term use are solvable" though we are just beginning to understand the magnitude of them, McGowan added.
